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## Complete Summary

#### TITLE

Health plan members\' satisfaction with care: adult health plan
members\' ratings of all health care received from their health plan in
the last 12 months.

#### SOURCE(S)

National Committee for Quality Assurance (NCQA). HEDIS 2008: Healthcare
Effectiveness Data & Information Set. Vol. 2, Technical Specifications.
Washington (DC): National Committee for Quality Assurance (NCQA); 2007
Jul. various p.

National Committee for Quality Assurance (NCQA). HEDIS 2008: Healthcare
Effectiveness Data & Information Set. Vol. 3, Specifications for Survey
Measures. Washington (DC): National Committee for Quality Assurance
(NCQA); 2007 Jul. 118 p.

### Measure Domain

#### PRIMARY MEASURE DOMAIN

Patient Experience

The validity of measures depends on how they are built. By examining the
key building blocks of a measure, you can assess its validity for your
purpose. For more information, visit the [Measure
Validity](http://www.qualitymeasures.ahrq.gov/resources/measure_domains.aspx)
page.

#### SECONDARY MEASURE DOMAIN

Does not apply to this measure

### Brief Abstract

#### DESCRIPTION

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.

Four global rating questions reflect overall satisfaction.

1.  Rating of All Health Care

2.  Rating of Personal Doctor

3.  Rating of Specialist Seen Most Often

4.  Rating of Health Plan

For this \"Rating of All Health Care\" measure, members rate all health
care received on a scale from 0 to 10, where 0 is the \"worst health
care possible\" and 10 is the \"best health care possible\".

#### RATIONALE

NCQA\'s Committee on Performance Measurement has long felt that consumer
experience with health care is a critical component of quality of care
and is itself an outcome of care.

#### PRIMARY CLINICAL COMPONENT

Health care; members\' satisfaction

#### DENOMINATOR DESCRIPTION

Health plan members 18 years and older who answered the \"Rating of All
Health Care\" question on the CAHPS 4.0H Adult Questionnaire (see the
\"Description of Case Finding\" and the \"Denominator
Inclusions/Exclusions\" fields in the Complete Summary)

#### NUMERATOR DESCRIPTION

Member\'s ratings of all health care received on a scale from 0 to 10,
where 0 is the \"worst health care possible\" and 10 is the \"best
health care possible\" (see the related \"Numerator
Inclusions/Exclusions\" field in the Complete Summary)

### Evidence Supporting the Measure

#### EVIDENCE SUPPORTING THE CRITERION OF QUALITY

-   A formal consensus procedure involving experts in relevant clinical,
    methodological, and organizational sciences

-   One or more research studies published in a National Library of
    Medicine (NLM) indexed, peer-reviewed journal

### Evidence Supporting Need for the Measure

#### NEED FOR THE MEASURE

Use of this measure to improve performance\
Variation in quality for the performance measured

#### EVIDENCE SUPPORTING NEED FOR THE MEASURE

National Committee for Quality Assurance (NCQA). The state of health
care quality 2007: industry trends and analysis. Washington (DC):
National Committee for Quality Assurance (NCQA); 2007. 93 p.

### State of Use of the Measure

#### STATE OF USE

Current routine use

#### CURRENT USE

Accreditation\
Decision-making by businesses about health-plan purchasing\
Decision-making by consumers about health plan/provider choice\
External oversight/Medicaid\
External oversight/State government program\
Internal quality improvement

### Application of Measure in its Current Use

#### CARE SETTING

Managed Care Plans

#### PROFESSIONALS RESPONSIBLE FOR HEALTH CARE

Measure is not provider specific

#### LOWEST LEVEL OF HEALTH CARE DELIVERY ADDRESSED

Single Health Care Delivery Organizations

#### TARGET POPULATION AGE

Age greater than or equal to 18 years

#### TARGET POPULATION GENDER

Either male or female

#### STRATIFICATION BY VULNERABLE POPULATIONS

Unspecified

### Characteristics of the Primary Clinical Component

#### INCIDENCE/PREVALENCE

Unspecified

#### ASSOCIATION WITH VULNERABLE POPULATIONS

Unspecified

#### BURDEN OF ILLNESS

Unspecified

#### UTILIZATION

Unspecified

#### COSTS

Unspecified

### Institute of Medicine National Healthcare Quality Report Categories

#### IOM CARE NEED

End of Life Care\
Getting Better\
Living with Illness\
Staying Healthy

#### IOM DOMAIN

Patient-centeredness

### Data Collection for the Measure

#### CASE FINDING

Both users and nonusers of care

#### DESCRIPTION OF CASE FINDING

Health plan members 18 years and older as of December 31st 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), with no more than one gap in enrollment of
up to 45 days (commercial) or up to 1 month (Medicaid) during the
measurement year and who were enrolled at the time the survey was
completed

#### DENOMINATOR SAMPLING FRAME

Enrollees or beneficiaries

#### DENOMINATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
Health plan members 18 years and older who answered the \"Rating of All
Health Care\" question 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 (see \"Description of
    Case Finding\" field)

-   Language barrier

-   Mentally or physically incapacitated

#### RELATIONSHIP OF DENOMINATOR TO NUMERATOR

All cases in the denominator are equally eligible to appear in the
numerator

#### DENOMINATOR (INDEX) EVENT 

Patient Characteristic

#### DENOMINATOR TIME WINDOW

Time window precedes index event

#### NUMERATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
Member\'s ratings of all health care received on a scale from 0 to 10,
where 0 is the \"worst health care possible\" and 10 is the \"best
health care possible\"

A rating mean and variance are calculated after recoding individual
member responses to a score value of 1, 2, or 3. A higher rating mean is
associated with better quality.

