NCQA-Certified survey vendors carry out the survey data collection. NCQA trains and certifies survey vendors to collect HEDIS/CAHPS 3.0H Child Survey and 4.0H Adult Survey Results from health plans according to the HEDIS protocols. Once certified, survey vendors may enter into contracts with health plans to survey a sample of members. It is anticipated that approximately 300 health plans will report HEDIS/CAHPS 3.0H and 4.0H survey results in 2008.
NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS) is the premier tool for monitoring the quality of care in health plans. HEDIS was developed through a partnership between NCQA, public, and private organizations representing health care consumers and purchasers, health plans, and health services researchers. Individuals representing all of these interests serve on NCQA’s Committee on Performance Measurement (CPM), which defines the criteria for HEDIS measures, reviews new submissions for measures, and makes all decisions about the measures included in every version of the data set.
HEDIS 2008 includes the revised HEDIS Volume 3: Specifications for Survey Measures. This manual includes surveys and protocols for the Consumer Assessment of Healthcare Providers and Systems (CAHPS®2) surveys. The CAHPS surveys represent an effort to accurately and reliably capture information from consumers about their experiences with care in health plans in the past year for commercial plans and the past six months for Medicaid plans. The CAHPS surveys for HMOs and POS plans was administered for the first time in 1999, capturing experience with care in 1998. CAHPS brings together into uniform survey instruments approaches to assessing consumer experiences based on the two preeminent efforts—the survey research that led to NCQA’s prior HEDIS Member Satisfaction Survey and CAHPS sponsored by the Agency for Healthcare Research and Quality (AHRQ). Consumers, purchasers and health plans have a core survey instrument that reflects state-of-the-art research about key components of health care quality, about how to elicit from a broad range of consumers their experiences with those key components, and about how to report the information meaningfully to the public. Health plans report survey results as part of HEDIS data collection, and NCQA uses survey results to inform accreditation decisions and to create national benchmarks for care. Health plans also collect HEDIS survey data for internal quality improvement purposes.
The CAHPS surveys were designed to collect data across populations—that is, there are versions for commercial and Medicaid populations, as appropriate. The HEDIS 2008 reporting set includes CAHPS 3.0H Child surveys and 4.0H Adult surveys directed to sampled Medicaid beneficiaries and sampled health plan members with commercial coverage. Previously, NCQA published a PPO version of Volume 3 that contained survey specifications applicable to PPOs. Effective 2008, the specifications for all reporting products are included in a single publication: HEDIS Volume 3: Specifications for Survey Measures. Updates are made to the PPO specifications to align them with HMO and POS product requirements.
A core group of questions makes up each of the CAHPS surveys. The questions in the surveys are worded to be understandable to a broad range of consumers and some questions combine to form composites about key areas of care and service. These composites provide summary results that are easier for consumers and purchasers to interpret. The questions chosen for the survey were those shown to discriminate best among health plans based on field tests. The HEDIS/CAHPS survey results provide comparable results across populations—Medicaid, commercial and Medicare.
Survey Vendor Certification Process
To become a NCQA-Certified survey vendor, an organization must demonstrate that it has the capabilities, experience and expert personnel to accurately collect and report survey results.
NCQA sends a Request for Proposal (RFP) to interested survey vendors in July each year (also available online). Survey vendors have three weeks to respond. Upon receipt of the response to the RFP, each proposal is evaluated based upon the following criteria:
- Relevant survey experience
- Organizational structure/capacity
- Quality control/management plan
- Human resources
- Past performance
For all qualified applicants who are accepted into the program, the project director and at least one other representative are required to attend the Survey Vendor Training, which takes place in the fall.
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Survey Vendor Training
For qualified applicants, a one-day onsite training will be held at NCQA in Washington, D.C. New Survey Vendor Training will cover the following:
- HEDIS survey sampling and data collection protocols, as described in the HEDIS survey volumes.
- NCQA's Quality Assurance Plan (QAP) for administering surveys
- Submission of survey data to NCQA
- Calculation of survey results
Each year, NCQA evaluates the survey results and feedback from survey vendors and health plans, and makes necessary protocol changes to ensure that the survey process runs as smoothly as possible and that the data is of the highest quality. Furthermore, survey content changes from year to year and new survey instruments may be implemented as part of HEDIS. These changes and other program updates are covered in the annual Survey Vendor Update Training. All new and returning vendors are required to attend annual Survey Vendor Update Training every year.
Upon successful completion of the training, survey vendors are certified to collect and report HEDIS data for one year. The names and contact information of certified survey vendors will be updated on NCQA’s website (Current Vendor List). Independently of NCQA, survey vendors enter into contracts with health plans and other survey sponsors, including States.
NCQA expects strict adherence to its procedures and protocols. Any deviation from or enhancement to the protocols must have the prior written consent from NCQA.
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Survey Vendor Oversight
Throughout survey administration, NCQA staff will monitor each vendor’s work by requiring the following:
- a review of all printed materials
- interim reports
- site visits
- monitoring of 1-800 number (customer support)
- monitiring of CATI interviews
- NCQA calculation of survey results
In addition, NCQA provides ongoing technical support to survey vendors. The data collection period is from January through June, all data must be submitted online through NCQA’s validation programs. The deadline for data submission to NCQA is late May. Surveys can be collected outside the January to June timeframe depending on the requirements of the vendor’s clients.
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HEDIS Surveys
Protocols for collecting and reporting HEDIS survey measures are updated annually. Occasionally, new survey measures are added.
Currently there are six HEDIS surveys, covering HMO, POS and PPO products:
1. CAHPS® 4.0H Adult Commercial
2. CAHPS® 3.0H Child Commercial
3. CAHPS® 3.0H Child Commercial with CCC (Children with Chronic Conditions)
4. CAHPS® 4.0H Adult Medicaid
5. CAHPS® 3.0H Child Medicaid
6. CAHPS® 3.0H Child Medicaid with CCC (Children with Chronic Conditions)
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Survey Vendor Certification Medicare HOS
NCQA, in partnership with the Centers for Medicare and Medicaid Services, administers the HEDIS® Medicare Health Outcomes Survey. Survey vendor certification for the Medicare Health Outcomes Survey (HOS) is a separate certification program at NCQA.
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Contact and Ordering Information
The NCQA HEDIS Specifications for Survey Measures are available for purchase online or by contacting NCQA's Customer Support at (888) 275-7585. For more information, to discuss or apply for certification, please contact the NCQA CAHPS Team by e-mail at CAHPS@ncqa.org.
1. HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
2. CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).
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