Updated: June 04, 2020
The Quality Measure Highlights are 2-5 page resources about each Primary Care Provider Quality Improvement Program (PCP QIP) and Perinatal QIP measure. The PCP and Perinatal QIP measures align closely with the HEDIS® measures for which Partnership HealthPlan of California is held accountable by the Department of Health Care Services. Each Quality Measure Highlight includes the measure description, a list of codes associated with the measure, PCP QIP point allocations and thresholds, exclusions (if applicable), guidance on compliant and non-compliant documentation, and best and promising practices to improve on measure performance.
Effective mid-May 2020, PHC implemented changes to the 2020 PCP QIP measurement set in response to the COVID-19 pandemic. The measures remaining in the measurement sets are listed under "Remaining Measures." The PCP QIP 2020 measurement set varies by practice type (Family Practice, Pediatrics, and Internal Medicine). Please refer to the PCP QIP measure specifications documents to learn more about the measures that each practice type are accountable for this year.
"Monitoring Measures" are those for which providers are no longer held accountable during 2020 to earn incentive funds. The Monitoring Measures will likely be part of the 2021 PCP QIP. Data on these measures remain available in eReports and the Partnership Quality Dashboard (PQD).
Perinatal Measures are current measures in the Perinatal QIP. Please refer to the Perinatal QIP measure specifications document for more information.
References: National Committee on Quality Assurance (NCQA) HEDIS® 2019 Vol 2
Technical Specifications for Health Plans; NCQA HEDIS 2018 Vol 1 Narrative.
HEDIS® is a registered trademark of NCQA.