The CAHPS Survey | Denver Health Medical Plan

About CAHPS

The CAHPS (Consumer Assessment of Healthcare Providers and Systems) survey is a tool for collecting standardized information on members' experiences with their health plan and services.

Since its launch in 1997, this survey has become the national standard for measuring and reporting on the experiences of consumers with their health plans.

A version of this survey is conducted in almost every state in the U.S. CAHPS measures health care consumers' satisfaction with the quality of care and customer service provided by their health plan.

DHMP CAHPS

Denver Health Medical Plan (DHMP) utilizes the mixed web-mail-telephone protocol. This includes mailing a questionnaire with a cover letter, mailing a web invitation for those with an email address. For those selected members who did not respond to the first questionnaire, a second questionnaire with a cover letter encouraging participation is sent and/or a second web invitation is emailed. If a selected member still does not respond to the questionnaire, at least three telephone calls are made to complete the survey using trained telephone interviewers.

Provider Tips for the CAHPS Survey

Help Improve Member Ratings of the Plan

In early March, many of our Elevate Medicare Advantage members will be asked to rate their experience with their health plan and their doctors in a Medicare Experience survey. It is also known as the CAHPS (Consumer Assessment of Healthcare Providers and Systems) survey.

What is the CAHPS Survey?

An annual survey mandated by CMS on the satisfaction of a member’s (or patient’s) health care experience over the last 6 months
The survey is conducted via mail and phone from early March through early June
Impacts the health plan’s CMS Star Rating

Provider Impact

Our members directly interact with you, as their provider, and it directly impacts these scores. Members will be asked questions on their experience with their provider. This guide is designed to help identify the survey questions and provide tips on how to shape the patient’s satisfaction.

Experience Is Not the Same as Satisfaction

Patient experience surveys sometimes are mistaken for customer satisfaction surveys. Patient experience surveys focus on how patients experienced or perceived key aspects of their care, not how satisfied they were with their care. Patient experience surveys focus on asking patients whether or how often they experienced critical aspects of health care, including communication with their doctors, understanding their medication instructions, and the coordination of their healthcare needs. They do not focus on amenities.

GETTING NEEDED CARE
CAHPS Survey Questions	Tips & Recommendations
In the last 6 months, how often was it easy to get the care, tests or treatment you needed?	Have patients be a part of the decision-making process regarding their care (e.g., tests/labs, referrals or treatment options). Encourage patients to pre-schedule their next appointment. Remind patients 48 hours before their appointment to reduce no-shows. If transportation is an issue, remind them they have unlimited rides to medical visits through Access2Care.
In the last 6 months, how often did you get an appointment to see a specialist as soon as you needed?

GETTING APPOINTMENTS AND CARE QUICKLY
CAHPS Survey Questions	Tips & Recommendations
In the last 6 months, when you needed care right away, how often did you get care as soon as you needed?	Apologize and explain the reason for delayed wait times. Remind patients of available care options (e.g., telehealth, NurseLine, DispatchHealth or Urgent Care facilities). Provide prompt responses to messages/voicemails based on urgency. Remind patients 48 hours before their appointment to reduce no-shows. If transportation is an issue, remind them they have unlimited rides to medical visits through Access2Care.
In the last 6 months, how often did you get an appointment for a check-up or routine care as soon as you needed?
In the last 6 months, how often did you see the person you came to see within 15 minutes of your appointment time?

CARE COORDINATION
CAHPS Survey Questions	Tips & Recommendations
In the last 6 months, when your personal doctor ordered a blood test, x-ray or other test for you, how often did someone from your personal doctor’s office follow up to give you those results?	Schedule/order tests and labs before patient leaves the office. Inform patient how to view their lab/test results and/or when you will reach out. Remind patients to enroll in the Patient Portal (e.g., MyChart) so they can see the results. Review lab and test results at follow-up visits. Review patient medication at each visit. Offer lower cost/tier medications, if appropriate. Offer 100-day supply. Remind patient of the mail-order program. Discuss the importance of medication adherence and address any concerns or side effects that members may have. Work with patients to come up with a strategy or plan to help maintain/improve their health issues.
In the last 6 months, when you visited your personal doctor for a scheduled appointment, how often did he or she have your medical records or other information about your care?
In the last 6 months, how often did you and your personal doctor talk about all the prescription medicines you were taking?
In the last 6 months, did you get the help you needed from your personal doctor’s office to manage your care among these different providers and services?
In the last 6 months, how often did your personal doctor seem informed and up to date about the care you got from specialists?

DOCTORS WHO COMMUNICATE WELL
CAHPS Survey Questions	Tips & Recommendations
In the last 6 months, how often did your personal doctor explain things in a way that was easy to understand?	Practice good bedside manners and actively listen to patients. Ask confirming or follow-up questions to ensure that patient concerns are addressed. Address patients appropriately. Ask if all questions or concerns have been addressed. Encourage members to keep a list of questions and bring it to the appointment. Treat patients with courtesy and respect. Minimize the use of technical/medical language that may be difficult for patients to understand.
In the last 6 months, how often did your personal doctor listen carefully to you?
In the last 6 months, how often did your personal doctor show respect for what you had to say?
In the last 6 months, how often did your personal doctor spend enough time with you?

GETTING NEEDED PRESCRIPTION DRUGS
CAHPS Survey Questions	Tips & Recommendations
In the last 6 months, how often was it easy to use your prescription drug plan to get the medicines your doctor prescribed?	Send prescriptions to the patient’s pharmacy of choice before they leave the office. Order 100-day supply of all applicable medications. Check to make sure that specialty medications are covered by the patient’s insurance. Help patient set up mail order prescriptions. If member is going to be traveling, remind them to request a vacation supply from their health plan.
In the last 6 months, how often was it easy to use your prescription drug plan to fill a prescription at your local pharmacy?
In the last 6 months, how often was it easy to use your prescription drug plan to fill a prescription by mail?

FLU VACCINE
CAHPS Survey Questions	Tips & Recommendations
Have you had a flu shot since July 1 of the prior year?	Offer the flu shot while patient is at their appointment. Order flu vaccines as soon as it’s available. Inform patients of outside flu clinics if the vaccine is not available in the office.