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net promoter score

nps_scr
quality·Updated Jun 23, 2026

Definition

ISO-11179 Definition

A member loyalty metric calculated from a single survey question asking how likely the member is to recommend their health plan or provider to a friend or family member on a scale of zero to ten, with promoters scoring nine or ten, passives scoring seven or eight, and detractors scoring zero through six. Net Promoter Score is calculated by subtracting the percentage of detractors from the percentage of promoters, producing a score ranging from negative 100 to positive 100. Health plan NPS scores typically range from negative 20 to positive 30 with higher scores indicating stronger member loyalty and advocacy.

NPS is used as a leading indicator of member retention because high scores predict lower voluntary disenrollment rates. Healthcare data teams track nps_scr by plan product, member demographic segment, geographic market, and provider attribution to identify loyalty drivers and at-risk populations, correlate NPS with subsequent retention and disenrollment behavior, and measure the impact of member experience improvement initiatives on loyalty scores across the enrolled population.

Standard Abbreviation

nps_scr

Category

quality

Production DDL — FACT_QUALITY_MEASURE

FACT_QUALITY_MEASURE.sql
CREATE OR REPLACE TABLE FACT_QUALITY_MEASURE (
    qlty_key        INTEGER        NOT NULL  -- surrogate key,
    mbr_key         INTEGER        NOT NULL  -- FK to DIM_MEMBER,
    plan_key        INTEGER        NOT NULL  -- FK to DIM_PLAN,
    meas_yr         SMALLINT                 -- measurement year,
    hedis_meas_cd   VARCHAR(20)              -- HEDIS measure code,
    denom_ind       CHAR(1)                  -- denominator eligible,
    numer_ind       CHAR(1)                  -- numerator met,
    excl_ind        CHAR(1)                  -- exclusion indicator,
    gap_open_ind    CHAR(1)                  -- care gap open,
    star_rtg_nbr    DECIMAL(3,1)             -- star rating,
    qlty_scr        DECIMAL(5,2)             -- quality score,
    perf_thrsh_pct  DECIMAL(5,2)             -- performance threshold,
    raf_scr         DECIMAL(10,3)            -- risk adjustment factor,
    outreach_cnt    SMALLINT                 -- outreach attempts,
    load_dt         TIMESTAMP_NTZ  NOT NULL  -- load timestamp
);

Standard Snowflake DDL for the canonical quality table. Convert to BigQuery or Databricks →

Why This Term Matters

Quality measure data determines how payers and providers are rated and reimbursed under CMS Stars, HEDIS, and value-based care contracts. Data engineers who understand quality terminology build measure calculation pipelines that correctly attribute patients, apply denominator exclusions, and flag documentation gaps before submission deadlines. Incorrect quality data directly affects star ratings, pay-for-performance bonuses, and Medicare Advantage plan bids.

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