Measurement Year 2011

Measure Set

The measurement set goes through a multi-step process of vetting by P4P committees, public comment, and P4P Steering Committee approval before becoming final. The most recent version of the 2011 measure set can be accessed at the link below. The red text represents changes from MY 2010.

MY 2011 Measure Set (Updated on December 19, 2011)


P4P Manual

The manual includes technical measure specifications along with data collection and reporting guidelines. The most recent version of the manual can be accessed at the link below.

MY 2011 P4P Manual (Posted on December 1, 2011)

• MY 2011 P4P Crosswalk to HEDIS 2012 NDC List (updated on January 19, 2012)
  
  
• MY 2011 P4P Crosswalk to June 2011 PQA NDC List (posted on December 16, 2011)
  
  
• PQA June 2011 NDC List (posted on December 16, 2011)
  
  
• Frequently Asked Questions (FAQs) (updated on January 23, 2012) 
  
  
• Using Arrays to Calculate Medication Utilization in SAS
  
  
• Meaningful Use of Health IT
  -  Survey Guide
  -  Survey Template - Reporting by Number of PCPs
  -  Survey Template - Reporting by Number of Patients

Please be sure to read the FAQs for the most recent changes to P4P measurement and reporting.

Audit Manual

P4P Audit Review Standards are derived from NCQA's HEDIS Compliance Audit Standards, the foundation on which Certified HEDIS Compliance Auditors assess a health plan's ability to report HEDIS data accurately and reliably. These standards represent key processes involved in P4P clinical data collection and reporting. This section includes the standards and assessments that apply to groups that opt to self-report the P4P clinical data and which are a derived subset of the HEDIS Compliance Audit Standards that health plans must meet during HEDIS audits. HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

MY 2011 Audit Review Guidelines

MY 2011 P4P Roadmap

MY 2011 Audit Review Guidelines - Appendices  2 and 3


Data Submission File Layouts

Health Plans:

Health Plan Clinical Measure File Layout
Health Plan Testing Measure File Layout

Physician Organizations:

Physician Organization Clinical Measure File Layout
Physician Organization Testing Measure File Layout