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Understanding the CAHPS® survey

The Consumer Assessment of Healthcare Providers and Systems (CAHPS)* survey is a great tool to help ensure safe, quality and coordinated patient care. Learn more about CAHPS, and the benefits to you.

What is CAHPS?

What is CAHPS?

The CAHPS survey asks consumers and patients about their experiences with health care. The survey standardizes this information to ensure safe, quality, and coordinated care. CAHPS covers topics that are important to consumers. It also focuses on aspects of quality that consumers are best qualified to assess, such as the communication skills of providers and ease of access to health care services. 

Your health organization probably hears a lot of feedback from Medicare patients that could improve their quality of care. And as a healthcare provider, chances are you want to do two things:

 

One, provide quality care for each of your patients. And two, expand your patient-base.   


But how do you get valuable patient data without the excess noise?

 

The Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Health Outcomes Survey (HOS) are two surveys that can help fine-tune your care approach and achieve your practice goals.

 

What do these surveys cover?

 

The CAHPS survey focuses on quality measures, things like the communication skills of providers and ease of access to health care services.

 

The HOS survey measures patient-reported outcomes related to mental and physical health.

 

The data from these surveys influences quality improvement and pays for performance and enhancements to the overall healthcare experience — so these surveys are very important for both you and your health plan partners.

 

Plus, positive patient experiences can improve health outcomes and they can lead to more meaningful patient-provider interactions.

 

When patients feel their doctor cares, they develop a greater sense of loyalty and they're more likely to stay committed to a specific provider.

 

But which talking points should you discuss with your patients to improve their experience? Follow the links to these modules for some tips that can help with your patient care, outcomes and retention.

 

For more information on the surveys and access to a detailed pocket guide full of tips on how to keep applying the CAHPS and HOS best practices, visit our library of materials in the Availity Aetna Payer Space resource tab. You can also contact your Aetna representative to learn more.

Why does CAHPS matter?

Why does CAHPS matter?

CAHPS performance is key to several objective health care evaluations to learn how members believe their health plan supports them in:

 

  • Improving and maintaining their health
  • Managing chronic conditions
  • Ensuring satisfaction with customer service and pharmacy services

Programs like the National Committee for Quality Assurance (NCQA) Health Plan Accreditation rely on CAHPS to measure Medicare star ratings. Star ratings were created to help beneficiaries assess their care needs against the quality of Medicare Advantage health plans care and service. The Centers for Medicare & Medicaid Services (CMS) assigns scores to Medicare Advantage plans based on over 50 service and care quality measures across 5 important categories.

 

Benefits for providers

 

The CAHPS survey lets you see how you provide care through your patients’ eyes. CAHPS encourages quality care through an enhanced relationship with patients. Survey insights allow you to develop enhanced plan relationships with patients that include greater emphasis on preventive medicine and early disease detection and stronger decision support for chronic condition management. For patients and their caregivers, you can bring increased awareness of patient safety issues for a holistic approach to care.

Patient Experience Survey

As an Aetna provider, we’re here to help you meet the standards of care measured by CAHPS to assign performance scores for Medicare Advantage plans. That is why we developed our patient experience survey sent to our Medicare Advantage members.

Each year, Medicare members are given surveys by the Centers for Medicare & Medicaid Services (CMS), such as:

 

  • The Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey

  • The Health Outcomes Survey (HOS)  

In addition, we also conduct a patient experience survey for Aetna Medicare Advantage members. This survey focuses on metrics that are important to you. Patients will be asked to complete this digital survey after an in-person visit with a provider. It’ll help us understand their perceptions of the care they get from providers like you.

Who gets the survey

 

We select an Aetna member for the survey based off the medical claims or encounters submitted to us within the last 90 days. On average, a selected member will receive a survey within 45 days of their visit. They may receive a subsequent survey if they have had a visit within 180 days.

 

When the survey is sent

 

However, the timing of a survey varies based on when we receive claims from a visit. Within 30-45 days of receiving a claim for any visit to their PCP, including annual wellness visits, annual physical exams and other outpatient PCP visits, we’ll survey the member digitally.

 

Explore our new Patient Experience Playbook for all the information you need to serve Aetna Medicare Advantage members, including the latest updates about the patient experience survey, questions and scoring.

 

Explore our Patient Experience Playbook (PDF)

 

CAHPS resources for providers

The heart of the Aetna network is providers who ensure patients receive safe, high quality, and coordinated care. We have developed these resources to give you the tools, data, and knowledge to provide the best care possible while keeping patients informed throughout their health care journey.

 

Resources for your patients

Patients are an important part of health care. The resources below will help empower them to take charge of their well-being.

 

Notes

*FOR CAHPS SURVEY DETAILS: CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).

Legal notices

Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).

Health benefits and health insurance plans contain exclusions and limitations.

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