NCQA Physician Office Requirements

The National Committee for Quality Assurance, a nonprofit that sets quality standards for healthcare organizations, has developed recognition programs for physicians who improve the quality of patient care. One of those initiatives---the NCQA Physician Office Systems program---rewards doctors who use office systems to reduce medical errors. Bridges to Excellence, one of NCQAs partners in the initiative, notes that physicians who meet one, two or three levels of requirements can earn bonuses of $50 per year for every patient covered by a participating employer or health plan.

Level 1 Requirements

• Physicians who use evidence based standards of care in their office practices qualify to meet NCQA's Level 1 requirements for the Physician Office Systems initiative. Evidence-based standards include using clinical practice guidelines to treat common illnesses as well as using patient registries to identify and follow up with patients who are at risk for common chronic illnesses like diabetes. NCQA's Level 1 requirements for the Physician Office Systems initiative also require that doctors and their staff provide educational resources to their patients. These can be as simple as descriptive brochures, links to patient education websites or educational wallet cards; they can also include assigning nurse educators to patients who need training on self-care.

Level 2 Requirements

• NCQA's Level 2 requirements for its Physician Office Systems initiative focus entirely on clinical information systems that a doctor might use in his practice. Physician practices that use electronic medical records systems or e-prescribing software qualify for the bonus payment. Software programs that allow for computerized entry of physician orders---such as those that order lab tests or prescriptions---also meet the requirement for the Level 2 bonus payment, as do desktop and handheld decision support systems. Digital flags in a patient's medical record about his specific needs, or automated patient reminders also will meet Level 2 NCQA requirements. All of these clinical information systems support the doctor with information, reminders or guidance at the point of care.

Level 3 Requirements

• Interoperability between office systems is the main focus of NCQA's Level 3 requirements for the Physician Office Systems Initiative. Information systems in a doctor's office must not only cooperate and share data easily within the practice, but they must also work seamlessly with external systems, such as health insurance billing and payment systems or federal government health data collection systems. Physicians who use nationally accepted sets of medical codes qualify for the Level 3 bonus payment. NCQA also rewards physician office systems that can automatically send, receive and integrate data between patient medical records and payment systems.