Boost Star ratings with a focus on CAHPS®

OnTrendIn a value-based model world, there are fewer points of differentiation for health plans seeking to show increasingly engaged consumers that quality comes first. Plans are beginning to realize that establishing a year-round focus on the annual Consumer Assessment of Healthcare Providers & Systems (CAHPS®) survey is essential to reaching that level of separation.

CAHPS scores account for 17 percent of all Star points and directly address the customer experience. Enterprise-wide and year-round improvement efforts that drive member satisfaction and leverage data assets can help health plans raise their Star ratings.


Why the focus on CAHPS now?

There is a correlation between achieving four and five stars and high 10-26-2016-9-37-03-pmCAHPS scores. The health plans achieving both understand that improving member satisfaction doesn’t happen in a silo — it’s an integrated effort throughout the organization. Mining your CAHPS data will provide the insight into those areas that could use improvement or enhancement, and help you identify the organizational or operational changes that will increase enrollment and reduce attrition.

As consumers become more knowledgeable about health care, they have shown they are willing to shop around for Medicare Advantage plans that meet more of their expectations. A reputation for high customer satisfaction is one of those expectations. There is a tendency to get caught up in the initial enrollment phase, but the customer experience does not end with the sales cycle. Beginning with onboarding and continuing through the year as members engage with their plan and the health system, there are opportunities for member outreach and to correct issues that rise.

For more insight into the impact of CAHPS on Star ratings, download our latest issue of OnTrend — “Star Ratings: Boosting ratings with CAHPS scores.”

2. Threnhauser S C. Medicare Advantage Star Ratings create new market opportunities. Open Minds. March 26, 2016.


About the Author:

Brandon Taylor, JD, MBA
Director of Clinical and Quality Solutions, Optum

Brandon is responsible for product strategy and growth of the Stars line of business. His expertise includes leading HEDIS and Stars strategy, in addition to HIE and EMR data integration strategy, for the first national publicly traded company to receive a 5-Star rating. He also managed IT innovation projects for one of the largest health plans in the industry.


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