Optimizing Your CAHPS® Survey Results

By HCDI Communications

Why is the CAHPS ® Survey Important to Health Plans

The Consumer Assessment of Healthcare Providers and Systems (CAHPS®) surveys are just around the corner!   CAHPS® is an Agency for Healthcare Research and Quality (AHRQ) program designed to understand patient experience to improve quality of care.  For over 25 years, AHRQ has conducted patient experience research through annual surveys, generally distributed between February and April, that ask consumers to evaluate their experiences with providers, including hospitals, primary care physicians, and specialists, and especially their health plans.

CAHPS® surveys ask a series of questions that focus on:

  • Communication skills
  • Ability to schedule timely appointments
  • Coordination of care
  • Ease of access to information

Patients, healthcare professionals, public and private healthcare purchasers, healthcare accreditation organizations, regional improvement collaboratives, and health plans leverage the CAHPS® survey results to evaluate and compare healthcare providers and improve patient experience.

Who are the Drivers of CAHPS ® Surveys for Health Plans
CAHPS ® surveys are administered among the following health plan improvement drivers:

  • The Centers for Medicare & Medicaid Services (CMS) conducts CAHPS ® surveys annually for Medicare beneficiaries with results, combined with other quality measures in “star ratings,” reported publicly on the Medicare Plan Finder website
  • CAHPS ® surveys are a National Committee for Quality Assurance (NCQA) accreditation requirement for commercial and Medicaid health plans
  • States require CAHPS ® survey collection and reporting of Medicaid health plans
  • Federal and State-Based Health Insurance Marketplaces will be required to conduct the Qualified Health Plan (QHP) survey, which is a version of the CAHPS ® survey, for their health plans and are incorporated into “star ratings” and may be reported on Marketplace websites

Best Practices for Optimizing Your Health Plan’s CAHPS® Survey Results
To ensure member satisfaction to optimize your CAHPS ® survey results, consider the following best practices:

  • Incorporating a year-round focus on improving CAHPS ® results that extends beyond the February to April survey period and should begin in October when the sales cycle starts
  • Leveraging data to gather customer insights through ongoing healthcare experience assessment surveys, disenrollment surveys, complaint tracking, customer service data, and grievance data
  • Cultivating and supporting an environment built on quality improvement (QI) by organizing QI teams and training staff in QI concepts and techniques
  • Developing member forms that are easy to use and understand
  • Paying attention to customer service that involves cultivating relationships with members built on effective, culturally intelligent communication, empathy, and accountability to resolve issues
  • Establishing an effective process for resolving member issues that includes effective communication, issue escalation, issue resolution, and above all else, member success
  • Recognizing and rewarding success among employees

HCDI Works With Health Plans to Improve Member Outreach

Healthcare Dynamics International (HCDI) has the tools to help any health plan with member outreach, with success connecting with even the hardest-to-reach, at-risk populations. Our diverse staff of over 150 full-time professionals is dedicated to ensuring engagement with members is culturally competent and empathetic while we work to close gaps in care.

During each interaction, HCDI has a unique member engagement approach. We not only work to close gaps in care, but we also assess their quality of care and address any social needs by providing the necessary resources, whether it is access to healthy food, housing assistance, or transportation to their primary care visits.

We also leverage state-of-the-art, trademarked data analytics tools to understand member demographics and report not only whole-community quantitative data, but also whole-person, qualitative data to help health plans gain better insight into member needs and opinions.

To learn more about our member engagement approach, visit hcdi.com or contact us directly at info@hcdi.com.

References:
https://www.ahrq.gov/