The Consumer Assessment of Healthcare Providers and Systems (CAHPS) is an annual survey that asks a random sample of health plan members about their experiences with their health plan and providers in the past six months.
- CAHPS questions are based on members’ experience and perception — meaning that any patient interaction can impact CAHPS scores.
- The Centers for Medicare and Medicaid Services (CMS) considers CAHPS and the member experience to be so important that currently, approximately 40% of a health plan’s Medicare Star Rating is based on the survey scores.
The CAHPS survey is scheduled to take place during the second quarter of 2024.
CAHPS Measures
There are nine CAHPS measures that are incorporated into a plan’s Star Rating, with four presenting a strong opportunity for providers to positively impact the patient experience:
- Getting Appointments and Care Quickly
- Getting Needed Care
- Care Coordination
- Rating of Health Care Quality
These measures contain questions that ask members if they found it easy to get the care, tests, and treatment they needed; if they were able to get appointments for routine and specialist care when needed; if their doctor was informed about their care and helped to manage it and they received test results when they needed them; and the overall rating of the quality of their health care.
Collaboration Is Key
Collaboration between health plans and providers is key to ensuring that members/patients have positive health care experiences. Providers and practices that have seen high patient satisfaction results generally do the following:
- Follow up with patients when they have seen another provider or specialist.
- Ask about prescription drugs patients may now be taking.
- Share pertinent clinical information with your patient’s other providers through a HIPAA-compliant health information exchange, such as Availity®
.
- Assist patients with scheduling tests and referral appointments.
- Let patients know when to expect test results, and who will provide them.
Your staff can also improve patient satisfaction by:
- Leaving some open appointment slots each day for urgent and post-inpatient visits.
- Reducing perceived wait times by assigning staff to perform preliminary work-up activities, such as blood pressure and temperature checks.
- Providing brief and frequent updates for appointment schedule delays and offering options to reschedule or be seen by another provider.
- Encouraging patients to make routine checkup or follow-up appointments in advance.
- Proactively scheduling patients — by phone, text, or email — months in advance for tests, screenings, or physicals.
For more information about the CAHPS health plan survey, click here.
Provider News, Issue 10, October 2023 | © 2023 Highmark Blue Shield of Northeastern New York
