Header Record Specification - HEDIS CAHPS Health Plan Survey 5.0H Submission Type Adult. 1 = Commercial
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1 Without With Measurement Year 2017 MeasurementYear R R R R R = Required Data File Type 1 = DataFileType R R R R 2 = NCQA Healthcare Organization ID NCQAHealthcareOrganizationID R R R R Identifies the Organization ID assigned by Healthcare Organization Name Text (do not include commas) HealthcareOrganizationName R R R R Identifies the organization name of the health plan (provided by the health plan). Product Line 1 = ProductLine R R R R 2 = Product 0 = N/A 1 = HMO 2 = HMO/POS Combined 3 = POS 4 = PPO 8 = PPO/FFS 9 = HMO/POS/PPO Combined 10 = HMO/PPO Combined 11 = POS/PPO Combined 12 = EPO 13 = HMO/EPO Combined 14 = POS/EPO Combined 15 = PPO/EPO Combined 16 = HMO/POS/EPO Combined 17 = HMO/PPO/EPO Combined 18 = POS/PPO/EPO Combined 19 = HMO/POS/PPO/EPO Combined Product R R R R NCQA Submission ID NCQASubmissionID R R R R Identifies the Submission ID assigned by Survey Vendor Organization Text (do not include commas) SurveyVendorOrganizationName R R R R Name Survey Mode 0 = Non-HEDIS Protocol 1 = HEDIS Mail-Only Protocol 2 = HEDIS Mixed Protocol SurveyMode R R R R Identifies the standard HEDIS protocol used for the submission. Non-HEDIS methodology submissions are not eligible for reporting as HEDIS. Code as 0 = Non-HEDIS Protocol if the health plan did not follow the HEDIS protocols for sampling or data collection as described in HEDIS Volume 3. HEDIS 2017 Copyright 2016 by All rights reserved 1
2 Without With Total Number of Telephone Attempts Internet Use Spanish Translation Use Extra Mailing 0 = 0 Attempts 1 = 1 Attempt 2 = 2 Attempts 3 = 3 Attempts 4 = 4 Attempts 5 = 5 Attempts 6 = 6 Attempts TelephoneAttempts R R R R Identifies the total number of telephone attempts the vendor was contracted to make (per member) for the submission. Code as 0 for mail-only methodology with no telephone attempts. InternetUse R R R R Identifies if an internet enhancement was used for the submission. SpanishUse R R R R Identifies if a Spanish enhancement was used for the submission. ExtraMailing R R R R Identifies if an extra mailing such as an extra questionnaire packet, reminder letter or reminder postcard enhancement was used for the submission. Tracking ID Number Tracking ID2 Number Tracking ID3 Number Tracking ID4 Number Tracking ID5 Number EnhancedMethodID R R R R Identifies the Enhancement assigned by EnhancedMethodID2 R R R R Identifies the Enhancement assigned by EnhancedMethodID3 R R R R Identifies the Enhancement assigned by EnhancedMethodID4 R R R R Identifies the Enhancement assigned by EnhancedMethodID5 R R R R Identifies the Enhancement assigned by Sample Frame Size SampleFrameSize R R R R Identifies the total number of members included in the sample frame generated by the health plan. HEDIS 2017 Copyright 2016 by All rights reserved 2
3 Without With Total enrollment as of the date the sample frame is generated TotalEnrollment NR NR NR NR NR = Not required (optional). This variable is not used by If the variable is included it must be filled. Identifies the total number of members enrolled in the health plan (total number of covered lives) as of the date the sample frame was generated. The survey vendor obtains this value from the health plan. This is a variable required for NCBD submission. Random Number RandomNumber R R R R Identifies the random number used to generate the systematic sample for the submission. Do not include the decimal. For example, if the random number is 0.30, enter 30. Oversampling Rate = The health plan did not oversample. This variable is submitted by the Survey Vendor but NOT returned by OversamplingRate R R R R Do not include the decimal. For example, a 50% oversampling rate is reported as 50. Enter 100 for oversampling rates 100% or greater. For the with surveys, report the oversampling rate for the General Population. Final Sample Size FinalSampleSize R R R R Number Complete and Eligible CompleteEligible R R R R Identifies the number of members in the sample whose Disposition was Complete and Eligible. Number Incomplete or Ineligible IncompleteIneligible R R R R Identifies the number of members in the sample whose Disposition was not Complete and Eligible. Is the Health Plan reporting results for the Flu Vaccinations for s Ages measure? HasFluVaccResults R R NA NA NA = Not applicable. Do not include this variable. HEDIS 2017 Copyright 2016 by All rights reserved 3
