TEFCA’s Moment and Policy Changes on the Horizon: A Conversation with Eric Musser at NCQA

What data and quality related policy changes are on the horizon for healthcare? And is TEFCA really having a breakthrough moment? Healthcare IT Today sat down with Eric Musser, Vice President of Federal Affairs at the National Committee for Quality Assurance (NCQA) to find out.

NCQA oversees the Healthcare Effectiveness Data and Information Set (HEDIS), a widely used tool for measuring healthcare performance. By maintaining and evolving HEDIS measures, NCQA helps standardize the collection and reporting of critical data across health plans and providers, ensuring consistency and comparability nationwide. This work supports broader efforts to modernize healthcare and drives interoperability.

NCQA operates in the space between government, payers, plans, and providers. As such, they are uniquely positioned to both influence policymakers and help the healthcare industry adapt to policy changes.

Healthcare IT Today jumped at the opportunity for an exclusive sit-down interview with Musser at the 2024 NCQA Health Innovation Summit that was held in Nashville, TN. You don’t want to miss his response when we for an explaination of his statement that “TEFCA is having a breakthrough moment”.

Key Takeaways

1. Driving Data Standardization through USCDI+ NCQA is actively working with federal agencies like the Office of the Assistant Secretary for Technology Policy (ASTP/ONC) to advance US Core Data for Interoperability (USCDI) and its expanded versions like USCDI+, which include data sets for quality, public health, and maternal health. These efforts aim to establish a unified framework that improves the accuracy and efficiency of healthcare data exchange, benefitting all stakeholders, including CIOs at health systems.
2. TEFCA’s Breakout Moment. Musser highlighted that TEFCA (Trusted Exchange Framework and Common Agreement) is gaining momentum as more industry players, like Oracle and Epic, commit to becoming Qualified Health Information Networks (QHINs). This growing public-private collaboration signals progress toward achieving nationwide interoperability.
3. Stakeholders Needed to Help Shape the Future Policy. Musser encouraged CIOs and other healthcare leaders to actively participate in shaping policy by providing feedback through public comment processes, engaging with organizations like NCQA, and attending conferences.

TEFCA’s Breakout Moment

“I think TEFCA is having a breakout moment because we are seeing both public and private industry come together to support it,” stated Musser. “It is the right policy construct for America to use to make sure we get to nationwide interoperability.”

Musser pointed to the increasing number of industry players signing up to become QHINs, like Oracle who recently announced their QHIN intention joining Epic, CommonWell, Kno2, eHealth Exchange, Surescripts, KONZA, MedAllies, and Health Gorilla.

As industry involvement increases so too does momentum for interoperability.

Future Policy Changes

Musser identified several key policy developments on the horizon for healthcare including the evolution of data standards like USCDI into specialized “Plus” datasets for areas like public and maternal health.

“I think the USCDI effort will help the industry come to a consensus on necessary data,” said Musser. “Whether it’s quality measurement, prior authorization, provider directory, accuracy, etc. If we can get them standardized that should help make the experience for all stakeholders more efficient and more valuable.”

Beyond data, Musser believes broader policy changes may also impact the industry. With subsidies under the Affordable Care Act set to expire in 2025, he highlighted potential shifts in the insurance market based on the direction from the new incoming administration.

On the flipside, federal programs supporting value-based care and digital transformation continue to gain bipartisan support according to Musser. This will mean a relatively stable foundation for healthcare innovation.

Musser emphasized that policymakers are actively seeking feedback from industry stakeholders, making it a critical time for healthcare leaders to engage in shaping the future of these standards.

“You have to be active,” Musser said. “You can’t be a passive participant.”

Through its advocacy and collaborative programs, NCQA provides a platform for stakeholders to influence the policies and standards that will shape the future of healthcare. By aligning with NCQA’s mission, healthcare leaders can help drive meaningful change while ensuring that their organizations are well prepared to navigate the fluid health policy landscape.

Learn more about NCQA at

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