Many types of organizations purchase software to meet specialized data reporting and quality improvement needs. NCQA's Limited Software CertificationSM program validates that software and streamlines related audit processes for any client organizations that use it.
Currently, to validate vendors’ software, NCQA generates, for all HEDIS and P4P (Pay For Performance) measures, unique sets of sample data or “test cases” for vendors to process. NCQA then compares the vendors’ output to expected results and determines if the software computes results accurately. Using the same process for vendors that produce less than the full HEDIS dataset will increase the rigor and efficiencies of the audit and rates for MCOs and Provider Organizations reporting a subset of measures. Vendors can test any subset of HEDIS measures; the measures are not packaged together, but tested individually.
After achieving limited certification, vendors can advertise that their subset of measures is certified. Only vendors with a report from NCQA indicating they successfully passed the minimum requirements can advertise their software as certified, and they would be required to advertise “limited” certification and the measures tested. As with the current program, all Limited Certification vendors must submit press releases to NCQA for review and approval.
Possible subsets
P4P Measure Set
- Appropriate Treatment for Children with Upper Respiratory Infection
- Chlamydia Screening in Women
- Breast Cancer Screening
- Cervical Cancer Screening
- Childhood Immunization Status
- Cholesterol Management for Patients With Cardiovascular Conditions
- Diabetes Care
- Use of Appropriate Medications for People With Asthma
- Colorectal Cancer Screening
Mental Health Measure Set
-
Antidepressant Medication Management
- Chemical Dependency Utilization - Inpatient Discharges and Average Length of Stay
- Follow-Up After Hospitalization for Mental Illness
- Identification of Alcohol and Other Drug Services
- Initiation and Engagement of Alcohol and Other Drug Dependence Treatment
- Mental Health Utilization - Inpatient Discharges and Average Length of Stay
- Mental Health Utilization - Percentage of Members Receiving Services
For further information, questions and application forms for Limited Software Certification Program, contact Suzanne Porter, Coordinator, Licensure & Certification at porter@ncqa.org / (202) 955- 5127.
CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
NCQA HEDIS Compliance Audit® is a registered trademark of NCQA.
NCQA HEDIS Software CertificationSM is a service mark of NCQA.