The CAHPS Health Plan Survey 4.0H, Adult Version provides information on the experiences of commercial and Medicaid members with the health plan and gives a general indication of how well the health plan meets members' expectations. Results summarize member satisfaction through ratings, composites and question summary rates.

Seven composite scores summarize responses in key areas.

1. Claims Processing (commercial only)
2. Customer Service
3. Getting Care Quickly
4. Getting Needed Care
5. How Well Doctors Communicate
6. Shared Decision Making
7. Plan Information on Costs (commercial only)

For this "How Well Doctors Communicate" measure, members indicate how often ("Never," "Sometimes," "Usually," or "Always") their doctors communicated well with them. The "How Well Doctors Communicate" composite measure is based on four questions in the CAHPS 4.0H Adult Questionnaire.

The National Committee for Quality Assurance's (NCQA's) Committee on Performance Measurement (CPM) has long felt that consumer experience with health care is a critical component of quality of care, that experience affects care outcome—and that experience is itself a measure of outcome. Survey results give health plans the opportunity for continuous improvement in member care.

Health care; members' experiences; physician communication

Health plan members 18 years and older who answered the "How Well Doctors Communicate" questions on the CAHPS 4.0H Adult Questionnaire (see the related "Denominator Inclusions/Exclusions" fields)

The number of "Never," "Sometimes," "Usually," and "Always" responses on the "How Well Doctors Communicate" questions (see the related "Numerator Inclusions/Exclusions" field)

In 2010, the average percentage of members who responded "Always" in response to how often their doctors communicated well increased by 1.5 (health maintenance organization [HMO]) and 1.8 (preferred provider organization [PPO]) percentage points for commercial plans, and by 1.6 (HMO) percentage points for Medicaid plans.

Unspecified

Age greater than or equal to 18 years

The measurement year

Inclusions
Health plan members 18 years and older who answered the "How Well Doctors Communicate" questions on the CAHPS 4.0H Adult Questionnaire. Include nonresponses*.

*Nonresponses:

• Refusal
• After maximum attempts
• Bad addresses
• Bad addresses and nonworking/unlisted phone number or member is unknown at the dialed phone number

Exclusions

• Deceased
• Does not meet eligible population** criteria
• Language barrier
• Mentally or physically incapacitated

**Eligible Population: Health plan members 18 years and older as of December 31 of the measurement year, who have been continuously enrolled in the health plan during the measurement year (commercial) or the last 6 months of the measurement year (Medicaid) and currently enrolled at the time the survey is completed.

Allowable Gap: No more than one gap in enrollment of up to 45 days during the measurement year. To determine continuous enrollment for a Medicaid member for whom enrollment is verified monthly, the member may not have had more than a 1-month gap in coverage.

Inclusions
The number of "Never," "Sometimes," "Usually," and "Always" responses on the "How Well Doctors Communicate" questions

From the responses, a composite mean and variance score are calculated. A higher composite mean is associated with better quality. Additionally, composite global proportions and variances are calculated as well as item-specific question summary rates for each composite question.

Note: A questionnaire must have the final disposition code of "Complete and Valid Survey" for inclusion in the survey results calculations.

Refer to the original measure documentation for details.

Exclusions
Unspecified

CAHPS® Health Plan Survey 4.0H, Adult Questionnaire

This measure requires that results are reported separately for the commercial and Medicaid product lines.

How well doctors communicate.

Unspecified

National Committee for Quality Assurance's (NCQA's) Measurement Advisory Panels (MAPs) are composed of clinical and research experts with an understanding of quality performance measurement in the particular clinical content areas.

In order to fulfill National Committee for Quality Assurance's (NCQA's) mission and vision of improving health care quality through measurement, transparency and accountability, all participants in NCQA's expert panels are required to disclose potential conflicts of interest prior to their participation. The goal of this Conflict Policy is to ensure that decisions which impact development of NCQA's products and services are made as objectively as possible, without improper bias or influence.

2012 Jan 3

This measure was adapted from the following source:

• CAHPS 4.0 Health Plan Survey (Adult Questionnaire)

Unspecified

Unspecified

Please note: This measure has been updated. The National Quality Measures Clearinghouse is working to update this summary.

The individual measure, "How Well Doctors Communicate," is published in "HEDIS® 2012. Healthcare Effectiveness Data & Information Set. Vol. 2, Technical Specifications for Health Plans."

For more information, contact the National Committee for Quality Assurance (NCQA) at 1100 13th Street, NW, Suite 1000, Washington, DC 20005; Telephone: 202-955-3500; Fax: 202-955-3599; Web site: www.ncqa.org .

The following is available:

• National Committee for Quality Assurance (NCQA). The state of health care quality 2011. Continuous improvement and the expansion of quality measurement. Washington (DC): National Committee for Quality Assurance (NCQA); 2011. 199 p.

For more information, contact the National Committee for Quality Assurance (NCQA) at 1100 13th Street, NW, Suite 1000, Washington, DC 20005; Telephone: 202-955-3500; Fax: 202-955-3599; Web site: www.ncqa.org .

This NQMC summary was completed by ECRI on March 28, 2007. The information was not verified by the measure developer. This NQMC summary was updated by ECRI Institute on March 17, 2008. The information was verified by the measure developer on April 24, 2008. This NQMC summary was updated by ECRI Institute on February 6, 2009. The information was verified by the measure developer on May 12, 2009. This NQMC summary was updated by ECRI Institute on April 30, 2010, August 4, 2011, and again on November 2, 2012.

This NQMC summary is based on the original measure, which is subject to the measure developer's copyright restrictions.

For detailed specifications regarding the National Committee on Quality Assurance (NCQA) measures, refer to HEDIS Volume 2: Technical Specifications for Health Plans, available from the NCQA Web site at www.ncqa.org .