FAQ Directory

NCQA does not prescribe a sample size or frequency of surveying; however, the survey must represent the entire patient population and not focus on specific conditions or patient groups

This applies to the following Programs and Years:

Practices select a vulnerable population for measurement using fields that are available in their practice system. Practices may use categories such as race, age, ethnicity, language needs, education, income, type of insurance, disability or health status to identify specific populations that may experience disparities in care.

This applies to the following Programs and Years:

Yes. Practices determine the area of patient experience on which to focus quality improvement efforts. This may be improvement of the results of a specific question on a survey, a section of a survey or the entire survey.

This applies to the following Programs and Years:

No. Practices must provide an example of having shared at least one report from each of the following criterion in Competency A: QI 01, QI 02, and QI 04

This applies to the following Programs and Years:

Yes. Because the practice has only one clinician, practice-level data would be the same as clinician-level data, and therefore count for both.

This applies to the following Programs and Years:

No. Any standardized (non-proprietary) survey administered through measurement initiatives providing benchmark analysis external to the practice organization may be used to meet QI 06. Please note that the practice must administer the entire standardized survey (not just sections) so that it can be compared to available benchmarks.

This applies to the following Programs and Years:

KM 20 G requires evidence-based guidelines on appropriate use of services, which could include a prompt at the point of care to consider appropriateness of laboratory test ordering, avoidance of MRI as a first-line diagnostic test for back pain, appropriateness of antibiotics use, or appropriateness of specific referrals. 

NCQA encourages practices to look at ABIM’s Choosing Wisely website for more information on overuse/appropriateness (www.choosingwisely.org).

This applies to the following Programs and Years:

By resource stewardship, we mean ensuring responsible use of resources while providing high quality, efficient, patient-centered primary care as it relates measures affecting health care costs and care coordination.

This applies to the following Programs and Years:

No. The requirement to provide new information applies to all new medications prescribed to a patient, especially for patients identified in Concept CM as needing care management. Patients may have multiple comorbidities and medications, so it is crucial that they receive information about all medications prescribed to them

This applies to the following Programs and Years:

Yes. A comprehensive health assessment should be conducted for all patients and described in a documented process so the practice has relevant and documented information about patients' physical health and social and behavioral influences. That information is then utilized to provide appropriate services, interventions and resources to the patient population.

This applies to the following Programs and Years:

No. For KM 16, the practice must both (1) generate a report that demonstrates more than 50 percent of patients have documentation in their medical record that they were assessed and provided education on new prescriptions and (2) demonstrate evidence of the process, which could include showing a patient medical record during virtual review. It is up to the practice to determine the best method for sharing new medication information with patients, and the practice should consider patient language, literacy and health literacy in providing information or materials.

This applies to the following Programs and Years:

No. KM 12 A focuses on preventive care services. HbA1c measurement is appropriate for patients with diabetes and meets criteria for KM 12 C (chronic care services).

This applies to the following Programs and Years: