Identifying Gaps in Care with NCQA Certified Health Appraisals

Health Assessment

Assess Risks
Assess Risks

Evaluate the health of commercial, Medicare, and Medicaid populations to meet NCQA requirements.

Evaluate the health of commercial, Medicare, and Medicaid populations to meet NCQA requirements.

Evaluate health with NCQA certified health assessments for commercial, Medicare, and Medicaid populations.

Drive Completion
Drive Completion

Use flexible delivery options and services to meet the needs of each population.

Use flexible delivery options and services to meet the needs of each population.

Use flexible delivery options and services to meet the needs of each population.

Personalize Feedback
Personalize Feedback

Deliver individual reports to summarize results and recommend behavior changes.

Deliver individual reports to summarize results and recommend behavior changes.

Deliver individual reports to summarize results and recommend behavior changes.

Target Interventions
Target Interventions

Identify individuals for health improvement programs such as health coaching.

Identify individuals for health improvement programs such as health coaching.

Identify individuals for health improvement programs such as health coaching.

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ConXus Profile is a configurable health risk assessment (HRA) engine that delivers PDHI’s NCQA-certified assessments and can also be used to deploy client-developed assessments.

ConXus Profile supports question completion from any PC, tablet, or smartphone. The questionnaire may also be completed using paper forms or facilitated by a health navigator.

Certifications

PDHI has received Wellness and Health Promotion (WHP) 5 certification from the National Committee for Quality Assurance (NCQA) for health risk assessments for the following populations:

  • Commercial — adult and pediatric
  • Medicaid — adult and pediatric
  • Medicare — seniors

These health appraisals use evidence-based guidelines and aim for a sixth-grade reading level. They follow the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health Care in their use of texts and images. To ensure currency with clinical guidelines, PDHI reviews and updates assessments annually, or more frequently when a guideline changes.

Delivery & Services

Online

The online health assessment can be completed on any PC, tablet, and smartphone. The questionnaire uses conditional branching logic to present relevant question sets to each user based on age, gender, and program options. Clients may configure the questionnaire to add or remove questions.

Data is saved automatically, and the participant may stop and return to complete the questionnaire at a later date. The questions can be switched between over 100 languages at any time using the Google Translate feature.

Upon completion, responses are locked before the personalized report is displayed to the participant. Optional review mode delays the display of the report until biometric data is available.

ConXus Profile is a configurable health risk assessment (HRA) engine that delivers PDHI’s NCQA-certified assessments and can also be used to deploy client-developed assessments.

Paper

Paper-and-pencil completion is also available using scannable bubble forms that support standard scanning technologies. Scanned data from paper forms is loaded into the ConXus database and merged with data collected through the online questionnaire, providing a single database for reporting. To simplify the user experience, we offer separate paper bubble forms in English and Spanish.

Completion Services

PDHI offers a range of tools and configurable services to facilitate health risk assessment completion. Our secure system supports multiple data inputs to accommodate your process flow. Our flexible delivery model allows you to use internal resources or outsource to PDHI or a combination of the two. We support:

  • Member outreach by phone, email, SMS-text, and mail
  • HRA completion by telephone
  • Processing paper questionnaires
  • Mailing reports to participants and providers

Biometric Data

Clients may configure ConXus Profile to collect laboratory results and vital signs from:

  • Biometric screenings
  • Central laboratories
  • Provider forms
  • Self-report by the participant

Biometric data can be loaded before or after the questionnaire is started and is consolidated with the responses.

Incentives

Program settings determine when the health assessment can be completed and the (optional) incentive points that may be awarded for one or more of the following:

  • Completion of the questionnaire
  • Batch load of biometric screening results
  • Biometric results that meet client-defined targets

Results

Participant Reports

When the questionnaire is locked, participants receive a personalized report, available in over 100 languages. The report provides a wellness score, domain scores, and an assessment of health risks and lifestyle behaviors, together with recommended actions for health improvement. Summary results from the previous two HRAs are displayed for comparison with current risks.

A printable provider summary report is also available, in English only.

Interventions

Assessment results drive health improvement interventions chosen by clients in their program configuration. Depending on program design, participants may be stratified according to their risk level into:

  • Self-learning action plans
  • Coaching programs
  • Care management
  • A health library of symptoms and treatments in plain language
  • Third-party programs

Administrator Reports

Client administrators run self-service reports at the Administrator Portal. Reports can be defined by service level, date range, and employer group or subgroup.

Management reports track participation rates. Health risk reports provide an analysis of health risks, readiness to change, and compliance with recommended screenings for a program. Trend reports compare results across programs, with options to review the total population (all participants in each program) or the cohort (participants in both programs only).

Batch Printing & Export

Batch-printing functions support the fulfillment of member and provider reports. Batch-export functions allow access to all questionnaire and assessment data for custom reporting and data sharing with partners.

Batch processes can be requested online and run overnight, with data delivered to the Administrator Portal. For repeat processes, automated batch jobs may be scheduled for delivery to a secure FTP server.

To further advance health equity and improve health outcomes for the more than 170 million individuals supported by CMS…
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The Centers for Medicare and Medicaid Services (CMS) requires a health risk assessment to be included in the Annual...

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