National Committee for Quality Assurance
NCQA is a not-for-profit healthcare quality measurement organization that develops HEDIS measures and operates accreditation, recognition, and certification programs for U.S. health plans, providers, and health IT vendors, with over 11,000 accredited entities covering 173 million Americans.
- Company typePrivate
- Founded1990
- HeadquartersWashington, United States
- Headcount501–1,000
- GTM typeB2B
- OfferingServices
What National Committee for Quality Assurance does
The National Committee for Quality Assurance (NCQA) is a private, not-for-profit organization founded in 1990 and headquartered in Washington, D.C., that develops and administers healthcare quality measurement frameworks, accreditation programs, and certification services for U.S. health plans, providers, and health IT organizations. Its core technology stack centers on the HEDIS (Healthcare Effectiveness Data and Information Set) measurement framework of 92 standardized measures across six care categories, the CAHPS patient experience survey, Digital HEDIS certification, the Q-PASS practice management portal, the Interactive Review Tool (IRT) for data submission, and the publicly accessible NCQA Report Cards platform. The organization also operates the Quality Compass benchmarking data product and the Bulk FHIR API Quality Coalition initiative supporting the digital quality measurement transition.
NCQA generates revenue through four primary streams: recurring accreditation, recognition, and certification fees paid by health plans and provider practices for programs including Health Plan Accreditation, PCMH Recognition, Population Health Program Accreditation, Utilization Management Accreditation, and Credentials Verification; HEDIS data licensing and Quality Compass benchmarking subscriptions sold to health plans, vendors, and researchers; professional education offerings including virtual seminars, HEDIS 101 training, and the PCMH Certified Content Expert credential; and HIT/data certification programs for measure calculation, HEDIS compliance audits, CAHPS survey administration, and Data Aggregator Validation. Pricing is not publicly disclosed and varies by program and organization size under separate license agreements, with billing on annual subscription cadences.
NCQA serves a diversified customer base of more than 11,000 accredited, recognized, or certified entities spanning health plans, primary care and specialty practices, behavioral health clinics, virtual care providers, health IT vendors, federal and state government agencies, and large employers. HEDIS is used by over 1,000 health plans covering 57% of the U.S. population, with 236 million people enrolled in plans reporting HEDIS results and 173 million Americans enrolled in NCQA-accredited health plans. NCQA employs 400+ full-time remote staff and operates independently with no parent company or equity investors, supplementing program fees with grants from foundations including the John A. Hartford Foundation and Helmsley Charitable Trust.
National Committee for Quality Assurance firmographics
Firmographics- Name
- National Committee for Quality Assurance
- Legal name
- National Committee for Quality Assurance
- Website
- https://ncqa.org
- Company type
- Private
- Founded year
- 1990
- Operating status
- Operating
- Headcount range
- 501–1,000 employees
- Short description
- NCQA is a not-for-profit healthcare quality measurement organization that develops HEDIS measures and operates accreditation, recognition, and certification programs for U.S. health plans, providers, and health IT vendors, with over 11,000 accredited entities covering 173 million Americans.
- Ownership category
- akta.pro rank
National Committee for Quality Assurance industry classification
Industry- Product category
- Healthcare Quality Measurement and Accreditation
- NAICS
- Health Care and Social Assistance (62)
- SIC
- Services-Health Services (8000)
- akta.pro primary industry
- Quality Measurement, Reporting & Benchmarking (HEDIS/Stars/CQM) (HLACAHAC)
- akta.pro secondary industries
- D-SNP Quality, Stars, HEDIS & Compliance (HLAEAFAJ), Non-Communicable Disease Prevention & Chronic Disease Programs (BPAIAJAI)
Keywords
Where National Committee for Quality Assurance is headquartered
LocationHeadquarters
- HQ city
- Washington
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
National Committee for Quality Assurance business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales, Others
Revenue model
- Accreditation and Certification Fees: NCQA charges fees for accreditation, certification, and recognition programs including Health Plan Accreditation, PCMH Recognition, PCSP Recognition, Population Health Program Accreditation, Utilization Management Accreditation, Case Management Accreditation, Credentialing Accreditation, CVO Certification, Wellness and Health Promotion Accreditation, and others. These programs are described as subject to fees under separate license agreements.
