On CAHPS surveys
CAHPS stands for Consumer Assessment of Healthcare Providers and Systems. Here’s a brief 101:
- WHAT: 15-minute or less survey to Medicare beneficiaries about their experiences (what happened and how often) with their healthcare providers and plans²
- WHO COMPLETES SURVEYS: Medicare beneficiaries (assigned randomly)³
- WHO COLLECTS THE RESULTS: Agency for Healthcare Research and Quality (AHRQ), a federal agency charged with improving the safety and quality of America’s healthcare system²
- WHO USES THE DATA: Centers for Medicare & Medicaid Services (CMS), healthcare providers and plans to better understand patient experiences4
- WHEN THE SURVEYS OCCUR: March–June annually5
- WHY CAHPS SURVEYS MATTER: CMS uses CAHPS survey responses to develop Medicare Star Ratings, which aim to empower beneficiaries to select the right plan for them with meaningful information about plan quality1
Take a deeper dive into CAHPS below.
What gets measured?
CAHPS surveys aim to understand the range of interactions beneficiaries have with the healthcare system by asking about provider communication, timely access to care, coordinated care and access to information. Here are the measurement categories:6
- Getting appointments and care quickly
- Care coordination
- Getting needed care
- Customer service
- Getting needed drugs
- Overall rating—healthcare quality
- Overall rating—healthcare plan
- Overall rating—drug plan
Which parts of the healthcare system get measured?
CAHPS surveys ask about the full spectrum of the healthcare system from primary care to hospitals, mental health to health plans. CAHPS surveys seek to measure patients’ experiences wherever they encounter care whether that’s in a facility or at home.7
- Clinicians and medical groups
- Home health care
- Surgical care
- Cancer care
- Mental health care
- Dialysis centers
- Nursing homes
- Outpatient ambulatory surgical centers
- Medical plans
- Dental plans
- Home- and community-based services
Why should agents and members care about CAHPS surveys?
Agents can help strategically identify where members face challenges or barriers to maximizing the benefits of their plan. Pay special attention to coverage education, customer service and helping them find the right care for them.
CAHPS surveys are how real people’s experiences get accounted for in the quality ratings. Medicare consumers use the Star Ratings to make informed choices.¹
CAHPS surveys matter to providers and health plans so they can compare and assess their performance to similar organizations, pinpointing strengths and weaknesses to develop plans to improve the member experience.4
A knack for knowledge
Must-have agent resources
Sharpen your pencils and get ready to school yourself in delivering positive member experiences all year long with these three on-demand agent tutorials.Explore resources
Got CAHPS survey or Medicare Star Ratings questions? Tee up your dedicated local Humana support team. Or feel free to call or email too.