Yes. Factor 1 applies because patient experience results are considered measures of quality.
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12.12.2008 Principles for use of results Does Element H, factors 1 and 2, apply to all patient experience surveys?
12.12.2008 Notice for providing results Does a 45-day notice period apply when measurement is more frequent than annual (e.g., quarterly)?
The 45-calendar-day notice period for providing results and an opportunity for a physician to request a correction or change applies to each cycle of measurement and action an organization takes, regardless of frequency (e.g., biannual, annual, semiannual, quarterly); however, if an organization recalculates results without changing its methodology or measures, it does not need to provide the methodology again as long as it supplies information on how to obtain that methodology.
The exception to the minimum 45-calendar-day notice period for action is if the action involves only pay-for-performance activities that are not publicly reported (e.g., an action that is only between the organization and the physician). In this instance, the organization may provide the results and methodology concurrent with additional or bonus payment. The organization must still provide a process for the physician to request corrections or changes.
This applies to the following Programs and Years:
12.12.2008 Survey measures How is Element A scored for non-NQF endorsed surveys? Is each question a measure or, if measures roll up to a composite, is the composite considered one measure?
12.12.2008 Requests for corrections or changes For Elements F and G, how can patient experience of care data corrected, when this information is not disclosed to physicians?
The plan is not required to disclose member-specific results, nor is it expected that a physician can correct member responses. At a minimum, the physician must be given the methodology (e.g., sampling, attribution) and survey questions and, upon request, be allowed to confirm that the patients in the universe from which the sample was drawn are his or her patients, given the methodology.
This applies to the following Programs and Years:
12.12.2008 Patient experience measures Are all questions related to patient perception considered quality measures?
11.17.2008 Approved measures What percentage of an organization's measures must be approved by NQF, AQA or AMA/PCPI?
To achieve certification, the organization must score at least 50% on Element A, Measuring Physician Performance. The 50% score threshold requires that at least 50% but fewer than 60% of the measures used by the organization to measure physician quality for taking action meet the element (i.e., are standardized). To achieve full points (100%), at least 70% of the measures used by the organization to measure physician quality for taking action must meet the element (i.e., must be standardized)
This applies to the following Programs and Years:
11.17.2008 Quality measures What criteria does NCQA use to determine what constitutes a quality measure vs. another kind of measure?
11.17.2008 Productivity measures Are productivity measures within scope? For example, number of visits per half day: does NCQA classify this as a utilization measure or as something else?
11.17.2008 PHQ and Physician Practice Connection Recognition Do you have a crosswalk for PHQ as it relates to Physician Practice Connection (PPC) Recognitionstandard 8 in particular?
No. The PHQ standards evaluate organizations that measure physician performance; PPC recognizes physician practices that use systematic processes and information technology to enhance quality of patient care. The two programs serve different purposes. In particular, PPC 8: Performance Reporting and Improvement focuses on the practices internal measurement and quality improvement process. It does not address the methodology required in PHQ, but focuses on the QI process.
This applies to the following Programs and Years:
11.17.2008 Surveyors for PHQ certification What organizations will conduct surveys now or in the future? Only NCQA or, for example, would Licensed HEDIS Audit Organizations conduct them?
11.17.2008 Standardized measures What counts in the denominator for standardized measuresall measures on which action is taken, or all quality measures on which action is taken?
11.17.2008 Coding accuracy Is evaluation of coding accuracy and quality considered to be in scope for these measures?
NCQA does not evaluate coding accuracy and quality. Element D, Verifying Accuracy requires an organization to have a process to evaluate the accuracy of its measure results. The organization may use external auditors to verify its methodology, but is not required to do so. In the future, NCQA may develop standards for auditing physician measurement and a program for certifying auditors. With such standards, NCQA will consider making external audit a requirement.