NCQA Diabetes Recognition Program (DRP)

What Is the NCQA Diabetes Recognition Program?

The NCQA Diabetes Recognition Program (DRP) is a credential that recognizes clinicians who use evidence-based measures to provide high-quality care to patients with diabetes. Co-developed by NCQA and the American Diabetes Association (ADA), the DRP evaluates clinician performance against a defined set of diabetes care measures — assessing whether clinicians are consistently applying evidence-based practices to their diabetic patient populations. Recognition signals to patients and payers that a clinician or practice has demonstrated measurable diabetes care quality, not merely claimed it.

Who Should Pursue NCQA DRP Recognition?

The refreshed DRP expands eligibility to any clinical setting that cares for patients with diabetes — not just endocrinologists and primary care internists. Target organizations include:

• Primary care physicians managing diabetic patient panels — family medicine, internal medicine, geriatrics
• Endocrinologists and diabetes specialists seeking to demonstrate performance against standardized measures
• Medical groups and group practices pursuing recognition across multiple clinicians in their practice
• FQHCs and safety-net practices with high-prevalence diabetic populations
• Accountable care organizations and value-based care participants where diabetes care quality affects shared savings and quality bonuses
• Specialty clinics with significant diabetes co-management responsibilities

DRP Recognition Requirements

Patient Sample

Each clinician seeking recognition must submit data on a random sample of at least 25 patients with diabetes. The sample requirement ensures that recognition reflects the clinician's performance across their diabetic patient population — not cherry-picked cases. The minimum sample size of 25 makes the program accessible to clinicians with smaller diabetic patient panels while still providing a meaningful statistical basis for performance assessment.

Digital Submission

The refreshed DRP requires digital data submission — CSV file or FHIR format. This modernizes the submission process and supports integration with EHR-generated data exports. Practices need EHR systems capable of generating the required data in the specified formats and staff capable of preparing and submitting compliant data files.

Demographic Data

Demographic data is collected via questionnaire accompanying the patient data submission. This supports NCQA's equity reporting objectives and enables analysis of whether recognition-level diabetes care quality is being delivered equitably across demographic groups.

Annual Recognition

DRP recognition is annual — clinicians submit data and are evaluated each year. This is a significant change from prior DRP cycles and reflects NCQA's broader move toward annual measurement as the standard for recognition programs. Annual recognition ensures that recognition reflects current performance, not a one-time data snapshot.

Current Diabetes Care Measures

The DRP measure set addresses the core clinical processes of diabetes management. Current measures focus on glycemic control, blood pressure management, lipid management, nephropathy assessment, retinal examination, foot examination, and smoking cessation counseling. For 2026, NCQA is adding three new measures to the DRP:

• Continuous Glucose Monitoring Utilization — effective January 2026, reflecting the growing adoption of CGM as a diabetes management tool
• Depression Screening and Follow-Up — effective January 2026, addressing the high comorbidity between diabetes and depression
• Statin Therapy Prescription — effective January 2026, addressing cardiovascular risk management in diabetic patients

Practices planning for 2026 recognition cycles should ensure their EHRs can capture and report on these new measures before the effective date.

Recognition Fee

NCQA publishes DRP recognition fees on its website — verify current per-clinician pricing directly with NCQA before budgeting. Medical groups pursuing recognition for multiple clinicians should factor per-clinician fees into the total program cost.

DRP and Value-Based Care

Diabetes is one of the highest-cost conditions in the US healthcare system — and diabetes care quality measures are embedded in virtually every major value-based care program. HEDIS diabetes measures are used by health plans, CMS, and state Medicaid programs to evaluate provider performance. DRP recognition demonstrates that clinicians consistently apply evidence-based practices to their diabetic patients — a direct signal of readiness for value-based arrangements where diabetes measure performance drives financial outcomes.

For practices in ACO shared savings programs, Medicare Advantage quality contracts, or commercial value-based arrangements, DRP recognition supplements quality measure performance data with a third-party clinical quality credential that supports contracting conversations with payers and health systems.

DRP and Patient Engagement

NCQA's DRP recognition is patient-facing — NCQA publishes recognized clinicians, and payers and health systems reference DRP status in provider directories and quality reporting. Diabetic patients and their families who are active healthcare consumers increasingly research clinician quality credentials before selecting providers. DRP recognition provides a verifiable, third-party quality signal that differentiates recognized clinicians from peers in online directories and health plan provider search tools.

IHS Consulting Approach

Thomas G. Goddard, JD, PhD, former Chief Operating Officer and General Counsel of URAC, leads IHS's recognition consulting practice. IHS DRP consulting services include:

• Eligibility and Readiness Assessment — evaluating current diabetic patient panel size, EHR data capture capabilities, and measure performance baseline
• Data Submission Preparation — guiding practices through CSV or FHIR data export preparation, data validation, and demographic questionnaire completion
• Measure Performance Analysis — identifying performance gaps against DRP measures and supporting clinical workflow improvements that close gaps before submission
• 2026 Measure Transition Planning — preparing practices for CGM utilization, depression screening, and statin therapy prescription measure requirements
• Multi-Clinician Program Management — coordinating DRP submissions across multiple clinicians in a group practice
• Annual Recognition Maintenance — supporting year-over-year recognition through ongoing performance monitoring and annual data submission preparation