As Proposed by the Health Services Advisory Group HSAG'

1
Recommendations for Improving Scoring and Ratings
for CAHPS and HEDIS

• As Proposed by the Health Services Advisory Group
  (HSAG).
• HSAG is the Agencys External Quality Review
  Organization (EQRO) for the Medicaid Program.
• HSAG has reviewed the past two years of data and
  the ratings (checkmarks) assigned by AHCA.
• Recommendations are based on their review of the
  Data and AHCAs Scoring and Assignment of Ratings.

2
CAHPS Scoring Ratings Recommendations from HSAG

• Assign health plan performance check marks using
  tests of statistical significance, rather than
  Standard Deviations.
• Standard Deviation is a measure of score
  distribution, but it cannot determine a
  statistically-significant difference between plan
  scores.

3
CAHPS Scoring Ratings Recommendations from HSAG

• Different checkmark ratings based on standard
  deviation may suggest differences that do not
  exist.
• Tests of statistical significance (F test t
  test) determine true differences in plan
  performance.

4
CAHPS Assignment of Ratings Current (Std Dev)
v. Proposed (Stat Test) Adult Medicaid Overall
Plan Satisfaction
5
CAHPS Proposed Assignment of Ratings (HSAG)
6
HEDIS Check Mark Methodology Current and
Proposed

• Currently, ½ standard deviation is used to define
  a 5-scale check mark rating.
• Use 1 standard deviation to define a 3-scale
  check mark rating.
• Is more likely to identify true differences in
  plan performance.

7
HEDIS Assignment of Ratings Current (Five
checks) v. Proposed (Three checks) Commercial
Diabetes care, dilated eye exam performed
8
HEDIS-Improving the Ratings Recommendations from
HSAG

• AHCA should consider moving the timeline for
  reporting of HEDIS data to July 1. Currently
  October 1.
• The HMOs independent auditors should validate
  the actual HEDIS data files submitted to AHCA.
• Allow the HMOs to use the Interactive Data
  Submission System (IDSS) for creation of a data
  file for AHCA.

9
CAHPS-Improving the Scoring Recommendation from
HSAG

• Analyze and report on the traditional CAHPS
  global ratings and composite measures defined by
  AHRQ and adopted by NCQA.
• HSAG Web Address www.MyFloridaEQRO.com/