We have a variety of resources to support organizations participating in our Align. Measure. Perform. program. Participants frequently use the manual and measure sets, but we also have information below on required audits, data file layouts, value set directories, and the appeals process.
IHA’s AMP Reporting Portal is an online tool which allows physician organizations and health plans to securely access their quality, resource use, and total cost of care results for each of the AMP programs. To access your organization’s results and statewide benchmarks, please login to the web portal. New program participants can register to create an account. Once registered, an existing contact from your organization must add you as an authorized contact for your organization using the “Contacts” page, which grants access to your organization’s results.
IHA releases an AMP Program Manual for each measurement year that includes technical measure specifications, along with data collection and reporting guidelines. A final measure set, audit manual, and data submission file layouts are also released for each measurement year. Audit manuals, value set directories, and data submission file layouts can be found in the “Data collection and submission resources” section on this page.
The AMP measure set goes through a multi-step vetting process which includes initial recommendations by the AMP Technical Committees, stakeholder input via an annual public comment period, and AMP Governance Committee approval before becoming final. The measure set strives to align measures and measure specifications across programs as much as possible to reduce reporting burden and amplify the performance signal that enables meaningful performance improvement. However, the measure sets for each of the AMP programs vary slightly to reflect the needs of the population.
All data file layouts for TransUnion were updated in February 2021 and are now final for MY 2020.
NCQA is updating their measure certification and audit program requirements. Beginning in MY 2019, health plans and POs that use vendors to calculate their AMP program results must use NCQA-certified vendors. Health plans and POs that run their own measure results (without a vendor) may do so until MY 2021 and must either undergo manual source code review by a certified auditor or certify their measure logic using NCQA’s automated source code review (ASCR). Beginning in MY 2021, all health plans and POs must either transition to an NCQA-certified vendor or contract directly with NCQA for certification of their software via the ASCR process.
Health plans and physician organizations that report quality results in the AMP Program must contract with a Healthcare Effectiveness Data and Information Set (HEDIS) compliance auditor. The National Committee for Quality Assurance (NCQA) licenses individuals and organizations to conduct HEDIS Compliance Audits, including audits for the AMP Program. Use of an individual auditor or audit firm is a matter of organizational preference; any NCQA licensed auditor or audit firm is sufficient.
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. The audit standards represent key processes involved in clinical data collection and reporting and include standards and assessments that apply to physician organizations that opt to self-report clinical results. HEDIS® is a registered trademark of the NCQA.
The Value Set Directory consists of an electronic Excel file that is sortable and provides an easy way to incorporate CPT®, ICD-9-CM, ICD-10-CM, ICD-9-PCS, ICD-10-PCS, POS, MS-DRG, HCPCS, LOINC, TOB, and UB codes into your organization’s data collection program—saving programming hours, eliminating the manual search for codes, and reducing keying errors. NCQA converts all code tables for the AMP Program Manual to an electronic format called Value Set Directories (VSDs), which are available free of charge to download from the NCQA website.
We have several incentive design resources available for AMP participants, including resources related to value-based incentives and total cost of care.
IHA conducts a call for public comment prior to finalizing measures, specifications, and program or policy changes. AMP program participants and stakeholders from across the healthcare industry participate in public comment to provide input on the future of performance measurement and reporting at IHA.
All comments received during public comment were reviewed by the IHA Technical Measurement Committee or Technical Payment Committee, and responses, including applicable changes, were approved by the IHA Governance Committee before being incorporated where appropriate into final measure sets and manuals.
IHA has aligned with recent changes to the annual timeline for HEDIS© specification releases. During the IHA 2020 Public Comment period, AMP program participants and stakeholders were invited to provide feedback on a Draft Manual and Measure Sets for both MY 2020 and MY 2021. Feedback received during this period was reviewed and incorporated as appropriate into the final MY 2020 AMP Program Manual published on December 1st, 2020, and the final MY 2021 AMP Program Manual to be published on June 1st, 2021.
IHA’s responses to the comments received are available below.
To see the final MY 2020 AMP Program Manual, open the “AMP Program Manual” section on this page.