4 Without With Is the Health Plan reporting results for the Medical Assistance with Smoking and Tobacco Use Cessation measure? Number of Supplemental Questions Added to the Questionnaire Tracking ID Number (1/12) 0 = Supplemental questions not used for this submission. HasSmokingResults R R NA NA NA = Not applicable. Do not include this variable. SupplementalQuestions R R R R SupplementalQuestion1 R R R R Identifies the Supplemental Tracking ID Number (2/12) Tracking ID Number (3/12) Tracking ID Number (4/12) Tracking ID Number (5/12) Tracking ID Number (6/12) Tracking ID Number (7/12) Tracking ID Number (8/12) Tracking ID Number (9/12) Tracking ID Number (10/12) SupplementalQuestion2 R R R R Identifies the Supplemental SupplementalQuestion3 R R R R Identifies the Supplemental SupplementalQuestion4 R R R R Identifies the Supplemental SupplementalQuestion5 R R R R Identifies the Supplemental SupplementalQuestion6 R R R R Identifies the Supplemental SupplementalQuestion7 R R R R Identifies the Supplemental SupplementalQuestion8 R R R R Identifies the Supplemental SupplementalQuestion9 R R R R Identifies the Supplemental SupplementalQuestion10 R R R R Identifies the Supplemental HEDIS 2017 Copyright 2016 by All rights reserved 4
5 Without With Tracking ID Number (11/12) Tracking ID Number (12/12) Tracking ID Number (13/20) Tracking ID Number (14/20) Tracking ID Number (15/20) Tracking ID Number (16/20) Tracking ID Number (17/20) Tracking ID Number (18/20) SupplementalQuestion11 R R R R Identifies the Supplemental SupplementalQuestion12 R R R R Identifies the Supplemental SupplementalQuestion13 R R R R Identifies the Supplemental SupplementalQuestion14 R R R R Identifies the Supplemental SupplementalQuestion15 R R R R Identifies the Supplemental SupplementalQuestion16 R R R R Identifies the Supplemental SupplementalQuestion17 R R R R Identifies the Supplemental SupplementalQuestion18 R R R R Identifies the Supplemental HEDIS 2017 Copyright 2016 by All rights reserved 5
6 Without With Tracking ID Number (19/20) Tracking ID Number (20/20) SupplementalQuestion19 R R R R Identifies the Supplemental SupplementalQuestion20 R R R R Identifies the Supplemental Survey Vendor Special Purpose Variable Text SurveyVendorVariable NR NR NR NR Survey vendors may use this field for their own purpose. NR = Not required (optional). If the variable is included it must be filled. Sample Frame Validation Result CAHPS Health Plan Survey 5.0H, Version Final Report Status Flu Vaccinations for s Ages Final Report Status Medical Assistance With Smoking and Tobacco Use Cessation Final Report Status 1 = Supports reporting 3 = Not Applicable The health plan did not have the sample frame validated by a HEDIS Compliance Auditor SampleFrameValidationResult R R R R This variable is not coded by the CAHPSReportStatus R R NA NA This variable is not coded by the FluReportStatus R R NA NA This variable is not coded by the SmokingReportStatus R R NA NA This variable is not coded by the CAHPS Health Plan Survey 5.0H, Version Final Report Status ren With Chronic Conditions Final Report Status CAHPSReportStatus NA NA R R This variable is not coded by the ReportStatus NA NA NA R This variable is not coded by the HEDIS 2017 Copyright 2016 by All rights reserved 6
Header Record Specification - HEDIS CAHPS Health Plan Survey 5.0H Submission Type Adult
Header Record Header Record Specification - HEDIS CAHPS Health Plan Survey 5.0H With Notes Measurement Year 2016 MeasurementYear R R R R R = Required Data File Type 1 = DataFileType R R R R 2 = NCQA Healthcare
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March 18, Dear Mitch:
Aon Hewitt 2601 Research Forest Drive The Woodlands TX 77381 Tel 281.363.0456 Fax 281.363.9049 March 18, 2011 Mr. Mitchell J. Goodstein Kaiser Foundation Health Plan, Inc. Senior Vice President, Actuarial,