Additionally, two question summary rates and question summary rate
variances are calculated.

1.  Question Summary Rate (8+9+10) and Question Summary Rate Variance
    (8+9+10) are calculated using Score Values (8+9+10)

2.  Question Summary Rate (9+10) and Question Summary Rate Variance
    (9+10) are calculated using Score Values (9+10)

**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

#### MEASURE RESULTS UNDER CONTROL OF HEALTH CARE PROFESSIONALS, ORGANIZATIONS AND/OR POLICYMAKERS

The measure results are somewhat or substantially under the control of
the health care professionals, organizations and/or policymakers to whom
the measure applies.

#### NUMERATOR TIME WINDOW

Fixed time period

#### DATA SOURCE

Administrative data\
Patient survey

#### LEVEL OF DETERMINATION OF QUALITY

Not Individual Case

#### PRE-EXISTING INSTRUMENT USED

Unspecified

### Computation of the Measure

#### SCORING

Non-weighted Score/Composite/Scale

#### INTERPRETATION OF SCORE

Better quality is associated with a higher score

#### ALLOWANCE FOR PATIENT FACTORS

Analysis by subgroup (stratification on patient factors, geographic
factors, etc.)

#### DESCRIPTION OF ALLOWANCE FOR PATIENT FACTORS

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

#### STANDARD OF COMPARISON

External comparison at a point in time\
External comparison of time trends\
Internal time comparison

### Evaluation of Measure Properties

#### EXTENT OF MEASURE TESTING

Unspecified

### Identifying Information

#### ORIGINAL TITLE

Rating of all health care.

#### MEASURE COLLECTION

[HEDIS® 2008: Healthcare Effectiveness Data and Information
Set](http://www.qualitymeasures.ahrq.gov/Browse/DisplayOrganization.aspx?org_id=8&doc=11336)

#### MEASURE SET NAME

[Satisfaction with the Experience of
Care](http://www.qualitymeasures.ahrq.gov/Browse/DisplayOrganization.aspx?org_id=8&doc=9229)

#### MEASURE SUBSET NAME

[CAHPS Health Plan Survey 4.0H, Adult
Version](http://www.qualitymeasures.ahrq.gov/Browse/DisplayOrganization.aspx?org_id=8&doc=9231)

#### DEVELOPER

National Committee for Quality Assurance

#### FUNDING SOURCE(S)

Unspecified

#### COMPOSITION OF THE GROUP THAT DEVELOPED THE MEASURE

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.

#### FINANCIAL DISCLOSURES/OTHER POTENTIAL CONFLICTS OF INTEREST

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.

#### ENDORSER

National Quality Forum

#### ADAPTATION

Measure was adapted from another source.

#### PARENT MEASURE

CAHPS 4.0 Health Plan Survey (Adult Questionnaire)

#### RELEASE DATE

1997 Jan

#### REVISION DATE

2007 Jul

#### MEASURE STATUS

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

#### SOURCE(S)

National Committee for Quality Assurance (NCQA). HEDIS 2008: Healthcare
Effectiveness Data & Information Set. Vol. 2, Technical Specifications.
Washington (DC): National Committee for Quality Assurance (NCQA); 2007
Jul. various p.

National Committee for Quality Assurance (NCQA). HEDIS 2008: Healthcare
Effectiveness Data & Information Set. Vol. 3, Specifications for Survey
Measures. Washington (DC): National Committee for Quality Assurance
(NCQA); 2007 Jul. 118 p.

#### MEASURE AVAILABILITY

The individual measure, \"Rating of All Health Care,\" is published in
\"HEDIS® 2008. Healthcare Effectiveness Data & Information Set. Vol. 2,
Technical Specifications.\"

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

#### COMPANION DOCUMENTS

The following is available:

-   National Committee for Quality Assurance (NCQA). The state of health
    care quality 2007: industry trends and analysis. Washington (DC):
    National Committee for Quality Assurance (NCQA); 2007. 93 p.

For more information, contact the National Committee for Quality
Assurance (NCQA) at 2000 L Street, N.W., Suite 500, Washington, DC
20036; Telephone: 202-955-3500; Fax: 202-955-3599; Web site:
[web.ncqa.org](http://web.ncqa.org/).

#### NQMC STATUS

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.

#### COPYRIGHT STATEMENT

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*, available from the NCQA Web site at
[web.ncqa.org](http://web.ncqa.org/).

### Disclaimer

#### NQMC DISCLAIMER

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© 2008 National Quality Measures Clearinghouse

Date Modified: 11/10/2008