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Frequently Asked Questions Insurance

How does OPM evaluate HEDIS Corrective Action Plans (CAPs)?

(a)   Please see Attachment 3 of Carrier Letter 2013-22 for the process and information required for OPM review of CAPs.

(b)   We are encouraged by the improvement in HEDIS results and look forward to additional performance gains in the coming year. Please note that progress toward HEDIS goals will be reflected in OPM's overall health plan evaluation. Contract specialists will pay particular attention to any health plan that declines in overall evaluation score, and any health plan remaining below OPM's minimum performance threshold despite two or more Corrective Action Plans for the same metric(s).

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