Twenty-nine Vendors Seek 2017 NCQA Measure Certification(SM)

Certified measures are exempt from source code review during an NCQA HEDIS® Compliance Audit™ and P4P Audit Review™

October 3, 2016

WASHINGTON, DC—The National Committee for Quality Assurance (NCQA) announced that 29 vendors will seek certification for software code that produces administrative measure results related to the Healthcare Effectiveness Data and Information Set (HEDIS®) and Integrated Healthcare Association’s (IHA) California Pay for Performance (P4P) measurement sets.

NCQA Measure Certification proves that vendors have the ability to produce accurate and reliable results using their software code. Health plans using NCQA-Certified vendors save time by eliminating the manual source-code review portion of the HEDIS Compliance Audit and the P4P Audit Review. This year’s program includes three new performance measures:

  • Follow-Up After Emergency Department Visit for Mental Illness (FUM)
  • Follow-Up After Emergency Department Visit for Alcohol and Other Drug Dependence (FUA)
  • Standardized Healthcare-Associated Infection Ratio (HAI)

Certification also includes two new measures that are collected using electronic clinical data systems:

  • Depression Remission or Response for Adolescents and Adults (DRR)
  • Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults (DMS).

Testing also includes the 2017 Quality Rating System measure set, which comprises clinical measures from HEDIS and a Pharmacy Quality Alliance measure, Proportion of Days Covered.

Fifteen of the 29 vendors are seeking P4P certification. Vendors that choose this type of certification are testing the P4P measurement set. Altegra Health Operating Company and Optum are this year’s beta-test sites.

For vendor contact information and certification status updates, or to request an application, click here. For more information on NCQA Measure Certification programs, contact Suzanne Porter, NCQA Measure Certification Director.

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