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Health Plans Medicare

4 Tips to Get Ahead of CAHPS

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As you settle in to 2022, don’t forget to keep your eyes on 2023 when patient experience Star Rating measures become quadruple weighted. 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. There are several things you can do now to ensure positive outcomes for your plan and members.

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

1. Revisit your 2021 survey results. Where did you shine? Where did you have pitfalls? Review your most recent results (especially those regarding patient experience) to get a better understanding of where your members were and where you would like them to be.

2. Clearly communicate member’s 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-pockets 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. 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 where/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:

  • Cut to the chase. If you could only ask your members five questions to understand their experience, what would they be?
  • 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
  • Think outside the box with transfer capabilities to easily connect members with an IVR survey. A call center team member can help address major issues on the spot, a unique way to improve your member’s experience
  • 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.