Yes, the FVA measure will be publicly reported for the Medicaid product line for HEDIS 2015.
HEDIS 2015
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.
Yes. In the Eligible Population section, replace the text in step 2 with the following: A member identified as having persistent asthma because of at least four asthma medication dispensing events, where leukotriene modifiers or antibody inhibitors were the sole asthma medication dispensed in that year, must also have at least one diagnosis of asthma (Asthma Value Set), in any setting, in the same year as the leukotriene modifier or antibody inhibitor (i.e., the measurement year or the year prior to the measurement year).
HEDIS 2015
The HCPCS code J1000 was deleted from the Osteoporosis Medications Value Set (refer to the HEDIS Volume 2 Technical Update memo released October 1, 2014, at www.ncqa.org). The update aligns the HEDIS OMW value sets with the September release of the P4P OMW value sets. We included these updates in the September release of MY 2014 P4P to reduce the edits that P4P organizations must apply with the December release.
IHA 2014
There were mislabeled columns on three of tabs on the October 1 release: Volume 2 Value Sets to Codes; Summary of Changes—Codes; Summary of Changes—Value Sets. In all of these spreadsheets, the first column should be labeled “Value Set Name,” not “Measure ID.” This was corrected in the updated VSD released on 10/8/14. No changes were made to the value sets or codes.
HEDIS 2015
Your example is correct. We will amend the example in the specifications for the final release of the P4P manual on December 1, 2014.
For P4P reporting, the cervical cytology and HPV test dates must be four days or fewer apart during the measurement year or the four years prior to the measurement year. We do not specify that the date of the HPV test must be after the cervical cytology test; if cervical cytology is four days or less after an HPV test, it is acceptable.
IHA 2014
You are correct: The draft P4P manual states that there are no modifications from HEDIS. The differences you see are the result of anticipated P4P changes and updates to the Volume 2 CHL measure, per the HEDIS 2015 Volume 2 Technical Update released on October 1, 2014, at www.ncqa.org.
The HEDIS technical update changes aligns the HEDIS CHL measure specifications and value sets with the September release of the P4P CHL measure and value sets. We included these updates in the September release of MY 2014 P4P to reduce the edits that P4P organizations must apply with the December release.
IHA 2014
The logic for identifying a member with diabetes should be the same in CDC and CBPH: At least two ED visits are needed. The bullet on page 64 of the P4P manual was inadvertently placed in the “Event/diagnosis” section. The specification should read:
Claim/encounter data. Members who met any of the following criteria during the measurement year or the year prior to the measurement year (count services that occur over both years):
· At least two outpatient visits (Outpatient Value Set), observation visits (Observation Value Set), ED visits (ED Value Set) or nonacute inpatient encounters (Nonacute Inpatient Value Set) on different dates of service, with a diagnosis of diabetes (Diabetes Value Set). Visit type need not be the same for the two visits.
· At least one acute inpatient encounter (Acute Inpatient Value Set) with a diagnosis of diabetes (Diabetes Value Set).
This change will be reflected in the December release of the MY 2014 P4P Manual.
IHA 2014
Numerator specifications no longer allow a blood urea nitrogen test. Incorrect references to blood urea nitrogen therapeutic monitoring were inadvertently left in the P4P MPM measure specifications and should be removed. This update will be made in the December release of the MY 2014 P4P manual.
IHA 2014
An NCQA-Accredited organization that received automatic accreditation via the Marketplace Add-On process may have the Marketplace product line reviewed against the First or Renewal Evaluation Option at the time of its Renewal Survey.
The organization must submit separate Survey Tools for an option other than a Renewal Survey.
The available accreditation statuses, elements reviewed and look-back periods are specified in the standards and guidelines for the selected Evaluation Option.
For First and Renewal Surveys, the accredited status is valid for up to 36 months.
The organization must provide a documented process for seeking and receiving input from consumers or consumer groups, and provide reports or materials showing that feedback was solicited and received.
The solicitation must address measures included in the program and how information about physicians is reported.
NCQA defines “consumers” as a non-health care professionals who have, or would, utilize health care services. NCQA defines “consumer groups” as organizations that advocate for people who are actual or potential users of health care services.
PHQ 2013