NCQA Issues Health Care Recommendations for the Trump Administration

Associated Press

09-04-2025

Proposal outlines vision for evolving the quality measurement ecosystem to support patient-centered, cost-effective, integrated care
WASHINGTON, D.C., WASHINGTON, D.C. / ACCESS Newswire / April 9, 2025 / The National Committee for Quality Assurance (NCQA) today released recommendations for the Trump Administration and the 119th Congress to build a more transparent, integrated and interoperable health care system. The National Committee for Quality Assurance: Recommendations for the Trump Administration outlines a vision for evolving the current U.S. quality measurement ecosystem to support patient-driven, cost-effective, integrated care and highlights three key themes: alleviate chronic disease burden; create a digital health infrastructure to support health care innovation; and address the behavioral health crisis.
'For 35 years, NCQA has worked to improve health care quality through measurement, transparency, and accountability,' said NCQA President Margaret E. O'Kane. 'We believe that advancements in quality measurement, care integration and interoperability are needed to create a more efficient and accountable health care system and urge the new administration to prioritize innovative care and payment models that align incentives with improved patient outcomes.'
Optimize Value-Based Care & Alternative Payment Models to Alleviate Chronic Disease
The U.S. health care system is fragmented and difficult to navigate, making decision-making both time-consuming and expensive. This issue is pronounced for the 133 million Americans living with chronic disease. While digital health technologies have the potential to improve communication, coordination, and care management, without appropriate integration and standardization, care may become even more fragmented.
To address these issues, NCQA recommends that the administration expands the U.S. Department of Health and Human Services (HHS) commitment to ensure that all Medicare beneficiaries are in value-based arrangements by 2030. Additionally, the Center for Medicare and Medicaid Innovation's (CMMI) new leadership create models that prioritize integration through technology and dynamic care plans, the Centers for Medicare and Medicaid Services (CMS) should introduce Medicare Advantage Star Ratings metrics that promotes standardized data exchange, and HHS should prioritize more effective use of patient-generated data, including person-reported outcomes measures.
Create a Lasting Digital Health Infrastructure to Support Health Care Innovation
While the availability of electronic health data has grown, the use and exchange of such data to foster health care innovation is impeded by misaligned policy incentives and payment programs. Stronger support from the administration, through government payment programs, can drive industry implementation, accelerate data exchange and stimulate innovation.
To address these issues, NCQA recommends that HHS expedites adoption of a digital quality measures (dQM) reporting architecture, develops a comprehensive health care data quality framework that supports a digital health data exchange ecosystem, and accelerates alignment with the CMS Universal Foundation across HHS quality reporting and value-based payment programs.
Address the Behavioral Health Crisis
More than 20% of American adults live with mental illness, and recent estimates place the resulting economic strain at over $280 billion. To address this crisis, we must strengthen efforts by increasing funding for fundamental quality improvement, establish national standards, and advance technology.
To address these issues, NCQA recommends that the administration work with Congress to incentivize behavioral health provider adoption of certified EHRs, expand access to medication for opioid use disorder as first-line, evidence-based treatment, and support states in evaluating prevention, treatment and recovery efforts through development, collection and reporting of opioid use disorder quality measures. Additionally, NCQA recommends that the administration instructs HHS to fund creation of a quality measures framework for substance use disorder care, require independent accreditation for SAMHSA's Certified Community Behavioral Health Centers certification, and urges the administration to collaborate with Congress to finalize policies that ensure telehealth and virtual care become permanent fixtures of American health care.
'The U.S. health care system faces numerous challenges including high costs, access to care, and varying degrees of quality of care,' said NCQA Vice President Federal Affairs Eric Musser. 'By leveraging NCQA's expertise, evidence-based practices, and resources, the new administration could make significant strides in addressing the systemic issues within the U.S. healthcare system, ultimately leading to a more efficient use of resources, and better health outcomes for all Americans. We look forward to working with the new administration to realize our common goals.'
NCQA is eager to collaborate with the Trump administration as it drives innovation and works to create a more cohesive, less fragmented experience for all stakeholders across the American health care ecosystem. Read NCQA's complete recommendation to the Trump administration: https://www.ncqa.org/trump-recommendations.
NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA Accredits and Certifies a wide range of health care organizations. It also Recognizes clinicians and practices in key areas of performance. NCQA's Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA's website ( ncqa.org) contains information to help consumers, employers and others make informed health care choices. NCQA can also be found at X @ncqa and on LinkedIn.
# # #