FAQ Directory

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:

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:

You can find the standard guidelines and restrictions for data usage in Section 2 of the Quality Compass license agreement. This agreement in located on our website as well as on the NCQA store site, prior to any purchase of a license. If you expect your data usage to fall outside of the permissions set forth in the standard agreement, NCQA offers customized agreements to grant extended permissions and use cases, subject to a separate fee.

If you are unsure if your use case falls outside the standard license terms, submit your question via my.ncqa.org for further assistance.
 

This applies to the following Programs and Years:

Only the measures whose results were eligible for public reporting are included in Quality Compass. Additionally, certain HEDIS measures are specific to certain product lines and do not have data across all product lines. Specific age and gender stratifications are only applicable to specific measures.
 

This applies to the following Programs and Years:

NCQA requires organizations to credential practitioners before they provide care to members. NCQA uses the date of the Credentialing Committee or medical director’s decision (in the case of clean files) to determine credentialing timeliness requirements.

This applies to the following Programs and Years:

You can experience Quality Compass’ functionality by watching the demo videos available on the Quality Compass webpage (https://www.ncqa.org/programs/data-and-information-technology/data-purchase-and-licensing/quality-compass/). The demo videos walks viewers through some of the key features of Quality Compass as well as how to navigate the tool.

You can also request a walk-through live demo from the Information Products team. Please submit your request through your my.NCQA.org account or contact NCQA’s Customer Support team.
 

This applies to the following Programs and Years:

Currently each license is separated and there is no way to compare Commercial, Medicaid and Medicare in the same license. However, with the Data Exporter function, you will be able to pull reports in Microsoft Excel and that can make data comparison easier.
 

This applies to the following Programs and Years:

We recommend that organizations not use PCS responses that are over 3 years old. If a question relates directly to a measure specification or a general guideline that was revised from a previous measurement year, you should resubmit the question.

This applies to the following Programs and Years:

You can contact the Information Products team for assistance in expanding your permissions to meet your data usage needs. This includes any changes to the amount of data being shared (number of indicators) and how/with who the data is being shared with (internally for quality analysis purposes, external reporting on a brochure, email broadcast, website, blog) or commercial use of the data.
 

This applies to the following Programs and Years:

No. Replace “NUCC Provider Taxonomy Value Set” with “Dental Provider Value Set.” This correction will be in the MY 2023 Technical Update.

This applies to the following Programs and Years:

Purchase order numbers may be included for payment and tracking purposes; however, NCQA does not accept additional terms and conditions outside the executed legal agreement. Any and all purchase order terms and conditions have no legal effect and the license is governed solely by the terms of the executed agreement between your entity and NCQA.
 

This applies to the following Programs and Years:

Yes. The Residential Program Detoxification Value Set and codes will be included in the Update release of the Value Set Directory on March 31, 2023. The OID for the value set is 2.16.840.1.113883.3.464.1004.2408, and it includes two HCPCS codes:

• H0010     Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient) (H0010)
• H0011   Alcohol and/or drug services; acute detoxification (residential addiction program inpatient) (H0011)

This applies to the following Programs and Years: