Esther Turner, Principal, Product Management
Here at SPH Analytics we’ve been busy interpreting and addressing all of the fast and furious regulatory updates that have come from NCQA and CMS these past few days. We’ve compiled the ones that impact health plan CAHPS® surveys here for your reference. We’ll update this page as more information becomes available.
NCQA released guidance about the HEDIS CAHPS program on March 27. While NCQA is not extending the data submission deadline of May 29, 2020, they are allowing for modifications to the protocol:
At (HEALTH PLAN) your health and safety are a priority. Amid the ongoing coronavirus pandemic, [HEALTH PLAN] continues to be committed to seeking ways to improve the services we provide to our members. For the purpose of this study, please reflect on your experience with the plan in the last (12 months/6 months).
On Thursday, April 2 NCQA released additional guidance regarding scoring for Health Plan Ratings, with clarification released on April 3. While NCQA continues to require submission of HEDIS and CAHPS data for Commercial and Medicaid plans, they are not planning to score plans using Health Plan Ratings in 2020.
This closely follows similar decisions from CMS regarding the MA & PDP Star Ratings.
NCQA does note several exceptions:
While data this year will not be used for scoring or rating purposes, we strongly believe it is an extremely valuable source of information that plans can use to track member experience during these difficult times. It is even more critical that plans review and understand their data.
Significant program changes were announced by CMS this week.
Survey administration and data collection has continued without interruption for this program and we don’t anticipate any changes to protocol. We await guidance from CMS about the how the Quality Rating System may be impacted for 2020.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).