No, practices are not required to use an NCQA-Certified survey vendor.
FAQ Directory
Here are some of the most frequently asked questions about NCQA’s various programs. If you don’t see what you are looking for in one of the entries below, you can ask a question through My NCQA.
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5.29.2018 QI 06 Are practices required to use an NCQA-Certified survey vendor to administer CAHPS PCMH?
5.29.2018 CC 01 What is the minimal information required to meet the requirements of the laboratory and radiology items outlined in CC 01?
There is no minimum data requirement. To meet this core requirement, practices must meet all six items outlined in CC 01. Practices must consider how best to demonstrate their process for each item to meet the intent as described in the guidance section of this criterion.
This applies to the following Programs and Years:
PCMH 20175.29.2018 QI 11 May practices focus on improving the number of patient experience survey responses it receives back from patients?
No. A measure looking to increase the number of patients who complete the satisfaction survey would not meet the requirement. Practice should look at improving an area identified using the patient experience data collected in QI 04.
This applies to the following Programs and Years:
PCMH 20175.29.2018 QI 12 How do practices assess the effectiveness of improvement actions?
Assessing effectiveness of improvement actions includes remeasurement to compare results over time and evaluation of what is driving change. Results may be quantitative (numerical data that demonstrate performance and can be compared to benchmarks) or qualitative (conceptual data that describe why performance is high or low), but practices must look at the goals set, actions taken to improve and previous or baseline results.
This applies to the following Programs and Years:
PCMH 20175.29.2018 QI 04A Are practices required to use the CAHPS PCMH survey to meet this requirement?
No. Practices may use any patient experience survey that includes questions related to three of the four categories specified in the standards (access; communication; coordination; whole-person care, self-management support and comprehensiveness).
This applies to the following Programs and Years:
PCMH 20175.29.2018 QI 12 When remeasuring to show improvement, what is an acceptable period of time between the initial measurement and the follow-up measurement period?
5.29.2018 QI 02B Are preventive care measures considered utilization measures?
No. Although effective preventive care can reduce future health care costs, preventive care measures address quality of care and are not utilization measures. Utilization measures address direct health care savings, in accordance with evidence-based guidelines.
This applies to the following Programs and Years:
PCMH 20175.29.2018 QI 04B May practices use the “comments” section in the patient experience survey to meet this requirement?
5.29.2018 QI 05 How can practices stratify data for vulnerable populations?
Practices select a vulnerable population for measurement using fields that are available in their practice system. Practices may use categories such as race, age, ethnicity, language needs, education, income, type of insurance, disability or health status to identify specific populations that may experience disparities in care.
This applies to the following Programs and Years:
PCMH 20175.29.2018 CC 08 Are practices required to only refer to specialists with whom they have agreements, or is the requirement that an agreement be in place? Give an example of an agreement.
Practices are not restricted to referring patients only to practices with whom they have established agreements. NCQA reviews at least one example of a formal or informal agreement with a subset of specialists, but does not expect practices to have agreements with all specialists to whom they refer patients. The goal is that expectations are outlined in the agreement, in addition to expectations of timeliness/content of response from specialists.
This applies to the following Programs and Years:
PCMH 20175.29.2018 CC 06 & CC 07 May a practice use credentialing information to meet CC 06 and CC 07?
No. Credentialing—although important to a clinician’s ability to practice—is not a specific indicator of performance or quality information. Practices must use performance data to evaluate the quality of specialists or consultants to whom they send patients. Performance data can be qualitative or quantitative and may be gathered from external reporting sources (e.g., PCSP recognition, CMS public reporting) or may be internal based on criteria defined by the practice (e.g., evaluating a specialist’s timeliness in returning referral reports, evaluating whether patients had a positive experience).
This applies to the following Programs and Years:
PCMH 20175.29.2018 CC 08 Our practice is part of an integrated health system. Do we need to show agreements between primary care providers and specialists?
Yes. Practices must have an agreement or documented process outlining the responsibilities of the referring provider and the specialist, even in an integrated system. It is essential that each provider understands the expectations and responsibilities of the referral, including the frequency and methods of communication.