- HEDIS Data Licensing and Quality Compass: NCQA licenses HEDIS measures and related data to health plans, vendors, and other organizations. Quality Compass provides access to quality data and benchmarking information for a fee.
- Education and Training: NCQA offers virtual seminars, webinars, on-demand training, team training, and the HEDIS 101 training program for a fee.
- HIT and Data Certification Programs: Fees for measure certification, HEDIS compliance audit certification, CAHPS survey certification, and prevalidation programs for health IT solutions.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Annual | Accreditation and Recognition Programs - fees vary by program type and organization size |
Go-to-market motion1 record
Distribution channels6 records
Marketing channels8 records
National Committee for Quality Assurance product offering
Product offeringCore offering
NCQA develops and administers healthcare quality measurement standards, accreditation programs, and certifications sold primarily to U.S. health plans, providers, and health IT vendors. Its flagship offerings include the HEDIS performance measure set (92 measures used by 1,000+ health plans covering 57% of the U.S. population), Health Plan Accreditation, Patient-Centered Medical Home (PCMH) Recognition, CAHPS survey certification, and a portfolio of specialized accreditations (Behavioral Health, Population Health, Utilization Management, Case Management, Credentialing, Wellness, LTSS, Virtual Care, Health Equity, Community-Focused Care).
Product overview
NCQA offers a comprehensive portfolio of healthcare quality measurement, accreditation, and certification programs. Core offerings include HEDIS measures (92 standardized quality measures used by over 1,000 health plans), Health Plan Accreditation, and the Patient-Centered Medical Home (PCMH) Recognition program. The organization provides accreditation programs for health plans (including Behavioral Health, Population Health, Wellness, Utilization Management, Case Management, and LTSS), recognition programs for providers (PCMH, PCSP, Diabetes Recognition), and certification for vendors (HEDIS Compliance Audit, Measure Certification, CAHPS Survey, Data Aggregator Validation, and HIT Prevalidation). Digital quality solutions include Digital HEDIS, Digital Quality Hub, and Bulk FHIR API Quality Coalition. The portfolio also includes data products (Quality Compass), education and training (Health Innovation Summit, HEDIS 101, CCE certification), and pilot programs (Advanced Primary Care, Learning Collaboratives, AI Learning Collaboratives).
Differentiator
Problem solved
Functional benefit
Products and services
- HEDIS Measures (Healthcare Effectiveness Data and Information Set) Set of 92 standardized performance measures used by more than 1,000 health plans covering 57% of the U.S. population. Measures span six categories of care including preventive services and chronic disease management. Sold as licensed measures to health plans and vendors.
- Health Plan Accreditation Accreditation program for health insurance organizations evaluating quality of care, customer service, and compliance with NCQA standards. Covers Medicaid, Medicare Advantage, and commercial health plans. Provides CMS-recognized deemed status.
- Patient-Centered Medical Home (PCMH) Recognition NCQA's flagship recognition program for primary care practices demonstrating commitment to patient-centered, coordinated, team-based care delivery. Practices undergo evaluation against comprehensive care delivery standards.
- Patient-Centered Specialty Practice (PCSP) Recognition Recognition program for specialist practices committed to patient access, communication, and care coordination with primary care providers.
- Population Health Program Accreditation Accreditation for organizations managing population health programs, evaluating clinical quality, patient-centered care focus, and use of advanced data analytics to improve health outcomes.
- Wellness and Health Promotion Accreditation Accreditation for wellness and health promotion programs demonstrating compliance with high standards for evidence-based care, health coaching, and safeguarding health information.
- Utilization Management Accreditation Accreditation validating that utilization management services operate with transparency, clinical rigor, and accountability according to nationally recognized best practices.
