FAQ Directory

The expected release dates for Quality Compass 2022(MY2021) are as follows:

• • Commercial – July 29th, 2022
  • Medicaid – September 30th, 2022
  • Medicare – October 28th, 2022
  • Exchange – November 2022 

This applies to the following Programs and Years:

At a minimum, credentialing files must be retained for the period covering the survey look-back period. Otherwise, NCQA does not prescribe a specific time period for retaining credentialing files.

This applies to the following Programs and Years:

No. NCQA does not accept future dates of program completion as valid verification of completion of education and training.

This applies to the following Programs and Years:

In 2022, NCQA will be releasing  Quality Compass Exchange data for the first time. Exchange data will be available outside of the Quality Compass tool via a data file delivered on NCQA’s Download Center. The data file will contain individual plan level performance and benchmarks (averages and percentiles) for Exchange plans. It will contain results for QRS measure indicators used in the QRS Scoring program only. The Exchange data file is available for purchase now and will be released in November 2022.
 

This applies to the following Programs and Years:

For UM Accreditation, 75 files are reviewed per product line.  For CR Accreditation, 75 initial credentialing files and 75 recredentialing files are reviewed. 

Note: For non-health plan organizations, 30 files are reviewed per product line.  

This applies to the following Programs and Years:

Yes. Use the race/ethnicity value sets and direct reference codes in Tables RES-C-1/2/3 and RES-D-1/2/3 (in General Guideline 31) to report the RDM measure. This clarification will be in the MY 2023 Technical Update.

This applies to the following Programs and Years:

The Hemoglobin A1c Control for Patients With Diabetes measure should be removed from the measure list. The Plan All-Cause Readmissions measure should be added to the list. This clarification will be in the MY 2023 Technical Update.

This applies to the following Programs and Years:

If your organization needs an invoice prior to placing your order for Quality Compass, please reach out to our Information Products team by submitting a case through your my.NCQA.org account.
 

This applies to the following Programs and Years:

Although the National Student Clearinghouse (NSC) is not an approved source for primary source verification, NCQA allows verification of credentials through an agent of an approved source. NSC can serve as an agent for some institutions. 

Before using NSC, the organization must obtain documentation of a contractual relationship between it and the approved source (institutions that work with NSC). The contractual relationship must entitle the agent to provide verification of credentials on behalf of the approved source. 

This applies to the following Programs and Years:

Quality Compass is NCQA’s interactive database containing individual plan performance results for HEDIS® and CAHPS® measures, as well as benchmark data at the national, regional (Census, HHS) and state levels. It reports individual plan data from plans that chose to publicly report their performance results. Benchmark results comprise all plan data submitted to NCQA, regardless of reporting status.
NCQA Health Plan Ratings (HPR) is a separate method of evaluating and distributing information related to health plan quality and performance. It assesses and reports plan performance in several domains. The goal of HPR is to give plans a scale to assess their current operating status, to help ensure quality. HPR provides consumers with information that helps them select a high-quality health plan that suits their needs.
NCQA’s Health Plan Ratings 2022 assesses commercial, Medicare, and Medicaid health plans. The overall rating is the weighted average of a plan’s HEDIS® and CAHPS® measure ratings, plus bonus points for plans with a current Accreditation status. Please visit our HPR website (https://www.ncqa.org/hedis/reports-and-research/ncqas-health-plan-ratings-2022/) to learn more.
 

This applies to the following Programs and Years:

Yes, if there is a unique electronic signature or identifier and if the organization can demonstrate that the signature/identifier can only be entered by the signatory. NCQA reviews organizations’ security and login policies and procedures to confirm that the signature/identifier can only be entered by the signatory.

This applies to the following Programs and Years:

The State of Healthcare Report includes data that is publicly available on the NCQA site. It contains national averages based on the prior measurement year and is updated once a year. The State of Healthcare Quality Report classifies health plans differently than NCQA’s Quality Compass. HMO corresponds to All LOBs (excluding PPO and EPO) within Quality Compass. PPO corresponds to PPO and EPO within Quality Compass.
To get access to the most recent data as well as additional data points such as plan level performance and percentiles check out Quality Compass. at this link:

https://www.ncqa.org/programs/data-and-information-technology/data-purchase-and-licensing/quality-compass/

If you would like to discuss Quality Compass further, please reach out to our Information products team by submitting a case through your my.NCQA.org account.
 

This applies to the following Programs and Years: