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NCQA HEDIS and CAHPS Measures for Health Plan Accreditation for Scoring in 2018 

Public Comment Period: November 14 through December 16, 2016   

NCQA seeks public comment on the proposed product updates listed below. Reviewers are asked to submit their comments in writing via NCQA’s public comment website by 5:00 p.m. (EST) on Friday, December 16, 2016. 

2018 Health Plan Accreditation Update 

NCQA is releasing proposed changes to the Healthcare Effectiveness Data and Information Set (HEDIS®) and Consumer Assessment of Healthcare Providers and Systems (CAHPS®) measures scored for Health Plan Accreditation for the 2018 reporting year.   

The final list of measures for scoring in 2018 will be will be released on NCQA’s Web site in April 2017.   

This public comment is specifically intended for input on adding and retiring HEDIS/CAHPS measures for Health Plan Accreditation. A second public comment for updates to Health Plan Accreditation standards will take place in March 2017. 

While submitting comments, NCQA encourages you to provide thoughts and insight on the updates proposed for Health Plan Accreditation. Questions have been provided below to guide comments and can be found on the public comment website under “Topics” for ‘HEDIS Measures for Addition to Health Plan Accreditation for scoring in 2018’ or ‘HEDIS Measures for Removal from Health Plan Accreditation for Scoring in 2018’.   

HEDIS/CAHPS Measures Proposed for Scoring in 2018 Questions:

HEDIS/CAHPS Measures for Addition to Health Plan Accreditation for Scoring in 2018 

  1. Should NCQA include the following measures for the commercial product line? 
    1. Should NCQA include the following measures for the Medicare product line? 
    2. Statin Therapy for Patients With Cardiovascular Disease (SPC) – both rates. 
    3. Statin Therapy for Patients With Diabetes (SPD) – both rates. 
    4. Initiation and Engagement of Alcohol & Other Drug Dependence Treatment (IET) – Initiation of AOD Treatment rate. 
  2. Risk Adjusted Emergency Department Utilization (EDU). 
    1. Statin Therapy for Patients With Cardiovascular Disease (SPC) – both rates. 
    2. Statin Therapy for Patients With Diabetes (SPD) – both rates. 
    3. Initiation and Engagement of Alcohol & Other Drug Dependence Treatment (IET) – Initiation of AOD Treatment rate. 
    4. Risk Adjusted Emergency Department Utilization (EDU). 
    5. Non-Recommended PSA-Based Screening in Older Men (PSA). 
  3. Should NCQA include the following measures for the Medicaid product line? 
    1. Statin Therapy for Patients With Cardiovascular Disease (SPC) – both rates. 
    2. Statin Therapy for Patients With Diabetes (SPD) – both rates. 
    3. Initiation and Engagement of Alcohol & Other Drug Dependence Treatment (IET) – Initiation of AOD Treatment rate. 
    4.  Adherence to Antipsychotic Medications for Individuals With Schizophrenia (SAA). 
  4. General Feedback 
    1. Should NCQA include any other HEDIS/CAHPS measures for HPA scoring in reporting year 2018? If yes, which measures should be included for which product lines, and why?   

HEDIS/CAHPS Measures for Removal from Health Plan Accreditation for Scoring in 2018   

  1. Should NCQA remove the following measures for the commercial product line? 
    1. Comprehensive Diabetes Care (CDC) – Medical Attention for Nephropathy rate. 
    2. Comprehensive Diabetes Care (CDC) – HbA1c Poor Control (>9%) rate. 
    3. Medical Assistance With Smoking and Tobacco Use Cessation – Advising Smokers to Quit rate.  
  2. Should NCQA remove the following measures for the Medicare product line? 
    1. Comprehensive Diabetes Care (CDC) – Medical Attention for Nephropathy rate. 
    2. Comprehensive Diabetes Care (CDC) – HbA1c Poor Control (>9%) rate. 
    3. Adult BMI Assessment (ABA). 
  3. Should NCQA remove the following measures for the Medicaid product line? 
    1. Remove: Comprehensive Diabetes Care (CDC) – Medical Attention for Nephropathy rate. 
    2. Remove: Comprehensive Diabetes Care (CDC) – HbA1c Poor Control (>9%) rate. 
  4. General Feedback 
    1. Should NCQA remove any other HEDIS/CAHPS measures for HPA scoring in reporting year 2018? If yes, which measures should be removed for which product lines, and why?     

For an overview on the measures and the full list of proposed measures for scoring, please see: 

About Public Comment 

The public comment system is integrated with NCQA’s single-sign on platform. If you have access to any of the systems listed below, you can use the same credentials to login and submit comments: 

  • Interactive Data Submission System (IDSS). 
  • Health Organization Questionnaire (HOQ). 
  • Download Center. 
  • Recognition Program Online Application. 
  • Quality Compass (QC). 
  • Policy/Program Clarification Support (PCS). 

Note: Use the Forgot Password if you are unsure of your password. By using this feature, you will change your password for all NCQA systems to which you have access. 

If you do not have access to any system listed, click the Create an Account button and complete the entire form. Retain the password for your records.   Submitting Comments Submit all comments through NCQA’s Public Comment Web site (http://publiccomments.ncqa.org). NCQA does not accept comments via mail, e-mail or fax. 

All comments are due by 5 p.m. (ET) on Friday, December 16. 

To enter comments: 

  1. Go to the Public Comment database. 
  2. Enter your e-mail address and contact information. 
  3. Select one of the following:
    HEDIS/CAHPS Measures for Addition to Health Plan Accreditation for Scoring in 2018
    HEDIS/CAHPS Measures for Removal from Health Plan Accreditation for Scoring in 2018 
  4. Click on the Instructions link to the view public comment materials including instructions, proposed specifications and measures. 
  5. Select the Topic and Element (i.e., question) on which you would like to comment.  
  6. Select your support option (i.e., Support, Do not support, Support with modifications). If you choose Do not support, include your rationale in the text box. If you choose Support with modifications, enter the suggested modification in the text box.       
  7. Enter your comments in the Comments box.
    Note: There is a 2,500 character limit for each comment. Be concise in your feedback. We suggest you develop your comments in Word to check your character limit, and save a copy for reference. Use the “cut and paste” function to copy your comment into the Comments box. 
  8. If you are submitting more than one comment use the Submit and Return button. When you have submitted all comments use the Submit and Logout button to receive an e-mail notification with all submitted comments. 

All comments are due Friday, December 16, by 5:00 p.m. ET.