NCQA Releases Virtual Care White Papers for Payers and Care Delivery Organizations
July 2, 2025 · Becky Kolinski
The demand for virtual care is growing: Post-pandemic, 10% of outpatient visits are conducted virtually—pre-pandemic, only 1% were. Patients are drawn to the convenience of accessing care virtually, and health care organizations recognize its potential to expand access.
“Virtual care is a rapidly evolving care delivery model that lacks standardization,” says NCQA’s Claire Mendelson, Product Manager. “NCQA has been working to define high-quality virtual care through a consensus-driven process informed by extensive stakeholder input, real-world experience and validation.”
NCQA completed a pilot program to test its Virtual Care Accreditation standards with 18 participating organizations across 12 states and Puerto Rico. Convening experts in virtual care—including providers that are ahead of the curve, and those whose virtual offerings are less mature—helped NCQA understand the current market landscape.
We’re sharing what we’ve learned in two new white papers:
- For payers: High-Quality Virtual Care for Health Plans: Enhancing Your Members’ Experience.
- For care delivery organizations: How Standardization Can Elevate the Quality of Virtual Care Services.
The white papers outline the current state of virtual care, and how payers and care delivery organizations can design and implement high-quality virtual care programs.
How Payers Can Forge Strong Partnerships with Virtual Care Providers
The majority of payers—97% of large payers, 89% of smaller payers—cover telehealth services. Contractual arrangements are often dictated by a line of business or specific market. Payers should take a more holistic approach to building out and optimizing their virtual care networks by choosing partners that share their vision for innovation, member-centric care, operational models and measurable health outcomes.
“When you think you have this figured out, know there’s always a better way,” says Misty Milby, VP, Clinical Business Development at Everly Health, and NCQA Virtual Care Accreditation pilot participant. “There were aspects of virtual care we would look at and say ‘we’re doing a great job and everything is operating smoothly.’ Then when industry-wide participants came together in the pilot program, we heard different ideas that could work better.”
Download the white paper for payers: High-Quality Virtual Care for Health Plans: Enhancing Your Members’ Experience.
How Care Delivery Organizations Can Become Preferred Partners for Payers
Care delivery organizations are investing in virtual care to improve the patient experience and address labor shortages. 88% of care delivery organizations have already invested in virtual care or plan to do so within the next 12 months. Organizations that can share data on outcomes, patient engagement and operational efficiencies have a distinct competitive advantage when contracting with payers.
“Virtual care is a quality journey—and like any other quality journey, delivering good care requires having proper infrastructure to ensure all measures and other health metrics are consistently met,” says Richard Gitomer, MD, Associate Medical Director for Virtual Primary Care at MD Live by Evernorth, and NCQA Virtual Care Accreditation pilot participant.
Download the white paper for care delivery organizations: How Standardization Can Elevate the Quality of Virtual Care Services.
Learn More
Join our webinar on July 30, Achieving Excellence in Virtual Care: Standardizing High-Quality Care with Real-World Insights, hosted by the American Telemedicine Association. We’ll be speaking with Firefly Health about how to navigate common pitfalls in virtual care delivery.
NCQA hosted a panel discussion with Misty Milby and other virtual care experts to share insights and lessons learned from the Virtual Care Accreditation pilot program. Watch the webinar recording here.
Visit our website to learn more about NCQA’s Virtual Care Accreditation Program.
