Building a strong foundation for the future of health care

When individuals aren’t feeling well, their primary focus is to get better as quickly as possible, with limited down time—but factors like cost of care, access to facilities, provider availability, scheduling conflicts and other barriers can affect how patients approach their health care needs. Traditional venues of care —the hospital and office settings—are shifting to a virtual setting (telehealth). This evolution in how care is delivered effects processes, reporting and quality of care.

In response to this trend, NCQA is considering virtual care as an area for quality improvement. We know that although accessible care is important, it must also be of high quality and equitable across the care continuum.

How We Help

Virtual care often has few or no associated quality metrics. NCQA’s potential virtual care product—currently, “Virtual Care”—focuses on primary and urgent care delivered through virtual modalities. We want the product to serve as a roadmap for safe, effective and equitable care delivered virtually, recognizing the elements that are crucial to quality in this area.

We are looking for pilot participants to inform, test and provide feedback on our initial virtual care product offering.

The pilot program will evaluate our new product’s usefulness and feasibility; validate the product’s standards and amend them where necessary; test the product’s modular design; and gather participant experiences. At the conclusion of the program, participants that have successfully satisfied program requirements may have the opportunity to gain NCQA Accreditation.*

Benefits of Participation

Participants will receive the following benefits for completing participation:

  • The opportunity to inform product development at NCQA to maximize long-term value for participants’ program, health plan/system and/or clients/patients.
  • Be recognized as an pilot on NCQA website(s).
  • Recognition included in NCQA press and marketing materials.
  • A marketing package to promote their participation in the Pilot Program, independently and with joint media releases, with NCQA-approved statements.
  • Technical support over the course of the program.

*Participants must comply with the program’s policies and procedures and will be assessed against draft standards through a review process. NCQA retains the ability to offer Provisional Recognition status, with the opportunity for the organization to seek full Recognition.

Continue to application.

Be among the first!

NCQA invites interested eligible parties to submit an application for participation in the pilot program, to inform, test and provide feedback on NCQA’s virtual and at-home primary and episodic care product offering. A select group of vendors, health plans and health systems providing care outside the office setting will help guide development of standards and guidelines for assessing/improving quality of care provided outside the office setting.

All interested organizations must submit an application to participate, as described in the attached request for participation. Applications must be completed by 5pm (ET), Friday, August 4. Application instructions are outlined below. Applications received after the stated time and date may be evaluated. Organizations will be notified of acceptance by the end of August.

If you have questions or would like more information about the virtual care pilot program, contact us at My NCQA or email our team at caredeliveryproduct@ncqa.org

Application Eligibility

Applicant organizations that meet the following minimum established criteria may be considered for participation in the Pilot Program.

Participants must:

  • Deliver primary care and/or episodic /urgent care services utilizing virtual modalities.
  • Have team members with expertise in a.) quality measurement and b.) technical expertise with data required for quality measurement in health care.
  • Commit to making their expert resources available to NCQA for the duration of the Pilot (estimated August 2023–March 2024). Resources will participate in working meetings to validate the Standards and measures, test product features, and prove implementation feasibility. Time commitment will likely vary between organizations and will increase as the program progresses from validation to testing. All meetings will take place during normal business hours (Eastern Time).
  • Application submission does not guarantee enrollment in the pilot program.