What is CAHPS?

The National Committee for Quality Assurance (NCQA) and the Centers for Medicare & Medicaid Services (CMS) require health plans to conduct a member satisfaction survey called the Consumer Assessment of Healthcare Providers and Systems (CAHPS). Results are produced annually and compared with national benchmarks. The surveys are administered in early spring by mail, with telephonic follow-up for nonresponders; results are available in late summer for commercial and Medicaid health plans and later in the year for Medicare.

CAHPS is a member survey that gauges satisfaction with services provided by the health plan and member perception of provider accessibility, patient-physician relationship and provider communication. The survey has approximately 70 questions; results are reported in composites and overall ratings.

There are several questions relating to member satisfaction with physicians. These may be of interest, as they pertain to the patient-physician relationship and may provide improvement opportunities in everyday practice, such as:

Shared Decision-making (commercial measure): Measures the patients’ experiences with physicians in discussing pros and cons of treatment and asking what was best for the patients

Health promotion and education (commercial measure): Measures the patients’ experience with physicians in discussing ways to prevent illnesses

Coordination of care (commercial measure): Measures the patients’ perceptions of the personal physicians’ knowledge and if the personal physicians were up-to-date about the care their patients received from other health care providers 

How well physicians communicate (commercial, Medicaid and Medicare measure): Measures the patients’ experiences with whether the physicians listened, explained, spent time with the patients and respected what the patients had to say 

Getting care quickly (commercial, Medicaid and Medicare measure): Measures the experiences the patients had in receiving care or advice in a reasonable time, including time spent in the offices waiting rooms

Getting needed care (commercial, Medicaid and Medicare measure): Measures the experiences the patients had when attempting to get care or services from physicians, specialists, including treatments or tests  

Rating of health care (commercial, Medicaid and Medicare measure): This survey item gives patients an opportunity to rate all the health care they have received in the last six to12  months

Rating of personal physician (commercial, Medicaid and Medicare measure): This survey item asks the patients to rate their primary physicians’ performance over the last six to 12 months

Rating of specialist (commercial, Medicaid and Medicare measure): This rating measures patients’ experiences with specialists over the last six to 12 months

Rating of health plan (commercial, Medicaid and Medicare measure): This rating measures the patients’ overall experiences with their health plans over the last six to 12 months

The CAHPS survey also contains effectiveness of care measures. Members are asked about whether they received flu/pneumonia shots, direction from their physicians on aspirin usage and if their physicians discussed tobacco cessation.

Actions physicians can take:

Communicate to patients thoroughly, completely and in a manner they understand

Specialists should communicate to patients’ primary physicians on status, tests, medications, outcomes, etc.

Submit referrals and obtain authorizations as appropriate

Facilitate appointments, schedule for urgent cases and limit patient wait times

Be aware of the time patients wait 

Listen to patients and make sure they understand orders and communications

Encourage preventive measures, such as influenza and pneumococcal vaccines

Also see ‘HEDIS‘ and ‘HOS‘