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NCQA Seeks Public Comment on Proposed HEDIS CAHPS Survey Changes

NCQA has proposed changes to its HEDIS Health Plan CAHPS surveys. Public comment is open through March 13, 2018.

hedis cahps survey

Source: Thinkstock

By Sara Heath

- The National Committee for Quality Assurance (NCQA) is seeking public comments on its proposed changes to the Healthcare Effectiveness Data and Information Sets (HEDIS) scores, including amendments to the HEDIS Health Plan CAHPS surveys.

NCQA proposed the CAHPS survey changes because the current CAHPS survey was not compatible with current healthcare trends and technology, the organization said.

“NCQA stakeholders have expressed frustration with the current HEDIS CAHPS survey,” NCQA wrote in its CAHPS proposal. “We are committed to including the patient voice in the evaluation of health plan quality, and we understand the need to adapt methods for capturing this perspective to changes in technology and consumer behavior.”

The proposed changes seek to streamline CAHPS reporting requirements across different healthcare entities. Healthcare organizations face requirements to submit CAHPS survey data both for NCQA and for state and federal reporting programs.

NCQA acknowledged that it is useful for these requirements to have better continuity across different requirements.

Specifically, NCQA seeks comment on several different elements of the health plan CAHPS survey:

  • Claims Processing
  • Customer Service
  • Getting Care Quickly
  • Getting Needed Care
  • How Well Doctors Communicate
  • Shared Decision Making
  • Plan Information on Costs
  • Health Promotion and Education
  • Coordination of Care

NCQA is additionally looking for insights as to whether it needs to consider new elements to the CAHPS survey and whether NCQA should measure ongoing CAHPS measures as opposed to the annual reports the agency currently collects.

The organization also floated the idea of dividing survey patient populations into subpopulations within a health plan beneficiary pool. For example, dividing high healthcare utilizers from those with lower rates of health service use.

“Health plan members use services to a varying degree; for example, members with chronic conditions may have high needs and use services more frequently,” NCQA explained. “The current HEDIS CAHPS survey methodology is based on a random sample of plan membership. How important is it for these surveys to stratify samples into target populations? What target populations are of greatest interest to you?”

These proposed updates come with a batch of other HEDIS measure updates. NCQA has also proposed changes to HEDIS that risk assess for opioid use, hospitalizations following discharge, health assessments for individuals with multiple high-risk chronic illnesses, adult immunization status, and prenatal immunization status.

The organization has also proposed four questions that would focus on long-term services and supports, revisions to measures looking at blood pressure control and emergency department use for certain populations, and revisions for populations that span multiple different HEDIS measures.

NCQA said it is amending these measures because new evidence has emerged that changes some clinical guidelines.

“When clinical guidelines change or new evidence becomes available in the scientific literature, NCQA reviews HEDIS measures to determine whether changes may be needed,” NCQA stated. “NCQA convenes multi-stakeholder advisory groups—including independent scientists, clinicians, consumers and purchasers—to ensure that measures meet and balance the high standards of relevance, scientific soundness and feasibility.”

The agency has opened public review and comment to help develop the updates to its HEDIS measures. Public comment will be open between now and March 13, 2018. From there, NCQA will review public comments and present them to advisory groups to help determine the new updates to HEDIS measures.


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