Yes. Plans that use patient experience measures must measure at least every two years to receive credit for this element.
FAQ Directory
Here are some of the most frequently asked questions about NCQA’s various programs. If you don’t see what you are looking for in one of the entries below, you can ask a question through My NCQA.
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11.15.2012 Frequency of re-measurement For plans using patient experience measures, must re-measurement occur every two years to meet Element E?
11.15.2012 Relative Resource Use (RRU) Measures Are HEDIS RRU measures appropriate for PQ 1 Element B?
11.15.2012 Taking action on cost measures Is an organization prohibited from using cost efficiency if quality results are not available?
No. The organizations program must consider quality in conjunction with cost, resource use or utilization when taking action. However, if the organization is unable to identify standardized measures of quality for a particular specialty or if there is insufficient data on an individual physician, practice or group the organization can act on cost performance when quality performance is not known. This is allowed in order to maximize the availability of performance information but must be handled in a fully transparent manner so that it is very clear when a physician is designated as high value and when they are purely designated as low cost. Refer to the standards _ specifically the explanation in PQ1 D (on page 51) _ for further explanation.
This applies to the following Programs and Years:
PHQ 201311.15.2012 Physician requests For PQ 2 Element C, could a collaborative manage the process?
Yes. PHQ requirements do not prohibit a collaborative from managing a request for corrections or changes made by physicians, but the organization remains accountable and responsible for responding to complaints from consumers and to requests for changes from physicians or hospitals based on actions taken by the organization.
This applies to the following Programs and Years:
PHQ 201311.15.2012 TDD/TYY requirements May organizations use State Relay services in lieu of offering TDD/TTY services?
11.15.2012 Automatic credit for NQF endorsed surveys Does an organization that uses the NQF-endorsed CAHPS-CG survey receive automatic credit? If not, what is the organizations accountability for confirming factors in the measurement methodology?
An organization does not receive automatic credit for using CAHPS-CG for an NCQA Survey. For Element C, the organization must follow the aspects of the survey methodology outlined in the endorsed specification, and must specify how it will address all other aspects of methodology required by the element.
This applies to the following Programs and Years:
11.15.2012 Noncompliant patients and physician ratings Has NCQA made recommendations or looked at the effect of noncompliant patients on physician ratings?
Although patient factors such as noncompliance may affect measure performance rates, an integral role of the physician is to work continuously with patients to educate them on the importance of a specific process or meeting a specific target/goal.
This applies to the following Programs and Years:
PHQ 201311.15.2012 Methodology for evaluation of cost measures What constitutes an acceptable methodological approach to evaluation of cost?
NCQA does not prescribe the cost measures an organization selects, though it requires an organization to specify all aspects of its methodology (Element C). In addition, the organization must risk-adjust its measures (Element C, factor 8) and must meet the minimum statistical requirements for measurement error and measure reliability (PQ1 Element D, factor 2).
This applies to the following Programs and Years:
PHQ 201311.15.2012 Organizational accountability Are organizations responsible for confirming the factors in Element F, or is this the responsibility of an external vendor?
For Element F, the organization must demonstrate that it has a process to verify that it has followed the specifications outlined in Element C (e.g., sample sizes, attribution,statistical validity). If the organization uses a vendor to administer the survey, this process may be performed by the vendor, but documentation demonstrating how the element is met must be included for the PHQ Survey.
This applies to the following Programs and Years:
PHQ 201310.16.2012 Comprehensive Diabetes Care Can CPT Category II code 4010F be used to identify ACE inhibitor/ARB therapy for the Medical Attention for Nephropathy indicator?
Yes, CPT Category II code 4010F (Angiotensin converting enzyme (ACE) inhibitor or Angiotensin Receptor Blocker (ARB) therapy prescribed or currently being taken) can be used to identify ACE inhibitor/ARB therapy (Table CDC-K) for the Medical Attention for Nephropathy indicator for HEDIS 2014 reporting.
This applies to the following Programs and Years:
HEDIS 201310.16.2012 General Guidelines What is the difference between "required" exclusions and "optional" exclusions?
Required exclusions identify members who must be excluded from the measure, regardless of numerator compliance. They are listed as part of the eligible population criteria because members who meet the required exclusion criteria are removed when identifying the denominator of the measure. Optional exclusions should only be used to remove members that did not meet the measure's numerator criteria. Organizations may choose to apply optional exclusions, which are listed separately at the end of the measure specification, or may choose not to apply the exclusions.
