National Committee for Quality Assurance

The National Committee for Quality Assurance (NCQA), is a private, nonprofit organization dedicated to improving health care quality.  NCQA accredits and certifies a wide range of health care organizations. NCQA's Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care.1,2  NCQA maintains and regularly updates quality standards utilized by the health insurance industry to gauge levels of ongoing quality and improvement. These requirements are central to our Quality Improvement Program that is designed to focus on the physical, mental, and social well-being of its members. Blue Cross NC chooses NCQA's Health Plan (HP) Accreditation process because the guidelines and standards provide a quality framework that contain key improvement activities that are most important for member safety and consumer protection.   

NCQA HP Accreditation surveys include rigorous on-site and off-site evaluations of over 60 standards and selected HEDIS® measures.1,2  Year-round, Blue Cross NC works to maintain its Accreditation by adherence to NCQA's Standard and Guidelines for the Accreditation of Health Plans and will complete the reaccreditation process in March 2023. NCQA has awarded Blue Cross NC an accreditation status of 'Accredited' for service and clinical quality that meet the requirements of NCQA's rigorous standards for consumer protection and quality improvement. NCQA performs quality review on the following Blue Cross NC product lines: Commercial PPO, Commercial POS, Commercial EPO, and On-exchange PPO, On-exchange POS and On-exchange EPO.

1 HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
2 National Committee for Quality Assurance, (2020, Sept 9). Advertising and Marketing Guidelines Health Plan Accreditation. Retrieved from NCQA HPR Advertising and Marketing Guidelines.