Quality Improvement Activity (QIA) Form Instructions
When to Use the QIA Form
This document is a guide for completing NCQA's Quality Improvement Activity (QIA) form. This form can be used for the QIA required NCQA accreditation and certification programs, as applicable. It must be used to meet the Quality Improvement Projects required for Medicare Advantage Deeming.
You are not required to use the QIA form; however, you must provide the data it requests in order for NCQA to review your QIAs completely and accurately. Submit a QIA for each activity you present by attaching it to the applicable element in the Survey Tool using the Attach Document feature in the Survey Tool.
Detailed instructions on attaching documents to the Survey Tool are found in the Survey Tool Instructions under Help on the Main Menu bar.
The purpose of the QIA form is to summarize the clinical and service quality activities that you are using to demonstrate meaningful improvement in the applicable element.
You should not complete the QIA forms for service or clinical activities that you use to demonstrate compliance with other standards that require data collection and analysis such as member/enrollee satisfaction, availability and access and satisfaction with UM. Document compliance with these standards as you would document any other standard.
All data points must be final when your organization submits the Survey Tool.
NCQA does not recommend using this form to report on activities that have only one data point (e.g., baseline only).
Consult the appropriate Explanation for the meaningful improvement standard for the accreditation or certification program for which you apply.
Remember that you cannot achieve a score of 100% with only one data point.
The activity will not be considered.
Achieving Meaningful Improvement
Submit enough data
To receive "credit" for meaningful improvement, you must submit enough data to allow an evaluation of any seasonal variations that could affect the results. On the service side, open-enrollment seasons can affect such activities as ensuring access to primary care and reduction in referral time frames. In most cases you must present:
annual measurement occurring during the same season (e.g., comparing the first quarter of one year to the first quarter of the following years) for areas that show seasonal differences, such as provision of enrollment cards five quarters of data fifteen months of data.
Note: If you do not have adequate data to satisfy the above conditions or if you believe that the results are not biased by seasonal issues, provide an explanation as it relates to QI 12 and QI 13 under Other Pertinent Methodology Features, in Section I.
The improvement must meet the time period covered in the survey
To receive "credit" for meaningful improvement, the improvement must have occurred in the three-year period covered in the survey. For example, if you have annual data on member satisfaction since 1996, but the date of the survey for which this QIA is being prepared is January 2008, only data beginning in 2005 should be shown.
In other words, the improvement must have started at some point during the three years immediately prior to the survey and have been subsequently sustained.
For Renewal Surveys, you may need to present measurements for the year prior to the current survey period if these data were not available for your previous survey.
The QIA Form
The form's five sections
The QIA form is divided into five sections:
Section I Activity Selection and Methodology
Section II Data/Results Table
Section III Analysis Cycle
Section IV Interventions Table
Section V Chart or Graph
Activity name and activity examples
The form first asks you to supply an activity name. The activity name should succinctly encompass the purpose of the activity and begin with an action word that accurately states what the activity is designed to do (e.g., "improving," "increasing," "decreasing," "monitoring"). Examples are listed below.
decreasing the risk of congestive heart failure improving claims turn-around time to practitioners increasing the rate of diabetic foot exams improving access to behavioral health services decreasing practitioner complaints with the referral process.
QIA Instructions and Form 15
2 QIA Instructions and Form
QIA Instructions and Form 1
Effective July 1, 2007
Effective July 1, 2007
Section I:
Activity Selection and Methodology
This section asks you to provide the rationale for choosing this QI activity for your organization. Explain why the clinical or service activity affects your members or practitioners.
NCQA requires you to choose service improvements based on their impact on members. NCQA also accepts improvements in practitioner satisfaction that relate to utilization management (UM) processes or effects (e.g., issues identified in UM 11) for one service QIA.
Examples are listed below:
improvements in turnaround time for prior-authorization requests decrease the time that members wait to receive care requiring authorization and/or increase productivity for practitioners...
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