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Member Experience Surveys

Consumer Assessment of Healthcare Providers and Systems (CAHPS)®

CAHPS® is an annual survey, mandated by the Centers for Medicare & Medicaid Services (CMS), that asks health plan members about their experiences and satisfaction with their providers, access to care, and the health plan.

A random sample of members, both adults and caregivers of children, receive the survey between February and May.

Members receive the survey via:

  • Mail - paper survey with cover letter that includes URL & QR Code options
  • Email
  • Phone follow-up - if member hasn't returned the paper copy or electronic copy

Why the CAHPS Survey is important to you

  • CAHPS® survey scores are publicly reported and compared across the industry, influencing individuals to seek coverage and care from the highest performing physicians and health plans.
  • The Medicare CAHPS Provider Scorecard you might receive at the beginning of the year is based on the "Mock" CAHPS survey, which is sent to a random selection of Medicare members in the summertime. This survey includes many of the same questions as the standard CAHPS survey. As you work with your Quality representative to address opportunities in your Scorecard, you will positively impact your overall patient experience reflected in the standard CAHPS survey.   
  • Trust and communication between providers and their patients can improve clinical outcomes, patient adherence, and patient safety.
  • Patients’ interactions with their providers directly impact their healthcare experience and perception of quality care. By focusing on patient satisfaction with each visit, you help provide a positive experience year-round.
  • We partner with you to help improve patients’ experiences and raise quality scores on Consumer Assessment of Healthcare Providers and Systems (CAHPS®) measures.

CAHPS topics about providers include:

  • Access to Care - Getting Care Quickly
    • Got care as soon as needed when care was needed right away (urgent care)
    • Got check-up/routine care appointment as soon as needed (routine care)
  • Access to Care - Getting Needed Care
    • Ease of getting care, tests, or treatments needed
    • Getting appointment with a specialist as soon as you needed
  • How Well Doctors Communicate
    • Personal doctor explained things in an understandable way
    • Personal doctor listened carefully to you
    • Personal doctor showed respect for what you had to say
    • Personal doctor spent enough time with you
  • Coordination of Care between their PCP and specialists
  • Overall rating of their health care
  • Overall rating of their personal doctor
  • Overall rating of their specialist

Tips for improving provider-related scores and more information around CAHPS

CAHPS - Outpatient Mental Health Survey (OPMH)

Trillium also supports ongoing measurement of member experience with mental health and substance use disorder services. The Outpatient Mental Health Survey (OPMH) assesses adult and child patient experience in receiving mental healthcare over the prior six months. OPMH results are reviewed by the Quality team and leadership to identify specific recommendations for performance improvement interventions or actions.

This annual survey assesses the following measures of patient experience. Many of the metrics are comprised of multiple questions:

  • Getting Appointments for Prescription Medicines
  • Getting Mental Health Counseling
  • Communication with Mental Health Counselor
  • Goal Setting
  • Getting Help Between Appointments
  • Rating of Mental Health Counselor
  • Unmet Need for Mental Health Services
  • Financial Barriers for Mental Health Services 

Understanding the survey questions to which members are responding may inform provider/patient conversations as well as areas of opportunity and care planning, leading to better patient outcomes, effective treatment, and member experience.