FAQ Directory: HEDIS

Filter Results
  • Save
  • Email
  • Print

9.15.2022 Follow-Up After Emergency Department Visit for Substance Use (FUA) Should the Residential Program Detoxification Value Set be used when reporting the FUA measure? It is not listed in the Value Set Directory.

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)

HEDIS MY 2023

9.15.2022 Purchasing Quality Compass How do I purchase Quality Compass?

If you are purchasing Quality Compass directly from the NCQA Store and your organization does not require a custom license agreement, you can simply visit the NCQA Store page to complete your purchase.
If you require a custom data license agreement and have accepted the quote provided by the Information Products (IP) team, the next step is to have a customized agreement forwarded to you for the organization’s review and signature. The customized agreement will include information on the permissions, data usage and fees discussed with the IP department.

Once the agreement is signed by both parties, NCQA will issue an invoice for payment. Once payment is received, you will be granted access to the data and/or the agreed upon permissions take effect.
 

HEDIS MY 2021

9.15.2022 Quality Compass Data Extract What if I only need access to a subset of the data from Quality Compass? Can I obtain a data extract?

If you do not need access to all the data results available within Quality Compass, you can request a custom data extract. Pricing for data extracts start at $2,500 and are determined by the amount of data requested and the client’s use case.

You can obtain a custom quote by reaching out to the Information Products team and completing a data request form that details your data needs and requested permissions.
 

HEDIS MY 2021

9.15.2022 Quality Compass How can I obtain plan performance data and/or benchmark results for HEDIS and CAHPS measures?

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

9.15.2022 Quality Compass Data Comparison Across All Product Lines Is there a way to compare the data across product lines?

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

9.15.2022 Difference Between HPR and Quality Compass How are HPR and Quality Compass different?

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

9.15.2022 Quality Compass Access When will I receive access to Quality Compass?

Access to the data is granted as soon as payment is received by check or credit card.

The default email address used for access will be the individual’s whose information was included under the “Ship To” section completed at checkout Login and password information will be emailed to the default user after NCQA sets up the account. The default user, also known as the Administrative User, will have access to manage the additional licensed users on the account.

 

HEDIS MY 2021

9.15.2022 Quality Compass Appearance Prior to Purchasing How can I see what Quality Compass looks like prior to purchase?

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.
 

HEDIS MY 2022

9.15.2022 Purchase Order Number Will NCQA accept a purchase order number?

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

9.15.2022 Quality Compass License Agreement How can we determine if the Quality Compass license agreement meets my needs?

The standard license agreement for Quality Compass allows internal or external reporting for 15 measure indicators, 20 health plan submissions and 2 benchmarks (averages and/or percentiles) outside of the users licensed on the account. If your organization’s expected data usage does not align with the standard agreement, we can review your requested permissions and draft a customized agreement, subject to a different fee structure.
 

HEDIS MY 2021

9.15.2022 Social Need Screening and Intervention (SNS-E) For SNS-E, are organizations allowed to count screenings that were conducted using adapted or translated versions of screening instruments?

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

9.15.2022 Quality Compass Medicare Include CAHPS Data Does the Medicare dataset include CAHPS data?

The Medicare product line does not include CAHPS survey results. We recommend contacting Centers for Medicare and Medicaid Services (CMS) if you are interested in obtaining Medicare CAHPS data.

 

HEDIS MY 2021