Self-reporting provider organizations (POs) have until April 22 to review your data submissions before sending them to your auditors. Please make sure you’ve included all the measures you’ve chosen to report and double-check your data for accuracy.
Thank you in advance for taking the extra time to validate your self-reported results. IHA is dedicated to giving you accurate results, but unfortunately, we can’t accept appeals for incorrect results caused by PO self-reporting errors.
Please note, test files to FinThrive are also due by April 22.
Submit audited clinical quality measures
Health plans and providers
Once your test files have been approved by FinThrive, please turn your attention to the following milestones:
April 22: Send your data to your auditor
Health plans and self-reporting POs: send your data files to auditors for review before final submission to FinThrive.
May 3: Submit your audited data to FinThrive
Health plans and self-reporting POs: submit your auditor-locked data files to FinThrive via email at AMP@finthrive.com by 5pm PDT.
Please see page 12 of the AMP Program Guide for a detailed data submission timeline.
Submission deadlines for health plans
Onpoint data pathway
April 17: Sign off on Enhanced Validation Report I (EVR I) and review Mid Cycle Measure Trending Report (MTR)
The MTR and EVR are essential parts of IHA’s holistic approach to data quality to help catch issues further upstream.
EVR provides plans a glimpse into trends in claims data
MTR provides plans an opportunity to review measure results using a rolling four quarters of data (Q3 2022- Q2 2023 with Q3 2023 runout)
Health plans received the EVR I report with instructions for review and sign off via email on March 22nd. MTR findings that require further investigation from the health plan were included with the EVR I email, if applicable. Please feel free to reach out to Onpoint and/or the AMP Client Success Manager if you have any questions or concerns.
April 30: Submit Q1 2024 data files and 2023 Annual Member Identifier file
Health plans have until April 30 to submit Q1 2024 data files and the 2023 Annual Member Identifier file.
Q1 2024 data submission should include monthly eligibility between January 1, 2024 and March 31, 2024 and all claims paid or changed through March 31, 2024 that have not been previously submitted.
The Annual Member Identifier file should include eligible members enrolled for at least one day between 1/1/23-12/21/23 and are included in your eligibility file submissions (no continuous enrollment criteria apply).
Please see page 12 of the AMP Program Guide for a detailed data submission timeline.
in other news
Research from our advanced primary care team
Led by IHA and the California Quality Collaborative, our California Advanced Primary Care Initiative is bringing stakeholders together to increase investment in and access to a primary care model that strengthens the provider-patient relationship, reduces costs, and improves quality and equity.
The preview period for updates to the 2023–2024 Edition Health Care Quality Report Cards — Commercial and Medicare is scheduled to begin soon.
Prior to the preview period, organizations will be sent a link to access the OPA Stakeholder page. To be added to OPA’s mailing list, send an email to OPAReportCard@ncqa.org.
IHA partners with the California Office of the Patient Advocate (OPA) to publicly report AMP Commercial HMO and Medicare Advantage performance results each year. The report cards highlight overall performance and individual quality results for select clinical topics. Commercial report cards also include patient experience and total cost of care results.
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