Quality Plus

QualityPlus generalRGBlowres.jpgQuality Plus was NCQA’s multi-year program to transition to a new generation of measurement and accreditation programs designed for the full range of health plans. It included the development of new, voluntary standards, come of which were eventually incorporated into a revised Accreditation program

The release of Health Plan Accreditation in 2008, which incorporates HEDIS performance measures for PPOs, completed the transition. Health Plan Accreditation also now includes Member Connections and Care Management and Health Improvement areas. However, because plans are accredited every three years, plans whose Accreditation survey did not include Member Connections and Care Management and Health Improvement can still opt to achieve Distinction in the Quality Plus.

Member Connections

Member Connections standards are designed to measure how well health plans connect their members with important information such as their health status, the resources provided by their health plan, their care options, and the costs of different services and prescription drugs. Member Connections standards have been included in the MCO Accreditation and PPO Accreditation standards since 2007 and Health Plan Accreditation since 2008. Some plans voluntarily achieved distinction in this area prior to its inclusion in accreditation.


Care Management and Health Improvement

Care Management and Health Improvement standards measure the promotion of wellness and prevention as well as the identification and management of members with chronic illnesses or complex conditions. Care Management and Health Improvement standards have been included in MCO Accreditation since 2007 and Health Plan Accreditation since 2008. Some plans voluntarily achieved distinction in this area prior to its inclusion in accreditation.


Physician and Hospital Quality

Physician and Hospital Quality was the third voluntary content area for Distinction in Quality Plus. The Distinction standards were released in 2006 (referred to as “PHQ 2006”). In 2008, NCQA introduced Physician and Hospital Quality Certification, which replaced the Distinction program. The revised standards represent a more comprehensive review of organizations’ programs to measure and report quality and cost of physicians and hospitals. The standards also reflect changes in physician measurement since 2006. As a result, the updated program is Certification instead of Distinction. Effective March 2008, NCQA is no longer taking applications on the Quality Plus version of PHQ.

For more information on the current PHQ Certification program, click here. The information below refers to the Quality Plus Distinction Physician and Hospital Quality program that has been retired. NCQA is providing this information as it is still applicable to organizations that hold the two-year Distinction status. The last of these will expire in 2010.

Physician and Hospital Quality 2006

Physician and Hospital Quality 2006 standards evaluate how well health plans measure the quality and cost of care provided by network physicians and hospitals. Physician and Hospital Quality is a voluntary distinction program. Distinction in Physician and Hospital Quality displayed on the Health Plan Report Card refers to plans’ performance on the 2006 version of the Physician and Hospital Quality standards only. NCQA no longer accepts applications from health plans for PHQ Distinction. For more information the updated PHQ Certification which is open for applications, click here.


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