- Case Management Accreditation Accreditation for organizations providing case management services, evaluating care coordination, patient advocacy, and outcomes-focused service delivery.
- Credentialing Accreditation Accreditation strengthening patient safety through rigorous evaluation of credentialing and recredentialing processes for healthcare providers.
- Long-Term Services and Supports (LTSS) Accreditation Accreditation for health plans and organizations managing long-term services and supports, evaluating case management, care coordination, and quality of life outcomes for beneficiaries.
- Behavioral Health Accreditation Accreditation for Managed Behavioral Health Organizations (MBHOs) and health plans covering behavioral health services, evaluating access, clinical quality, and member protections.
- Virtual Care Accreditation Accreditation for virtual primary care and urgent care providers, evaluating quality, safety, and effectiveness of telehealth service delivery.
- Certified Community Behavioral Health Clinic (CCBHC) Accreditation Accreditation for Certified Community Behavioral Health Clinics evaluating comprehensive behavioral health service delivery, crisis response, and community integration.
- Health Equity Accreditation Programs Programs addressing health equity including Distinction in Multicultural Health Care and health equity accreditation for health plans, health systems, and organizations focused on reducing disparities.
- Digital Health Engagement Accreditation Accreditation program for evaluating digital health engagement platforms and tools. Assesses digital engagement strategies, user experience, and health outcome integration for digital health vendors, health plans, and technology companies.
- Community-Focused Care Accreditation Accreditation for health plans and organizations demonstrating commitment to community health and addressing social determinants of health.
- Diabetes Recognition Program (DRP) Recognition program for clinicians and practices demonstrating high-quality diabetes care based on evidence-based clinical outcomes measures.
- Digital HEDIS Digital quality measurement program enabling electronic capture and reporting of HEDIS measures. Includes Digital HEDIS Measure Explorer, NCQA Digital HEDIS Directory, and certification for vendors and health plans using electronic clinical data systems.
- Health Plan Ratings Annual ratings program combining HEDIS and CAHPS results to score and rank health plans. Helps consumers compare plan performance by state using standardized quality metrics.
- Quality Compass Data licensing product providing access to comprehensive health plan performance data. Enables employers, consultants, and researchers to benchmark plan performance using NCQA-collected quality data.
- HEDIS Compliance Audit Certification Certification program for organizations licensed to conduct HEDIS compliance audits. Establishes auditor competency and ensures standardized audit methodology.
- HEDIS Measure Certification Certification program validating vendor software for accurate HEDIS measure calculation and reporting.
- CAHPS 5.1H Survey Certification Certification program for vendors administering the Consumer Assessment of Healthcare Providers and Systems survey, ensuring standardized methodology and data quality.
- Data Aggregator Validation Program validating third-party data aggregators that supply clinical data for HEDIS reporting, ensuring data quality and integrity.
- HIT and Data Prevalidation Programs Prevalidation programs evaluating HIT solutions including Population Health Management platforms, PCMH, and PCSP vendor products for compatibility with NCQA programs.
- Credentials Verification Organization (CVO) Certification Certification for organizations providing primary source verification of practitioner credentials for health plans and providers.
- Q-PASS Platform Online portal supporting NCQA recognition and accreditation programs including PCMH, PCSP, and related submissions, tracking, and reporting.
- PCMH Certified Content Expert (CCE) Certification Professional certification for individuals demonstrating expertise in NCQA's Patient-Centered Medical Home recognition program standards and implementation.
- NCQA Education and Training Programs Fee-based educational offerings including virtual seminars, webinars, on-demand training, team training, and HEDIS 101 training programs for healthcare quality professionals.
- Wellness and Condition Management Program New wellness and condition management program launched February 2026 focused on measuring patient engagement for health plans, vendors, clinicians, and policymakers, grounded in real-world patient experiences.
