Fall is the season when survey vendors attend vendor training sessions for HEDIS® CAHPS®, the QHP Enrollee Survey, and the MA & PDP CAHPS survey. SPH would like to share with you the program updates from both NCQA and CMS that impact each of these programs.
One of the key HEDIS CAHPS changes is an update to the survey questionnaires used for Commercial Adult, Medicaid Adult, Medicaid Child, and Medicaid Child CCC programs.
New NCQA HEDIS CAHPS Questionnaires
NCQA released updated versions of the HEDIS CAHPS surveys after vendor training. These are now called the CAHPS 5.1H surveys (instead of 5.0H). There are not any new questions, but existing questions have been modified so that the respondents know they should include telehealth visits as an appointment type as they respond to the survey. For instance, the introductory language to a section now reads (emphasis added to highlight, bold font is not part of the question format):
These questions ask about your own health care from a clinic, emergency room, or doctor’s office. This includes care you got in person, by phone, or by video. Do not include care you got when you stayed overnight in a hospital. Do not include the times you went for dental care visits.
This new wording about care “in person, by phone or by video” has been added to appropriate questions and introductions throughout the survey.
Below are some of the other key highlights and updates:
SPH attended CMS vendor training for the QHP Enrollee Survey in mid-October. As expected, CMS announced updates to the survey tool to address telehealth:
Most of the other updates were relatively minor or served to clarify previous guidance. These changes and clarifications include:
On January 4, 2021, vendors must submit their preliminary QHP client list and oversampling requests.
Additional QHP Documentation: CMS released the following documents regarding the 2021 QRS and QHP Enrollee Survey:
In the Final 2020 Call Letter, CMS says that they do intend to continue to update the QHP Enrollee Survey:
There were not many updates to the program for this year:
Supplemental questions must be submitted by December 3, 2020. Note that CMS did not make any modifications to the survey to address telehealth appointments.
SPH has 35 years of experience and success in administering and managing regulatory and non-regulatory experience survey programs for health plans and providers. Read more about what surveys would best support your patient/member experience and improvement initiatives.
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).