Databases Used for Health Plan Quality Measures
The sponsors of the major health plan measurement sets—the National Committee for Quality Assurance (NCQA) and the Agency for Healthcare Research and Quality (AHRQ)—are also the primary sources for data and benchmarks. In addition, a database of consumer complaints is sponsored by the National Association of Insurance Commissioners.
Quality Compass is NCQA’s interactive, Web-based comparison tool. Users can view HEDIS, CAHPS, and accreditation results as well as comparisons to averages and other benchmarks. For a fee, you can generate custom reports online or download data directly from the tool into spreadsheets for further analysis.
Learn more about Quality Compass on NCQA’s Web site at http://www.ncqa.org.
The CAHPS Database is sponsored by the Agency for Healthcare Research and Quality (AHRQ). The primary purpose of the CAHPS Database is to facilitate comparisons of CAHPS survey results among various types of sponsors. Each year, hundreds of health plans, government agencies, and purchasers agree to include results of the CAHPS Health Plan Survey in the CAHPS Database. Participating survey sponsors receive reports comparing plan-level results to national and regional benchmarks. The general public can obtain free reports with aggregate-level results including national and regional benchmarks as well as benchmarks for specific product types.
Timeliness Measures:Complaints Database System
The Complaints Database System (CDS), owned by the National Association of Insurance Commissioners (NAIC), is a nationwide database used for referencing and analyzing consumer complaints filed with state insurance departments. NAIC is the organization of insurance regulators from the 50 States, the District of Columbia, and the five U.S. territories. Learn more at http://www.naic.org.
The CDS includes data on closed insurance complaints, licensing, and finances for health plans and other insurance companies. A closed complaint is a complaint that has been investigated and resolved to the satisfaction of the state or jurisdiction in which it is filed. The CDS is continually updated, as new information is received from the states on an ongoing basis. Various company-specific reports are available to the public, including annual complaint data, complaints relative to the national median, and trended data. NAIC does not collect all complaint data from all States, but the CDS includes data for most states.
For more information about health insurance complaints, contact specific State insurance departments. A directory of State offices is available at http://www.naic.org/state_web_map.htm.