- Advanced Primary Care Pilot Program Pilot program testing new outcomes-focused primary care standards with selected healthcare organizations. Evaluates draft standards for population health, behavioral health integration, care coordination, and data-driven decision-making.
Quantifiable outcome
- 236 million people enrolled in health plans that report HEDIS results to NCQA
- +5 more outcomes
Companies that use National Committee for Quality Assurance
Customer profileNamed customers10 records
Segments6 records
Ideal customer profiles5 records
National Committee for Quality Assurance technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Feature8 records
National Committee for Quality Assurance partnerships and signals
Strategic signalPartnerships
Eight partnerships are on record, tiered core and minor.
- Institute for Healthcare ImprovementcoreGrant recipient alongside NCQA and UCSF for the Age-Friendly Health Systems movement, working to expand age-friendly care across health systems and Medicare Advantage plans toward reaching 14 million older adults annually by 2030.
- University of California, San FranciscocoreGrant recipient alongside NCQA and Institute for Healthcare Improvement for the Age-Friendly Health Systems movement, working to expand age-friendly care across health systems and Medicare Advantage plans toward reaching 14 million older adults annually by 2030.
- 13 Organizations - Learning Collaborative ParticipantscoreNCQA convened 13 organizations from across the health ecosystem including health plans, vendors, clinicians, and policymakers for its inaugural Measuring Patient Engagement Learning Collaborative to advise and test measures of patient engagement for NCQA's new Wellness and Condition Management Program.
- Health Resources and Services Administration (HRSA)coreNCQA was awarded a new task order by HRSA to enhance access to patient-centered and behavioral health care, supporting Federally Qualified Health Centers (FQHCs) in achieving and maintaining recognition for patient-centered medical homes and behavioral health integration.
- Council of Medical Specialty Societies (CMSS)minorCDC selected CMSS to participate in a five-year federal initiative to improve coordination between the U.S. public health system and healthcare system. Under this initiative, CMSS partnered with NCQA and the American Gastroenterological Association to develop HEDIS quality measures for follow-up of abnormal colorectal cancer screening results.
- American Gastroenterological AssociationminorPartnered with CMSS and NCQA under a CDC supplemental award to develop HEDIS quality measures for follow-up of abnormal colorectal cancer screening results as part of a five-year CDC initiative to improve public health-healthcare system coordination.
- West HealthcoreNCQA and West Health partnered to advance integration of behavioral health into primary care and convened national leaders to advance behavioral health across the healthcare system (announced April 2026).
- Medicare Advantage PlanscoreMedicare Advantage plans are beneficiaries of the Age-Friendly Health Systems movement grant funding, receiving expanded age-friendly care protocols and quality standards through NCQA's participation in the initiative.
Scale indicators8 records
Recent moves6 records
Expansion highlights7 records
National Committee for Quality Assurance competitors and assessment
Company assessmentDirect peers
- URAC: URAC is a direct competitor offering health care accreditation programs for health plans, utilization management, case management, and credentialing — directly overlapping with NCQA's portfolio. Customers like American Specialty Health hold dual URAC and NCQA accreditations.
- CARF International: CARF accredits behavioral health, aging services, and other health and human services providers, directly competing with NCQA's Behavioral Health Accreditation and Long-Term Services and Supports programs.
- National Quality Forum (NQF): NQF is the consensus-based measure endorsement body whose measure review and endorsement work shapes the quality landscape in which NCQA's HEDIS operates. NQF endorsement is a key upstream input that NCQA measures rely on for federal adoption.
- National Committee for Quality Assurance (Accreditation Association for Ambulatory Health Care - AAAHC): AAAHC accredits ambulatory health care organizations and primary care practices, directly overlapping with NCQA's PCMH recognition and ambulatory care quality programs.
Broad incumbents
- The Joint Commission: The Joint Commission is the dominant hospital and health system accreditation body in the U.S. While focused on facility accreditation rather than health plan accreditation, it overlaps with NCQA in quality measurement and is a broad incumbent in healthcare accreditation.
