NCQA HEDIS CAHPS Updates for 2017

November 29, 2016

Stethoscope placed on top HEDIS CAHPS Analytics

Are you ready for HEDIS CAHPS® 2017? There are some important updates for health plans conducting the 2017 Commercial and Medicaid CAHPS Survey. The good news is that SPH Analytics has incorporated these updates into our CAHPS protocol, and we can guide you each step of the way to help ensure you have a successful CAHPS administration in 2017.


SPH Analytics recently attended NCQA vendor training for 2017 HEDIS CAHPS. We’ve outlined many of the key updates for the upcoming survey administration as follows:

  • Updates to HEDIS CAHPS General Guidelines
    • Clarified in General Guideline 6 that Volume 3 is not used for QRS specific reporting
    • Added General Guideline 29: Members in Hospice
    • Clarified reporting requirements in General Guideline 31: Members with Dual Commercial or Commercial/Medicaid Coverage in the Same Health Plan
    • Added General Guideline 43: Identifying Events/Diagnoses Using Laboratory or Pharmacy Data
    • Pneumonia Question revised (Medicare CAHPS)
  • Child and Adult Survey Updates
    • Sample frames for different product lines and products cannot be combined
    • Subscriber or Family ID and Member-Unique ID in the sample frame can be an alphanumeric value
    • A standard transition statement may be added to the survey, before the supplemental question section
    • Added the rating questions to Table S-10
    • NCQA will not calculate the following results for HEDIS 2017:
      • Rating of Overall Health
      • Rating of Overall Mental/Emotional Health
    • Child Surveys Removed: The CAHPS Health Plan Survey 5.0H, Child Version and Children with Chronic Conditions (CCC) have been removed from the commercial product line.


The Child Version and Children with Chronic Conditions (CCC) Surveys
have been removed from the Commercial CAHPS product line.

Sampling and Deduplication

NCQA has revised the systematic sampling method steps to add a new deduplication method for household members. This is to reduce respondent burden and deduplicate the sample frame by household before pulling the systematic sample.

Because only the household selection remains in the sample frame, these disposition codes have been removed:

  • ID1 = ineligible: removed from sample during deduplication—duplicate household of sampled adult member
    • ID2 = ineligible: removed from sample during deduplication—duplicate household of sampled child member

In instances of multiple surveys per sample frame, NCQA has specified the following:

  • Must contact NCQA for permission to deduplicate across samples (refer to section in QAP for requirements and details)
  • Select the systematic sample and identify duplicates
  • Provide data (sample info, number of duplicates) in request


NCQA will review new taglines that are not part of a corporate logo or required by a state Medicaid agency.

Postcards and Cover Letters

Postcards and cover letters have been updated for the 2017 survey administration, and there are new Spanish translations.

The standard cover letter text may not be modified, except when a state’s reading level requirement is not met. In these cases NCQA will work with survey vendors to fulfill the state’s requirement.

Data Submission

There have been updates to the member-level data files as follows:

  • Revised variables
  • Added variable names
  • Notes column contains coding rules and instructions (information previously communicated in the QAP)
  • Member-Level record includes skip pattern information
  • The data file is now a CSV file

Non-HEDIS Survey Methodology

Survey vendors must notify NCQA of all non-HEDIS survey methodology submissions.


NCQA has revised the HEDIS CAHPS disposition categories for 2017 as follows:

  • 0 = Complete and valid survey
    • Responses indicate that the member meets the eligible population criteria
    • Three of the five questions listed in the table below are answered appropriately

HEDIS CAHPS Survey questions completed for a valid survey

  • If disposition is 0, then these variables are coded:
    • Response Mode (new)
      • 1 = Mail; 2 = Telephone; 3 = Internet; 0 = Incomplete/Ineligible
      • Indicates where a member completed the survey
    • Round (revised rules)
      • 1= First attempt; 2 = Second attempt; 3 = Third attempt; 4 = Fourth attempt; 5 = Fifth attempt; 6 = Sixth attempt; 0 = Incomplete/Ineligible
    • Survey Language
      • 1 = English; 2 = Spanish; 0 = Incomplete/Ineligible 
  • 1 = Does not meet eligible population criteria
    • Evidence member does not meet one or more EPOP criteria:
      • Current Enrollment
      • Age
      • Continuous Enrollment
    • 2 = Incomplete (but eligible)
      • Member is eligible but did not complete 3 of the 5 questions required
    • 3 = Language Barrier
      • Member does not read/speak the language in which the survey was administered
    • 4 = Physically or Mentally Incapacitated
      • Mentally or physically unable to complete the survey
      • Adult Survey does not allow use of proxy
      • Do not use this code for Child Surveys
    • 5 = Deceased
    • 6 = Refusal
    • 7 = Non-response after maximum attempts
    • 8 = Added to Do Not Call (DNC) list

These dispositions have been deleted and are now coded as 7 (Non-response after maximum attempts):

  • M23 (bad address)
  • T23 (bad address and bad phone)
  • M33 (nonresponse after max attempts)
  • T33 (nonresponse after max attempts)

These dispositions have been deleted since the sample frame is deduplicated prior to the sample selection:

  • ID1 (removed during deduplication – adult)
  • ID2 (removed during deduplication – child)

Because NCQA is now coding the telephone attempt where the member completed the survey, this disposition has been deleted:

  • MT = partially completed by mail and converted to complete by telephone

Data Coding

NCQA has deleted separate coding for:

  • 7 = Appropriately skipped
  • 8 = Multiple mark
  • 9 = Missing

Now these will all be coded as 9 = No Data.

2017 Survey Implementation Timeline Highlights

The 2017 HEDIS CAHPS Survey timelines is as follows:

HEDIS CAHPS Survey Administration Timeline

2017 Supplemental Question Submission Dates

The 2017 supplemental submission dates are as follows:

HEDIS CAHPS Supplemental Question Submission Dates

Preparing for HEDIS CAHPS

We’ve outlined above some of the key updates to keep in mind as you prepare for the 2017 HEDIS CAHPS Survey administration.  It’s also important to work with a trusted survey provider, like SPH Analytics. As an NCQA-certified CAHPS vendor, we partner with you to provide ongoing guidance, advanced analytics, and recommendations for continual improvement.

Note: Information provided above is based on interpretation of information provided by NCQA. Opinions, interpretations, and recommendations expressed above are those of SPH Analytics and not to be regarded as views or opinions expressed by NCQA or other governing authorities.
CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ)

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