NEQCA’s Quality and Clinical Teams coordinate efforts to help the network achieve the Triple Aim goals of providing better health, better care, at a lower cost. NEQCA deploys resources and programs necessary for network physicians to achieve these goals.

These programs aim to improve care for patients such as those with diabetes and high blood pressure, as well as promote preventative care such as increasing well child visits and cancer screenings.

How does it improve patient experience?

The NEQCA Medical Home is led by the patient’s personal physician who works with a care team to coordinate continuous and comprehensive care.  For example, through the care management program, high-risk patients engage with a nurse case manager to learn how to manage their health and become active participants in their treatment.   

What does it mean for a physician practice?

The Medical Home helps to improve quality and efficiency performance, improve provider and staff satisfaction, and achieve Meaningful Use attestation for electronic health records and Patient Centered Medical Home National Committee for Quality Assurance (NCQA) Recognition Level II or Level III.

The goal of the program is to promote adoption and use of electronic health records to reduce cost and improve the quality and measurement of care. 

The NEQCA Medical Home Program includes three main components: Meaningful Use; Patient Centered Medical Home (PCMH) System of Care, and Care Management.


How does it improve patient experience?

Practice Quality Coordinators (PQCs) are assigned geographically to provide data, tools, and recommend best practices from around the network. PQCs support enhanced access to physician practices by increasing their office’s ability to reach out to patients to remind them of appointments, tests, and follow up scheduling.

What does it mean for a physician practice?

This program was created in direct response from physician practices about not having sufficient resources to complete daily tasks, involved with population health management. Through a collaborative relationship with Local Care Organization (LCO) staff, office managers and practice staff, practices with PQCs have improved more quickly than their peers on performance measures—resulting in higher performance ratings.

How does it improve patient experience?

NEQCA pharmacists help  NEQCA providers  optimize their medication prescribing  by developing preferred drug lists, providing the most cost-effective drug choices—reducing costs without sacrificing quality.

What does it mean for a physician practice?

Management of pharmaceutical costs offers great opportunity for more effective use of medical costs and quality. NEQCA’s Pharmacy Program deploys pharmacists to work with physicians to support LCO clinical initiatives by providing data and tools with the goal to improve optimal prescribing.  Pharmacists provide information about medications as new drugs are developed or new information (such as changes in labeling or market withdrawals) becomes available.

One of NEQCA’s most successful models for managing medical utilization while improving quality is the Care Alliance Integrated Care Management model.  The program focuses on patients enrolled in Medicare Advantage.

Key components of this model include care for complex patients, referral management, and frequent physician and team meetings to monitor and improve quality of care.


NEQCA Network Relations Managers serve as a resource to our network Local Care Organizations (LCOs) by providing information, education and support to LCO management, physicians and office staff. Network Relations Managers support our LCOs and physicians in achieving success in the efficiency and quality initiatives required of our various payor contracts.
NEQCA has a robust performance reporting and informatics system including a patient registry, as well as a claims and clinical data warehouse.

NEQCA provides analytical services centrally and on-site at Local Care Organizations. These services include report development and data interpretation that delivers critical information to physicians to help them plan for patient visits by flagging those patients who have not met treatment goals across a various quality measures. NEQCA analysts identify areas to deliver care more efficiently and help inform strategies that will allow the network and its physicians to achieve clinical goals.

NEQCA's Healthcare Information Services (HIS) program is a strategic initiative designed to deliver high value care and provide a clinically-integrated platform that measures quality and performance.

To promote effective communications and engagement with patients, each EHR allows patients access to their health information from the internet through a secure Patient Portal. The Portal offers significant benefits for physicians and their patients. For physicians and their practices, the NEQCA Patient Portal provides the ability to securely communicate with their patients

NEQCA is committed to achieving the Quadruple Aim goals of better health of populations, better patient care, lower cost, and improved provider professional satisfaction.  Successful practice management is critical to performance and provider professional satisfaction. One way NEQCA is able to support this is by providing options to network primary care physicians to purchase professional practice management services. 

Physicians interested in focusing their time on patient care and not on administration, can select from an array of services designed to increase professional satisfaction, grow the patient base, provide the highest patient care and satisfaction, and improve practice workflow efficiency.  Services are available to meet the specific needs of practices of varying size and structure.

Contracting and Payor Relations manages contracts on behalf of NEQCA by leading the negotiations and managing the execution and implementation of managed care contracts and expanding contract opportunities for our network.