Emerging players
- PQA (Pharmacy Quality Alliance): PQA develops quality measures specifically for medication use and pharmacy services. It competes with NCQA for measure development influence in pharmacy-related quality metrics and CMS star ratings.
- Health Catalyst: Health Catalyst provides healthcare data and analytics platforms that enable quality measurement and improvement, intersecting with NCQA's Quality Compass and Digital HEDIS data licensing products in serving health plan analytics needs.
- Cotiviti: Cotiviti operates in healthcare payment accuracy and quality analytics, working closely with HEDIS measures and CMS quality programs. It is an emerging player that depends on and complements NCQA's measurement framework while also providing competing analytics.
- Inovalon: Inovalon provides cloud-based healthcare data analytics and quality measurement platforms serving health plans and providers, overlapping with NCQA's Quality Compass and HEDIS-related data services in serving payer quality reporting needs.
Others
- Agency for Healthcare Research and Quality (AHRQ): AHRQ is the federal agency that owns and develops the CAHPS survey methodology that NCQA administers. AHRQ is an enabling partner and ecosystem participant whose CAHPS IP is core to NCQA's survey certification business.
Market position
Strengths4 records
Weaknesses4 records
Competitive moat5 records
Key risks5 records
Key highlights7 records
Customer concentration
National Committee for Quality Assurance social profiles
Digital presenceNational Committee for Quality Assurance financial estimates
Financial estimateRevenue estimate
Valuation estimate
National Committee for Quality Assurance leadership team
Management profileNumber of profiles
Profiles7 records
National Committee for Quality Assurance funding detail
Funding detailFunding overview
Funding rounds2 records
Investors2 records
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
National Committee for Quality Assurance M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about National Committee for Quality Assurance
What does National Committee for Quality Assurance do?
NCQA develops and administers healthcare quality measurement standards, accreditation programs, and certifications sold primarily to U.S. health plans, providers, and health IT vendors. Its flagship offerings include the HEDIS performance measure set (92 measures used by 1,000+ health plans covering 57% of the U.S. population), Health Plan Accreditation, Patient-Centered Medical Home (PCMH) Recognition, CAHPS survey certification, and a portfolio of specialized accreditations (Behavioral Health, Population Health, Utilization Management, Case Management, Credentialing, Wellness, LTSS, Virtual Care, Health Equity, Community-Focused Care).
Is National Committee for Quality Assurance a public or private company?
National Committee for Quality Assurance is a private company. It is classified as nonprofit foundation owned and is currently operating.
When was National Committee for Quality Assurance founded?
National Committee for Quality Assurance was founded in 1990. It employs 501 to 1,000 people.
Where is National Committee for Quality Assurance based?
National Committee for Quality Assurance is headquartered in Washington, United States, in the North America region.
How does National Committee for Quality Assurance make money?
Four revenue lines are on record. Accreditation and Certification Fees are the primary driver. The others are HEDIS Data Licensing and Quality Compass, education and Training and HIT and Data Certification Programs.
Who are National Committee for Quality Assurance's main competitors?
Direct peers on record are URAC, CARF International, National Quality Forum (NQF) and National Committee for Quality Assurance (Accreditation Association for Ambulatory Health Care - AAAHC). The Joint Commission is listed as a broad incumbent. Emerging players are PQA (Pharmacy Quality Alliance), Health Catalyst, Cotiviti and Inovalon. Agency for Healthcare Research and Quality (AHRQ) is listed as an others.
Does National Committee for Quality Assurance have an API?
No public API is recorded for National Committee for Quality Assurance.
What industry is National Committee for Quality Assurance in?
National Committee for Quality Assurance's product category is Healthcare Quality Measurement and Accreditation. Its primary akta.pro industry code is HLACAHAC, Quality Measurement, Reporting & Benchmarking (HEDIS/Stars/CQM), with a secondary code of HLAEAFAJ, D-SNP Quality, Stars, HEDIS & Compliance. Its NAICS code is 62 and its SIC code is 8000.