What’s the Passing Score for the CPHQ Exam?

“What score do I need to pass the Certified Professional in Healthcare Quality (CPHQ) exam?”

People ask me this question from time to time, so I thought I’d write a brief article on the topic.

Let’s first back up and review some things about the exam. There are 140 questions – 125 of them will contribute to the scored examination result, the remaining 15 will be “pretest” questions (ones that are not included in your score but are being considered for future exams). These questions will cover a variety of “tasks” listed in the CPHQ exam content outline. The Healthcare Quality Certification Board (HQCB) has provided the following information:

The methodology used to set the minimum passing score is the Angoff method, applied during the performance of a Passing Point Study by a panel of experts in the field. The experts evaluated each question on the examination to determine how many correct answers are necessary to demonstrate the knowledge and skills required to pass this examination portion. Your ability to pass the examination depends on the knowledge and skill you display, not on the performance of other candidates.

In other words, a panel of subject matter experts examined the content of each item (question) on the exam and then estimated how many minimally-qualified candidates would answer the item correctly.

Based on the panel’s expert opinion, a pass/fail score (cut-score) is then determined. Not without controversy, the Angoff method is “empirical”, has undergone extensive research and meets the Standards for Educational and Psychological Testing.

That’s all fine. But it doesn’t really answer the question, does it?

Over the years, I got the impression from various sources that the passing percentage grade was 75%.

Being intrigued by this issue, I contacted the good people at the Healthcare Quality Certification Board (HQCB), now called the Healthcare Quality Certification Commission (HQCC), and received, among other details, the following information:

On the actual exam you need 92 questions correct out of the 125 total questions.

So there you have it. To pass the CPHQ exam, you’d need to correctly answer 92 out of the 125 questions (or 73.6%) that contribute to your score.

In truth, the quoted figure of 92 is not entirely accurate (yes, even if it came directly from the HQCC). Here’s why.

Why the Passing Score on the CPHQ Exam Varies Among Candidates

The questions on the exam are randomly pulled from a collection of questions – a question bank.

The question bank is divided into four pools (groups) of questions – one for each main category on the CPHQ exam content outline. As mentioned above, each candidate needs to answer 125 scored questions and 15 pretest questions. Among the 125 scored questions, there is a predetermined number the “CPHQ exam machine” (server) has to pull from each pool. For example, in 2020, we know there will be 35 questions on “Organizational Leadership.” Therefore, the “CPHQ exam machine” will pull exactly 35 questions of scored questions from the “Organizational Leadership” pool of questions. Likewise, the machine will pull 30 questions randomly from the “Health Data Analytics” pool of questions.

Because the questions on each test are pulled randomly from the question bank, the set of questions Candidate A sees on his/her test are very unlikely to be exactly the same as those Candidate B encounters on his/her test.

Of course, both candidates will see some identical questions on their respective tests – this number will be high (many) if the pools of questions (one pool for each main category) are relatively small and low (few) if the pools are large. Due to the randomization process, there will be some questions Candidate A sees on his/her test that Candidate B won’t, and vice versa.

And because the questions have different levels of difficulty, the passing score – or cut-score if you like – must take into account the overall level of difficulty of the entire set of questions to make things fair. Enter the Angoff method.

Therefore, the passing score may be ⁹²/₁₂₅ as reported to me by the HQCC. But, depending on the relative difficulty of the set of questions on any particular test, the cut-score may be a little higher or a little lower than 92.

For example, if, by chance, the overall difficulty of the questions on your test is a little higher than average, you may need to answer only 91 (instead of 92) of the 125 scored questions correctly to pass the exam. On the other hand, if the questions were less difficult overall on your test, you may need to answer 93 or even 94 questions correctly to be deemed to have passed.

Why Knowing the Passing Score Matters Little

In my opinion, knowledge of how many questions you need to get correct is more academic than practical. This is because most candidates can’t tell the difference between the “real” (i.e. scored) exam questions and the pretest (unscored) ones.

Therefore, as a rough guide, the minimum number of correct responses to pass the exam is 0.736 × 140 = 103. You will only see the number of scored questions you answered correctly for each of the four main exam categories (plus the total number, which is the sum of the numbers for each category) on your score report – you will not see how well you did on all 140 questions, i.e. with the unscored questions included.

Conclusion

The passing score for the CPHQ exam ranges between ⁹¹/₁₂₅ and ⁹⁴/₁₂₅. (Don’t quote me on this point because the range may be a little wider, though I am 95% confident candidates will have their pass/fail score in the 91–94 range. This confidence is based on what tens, if not hundreds, of test takers have reported to me.)

Remember that the passing scores quoted above refer to the number of scored questions that “minimally-qualified” candidates would answer correctly, as predicted by a panel of experts.

With proper preparation, most test takers will perform much better than the minimum standard.