NCQA AI Solutions: Supporting Responsible Innovation in Health Care

Why Responsible AI Matters

AI is transforming health care—from predicting population health trends to streamlining operations and engaging members. As adoption of AI grows, so does the need for thoughtful, responsible implementation and monitoring of solutions and implementation patterns that can move the needle in a positive direction for quality outcomes.

NCQA is engaging with health plans and AI solution providers to understand their evolving needs for implementing AI. We’re drawing on our 35 years of experience in evaluation, standards development and stakeholder collaboration to explore ways to support organizations and help them scale AI safely, transparently and effectively.

Outcomes Evaluation & Health Plan Learning Collaborative

Health plans ask for guidance on effectively integrating AI—while maintaining quality as a core principle—and prioritizing use cases that offer measurable value. In response, NCQA is exploring a cohort-based Learning Collaborative designed to foster shared learning and strategic clarity, and provide: 

• A structured environment for assessing internal AI strategy and implementations, and identifying opportunities for improvement.
• Peer insights that help reduce overall risk and accelerate innovation.
• Access to use case-specific best practices and models that reflect real-world implementation to maximize shared learning and optimize resources invested in pilots.
• A credible way to demonstrate commitment to responsible AI use, transparency and regulatory alignment. 

NCQA Evaluation for AI Solution Providers

Solution providers ask for guidance and validation as they navigate the complex and evolving AI landscape. NCQA is exploring a response that:

• Offers a structured, transparent assessment for AI implementation and ongoing monitoring, aligned with industry best practices.
• Helps build trust between health plans and system partners through shared accountability.
• Provides visibility through a directory of evaluated AI tools.

Join the Conversation

We’re listening and learning with you! If your organization is exploring AI adoption, or developing AI tools for health care, we invite you to connect with us. Fill out the form on this page, or contact your NCQA Account Executive to learn how NCQA is advancing responsible, high-impact AI adoption in health care, with a focus on quality, safety and transparency.