CAHPS survey results already comprise a significant part of a
health plan’s Star rating. And with CMS placing more weight on CAHPS survey
results going forward, improving member satisfaction has become an urgent
priority for Medicare Advantage plans nationwide.
CAHPS already comprises approximately 20% of a plan’s Star rating.
When CMS increases the weight of those measures from 1.5 to 2.0, as they’ve
said they intend to, that will jump to 25%.
In addition to the quality bonus payments and rebates at stake,
CAHPS scores are also critical because they’re closely linked to member churn.
Among the Part C CAHPS measures, C26: Rating of Health Plan, is the strongest
predictor of voluntary disenrollment. Members of the lowest-rated health plans
are 4X more likely to churn than members in the highest-rated plans.1 Given
what’s at risk, it’s no surprise health plans are prioritizing efforts to
improve member satisfaction in the hopes of impacting CAHPS.
Why your current CAHPS strategy
is incomplete
More than half of the CAHPS survey measures things that are
largely out of a plan’s control, such as how well members like their doctor,
and how easy or hard it was to get an appointment with a specialist. So most
plans focus on provider engagement initiatives to help address these
patient/provider experience measures.
But what about the member/health plan experience? Nearly 40
percent of the Part C CAHPS measures reflect a member’s experience with their
health plan. If you’re only focusing on the measures providers can impact,
you’re missing a big opportunity to proactively address the member experience
measures within your control.
Another tool plans often use, mock CAHPS surveys, are helpful to
identify members who are unsatisfied, but they don’t do anything to address the
reasons behind the dissatisfaction. Plus, they’re reactive; the members who
respond negatively are already dissatisfied.
The psychology of member satisfaction matters—it’s what
separates HEDIS measures from CAHPS. Unlike HEDIS measures that deal in
numerators and denominators, CAHPS measures deal in thoughts and feelings.
They’re highly subjective, which makes them far more difficult for plans to
impact.
Introducing NovuHealth’s Member
Satisfaction Solution
NovuHealth’s Member Satisfaction Solution is designed to help
health plans proactively address the most common sources of member
dissatisfaction—and the Part C measures plans can address directly. We zero in
on the members who are unhappy and/or unengaged, and we engage those members
and reward them for completing activities that support their health. The
result? An improved member experience, enhanced member satisfaction, and a
positive impact on your CAHPS measures.
1”Beneficiary
Reported Experience and Voluntary Disenrollment in Medicare Managed Care,”
Health Care Financing Review, 2003
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