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Health Plans Medicare

4 Tips to Get Ahead of CAHPS

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As you settle into 2023, remember that patient experience Star Rating measures are now quadruple weighted. So, if plans want to keep members, they’ll need to offer an experience akin to what they’re getting from places like Amazon or Netflix. A portion of measures in this domain come from data collected during the annual CAHPS (Consumer Assessment of Healthcare Providers and Systems) survey, which is right around the corner. 

Official CAHPS results aren’t released until later in the year, and they aren’t particularly helpful because they are de-identified and vague, making it challenging for plans to address member pain points. 

The good news is that plans don’t have to wait for official CAHPS results to act. You can do several things now to ensure positive outcomes for your plan and members. 

Here are 4 tips our member engagement experts recommend you can proactively do right now to promote strong Star Ratings for next year: 

1. Revisit your 2022 survey results. Where did you shine? Where did you have pitfalls? Review your most recent results (especially those regarding member experience) to understand better where your members were and where you would like them to be. 

2. Clearly communicate members’ benefits. Lack of understanding or confusion about coverage are just two proven pain points that lead to member churn, so make sure to address them from the start. Use an IVR welcome call and onboarding emails to help your members understand their benefit offerings early. Covering topics like in-network providers, prescription coverage and costs, and out-of-pocket costs, like copayments/coinsurance, will prepare members to use your benefits and boost satisfaction. Bonus! This proactive type of education will also minimize Q1 call center volume. 

3. Connect members with the resources they need and want. Once your members understand their benefits, do they know what other health and wellbeing resources you give them access to? Help by showing them what resources are also included (i.e., telehealth, wellbeing programs, coaching and mental health resources) and how they can access them. Use multiple communications channels like email, text, and direct mail to educate and invite members to engage with these resources. 

4. Don’t wait for CAHPS to understand your member satisfaction rates. Launch a pre-CAHPS survey of your own. By conducting your own survey ahead of the blackout period, you can achieve more granular results to pinpoint population needs based on location, age, and more. To get the most out of your survey we recommend you: 

  • Use multi-channel communications (automated voice (IVR) calls, email, text, and direct mail) to reach more of your population. Start with the most cost-effective channel and add follow-ups for non-responders through an additional channel 
  • Be creative with transfer capabilities to easily connect members with an IVR survey. A call center team member can help address key issues on the spot, a unique way to improve your member’s experience 
  • Respond to any negative feedback you get so that when the actual CAHPS survey is taken, you’ve already turned that negative into a positive 
  • Evaluate if bi-lingual support for your communications makes sense to reach your Spanish-speaking population 

Virgin Pulse has the technology and multi-channel capabilities to help plans quickly execute simulation surveys to get a pulse check on member experience ratings before it’s too late.