FAQ Directory: HEDIS

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.
 

HEDIS MY 2021

Quality Compass is priced according to the number of users, years of trended data, and whether your organization needs access to the Data Exporter feature. The cost breakdown is available on our pricing table on the NCQA Store .
 

HEDIS MY 2021

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.
 

HEDIS MY 2021

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.

HEDIS MY 2023

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.
 

HEDIS MY 2021

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.
 

HEDIS MY 2021

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.
 

HEDIS MY 2021

You can obtain access to performance data and benchmarks via the NCQA Quality Compass tool. Quality Compass is an 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. To learn more about Quality Compass and licensing access to HEDIS performance results, visit our Quality Compass homepage.
 

HEDIS MY 2022

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.
 

HEDIS MY 2021

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 

HEDIS MY 2021

No. A correction will be in the MY 2023 Technical Update. The Ages section in the Eligible Population should read as follows:
Members who were 3 months of age or older as of the Episode Date. Report three age stratifications and a total rate:

• 3 months–17 years.
• 18–64 years.
• 65 years and older.
• Total.

The total is the sum of the age stratifications.

HEDIS MY 2023

As an ECDS-reported measure, the SNS-E screening numerator counts only screenings that use instruments in the measure specification as identified by the associated LOINC code(s). Allowed screening instruments and LOINC codes for each social need domain are listed in “Definitions” in the measure specification.

NCQA recognizes that organizations might need to adapt or modify instruments to meet the needs of their membership. To clarify:

• The SNS-E measure specification does not prohibit cultural adaptations or linguistic translations from being counted toward the measure’s screening numerators.
• Only screenings documented using the LOINC codes specified in the SNS-E measure count toward the measure’s screening numerators.
• The Regenstrief Institute, which maintains the LOINC database, has indicated that LOINC codes do not distinguish between adapted and translated instruments.
• Tool developers have varying policies with regard to cultural adaptation and translations; some state that users may adapt screening instruments, others state that organizations must obtain permission first.

NCQA urges organizations to refer to the tool developer for information about adaptations or translations that are available or allowed.

HEDIS MY 2023