Tech-Enabled Ways to Improve CAHPS Ratings

What’s one of the best ways to find out if a patient is getting quality care? Ask the patients themselves.

Patient experience surveys, like the Consumer Assessment of Healthcare Providers and System (CAHPS) survey, are important tools to understand how patients perceive their healthcare. The CAHPS survey is preferred over other surveys because it prompts patients to think about the experience rather than satisfaction. As a result, the CAHPS survey produces feedback that’s actionable and outcome-driven.

Although the CAHPS survey provides valuable insight into patient care, some providers and health plans find it difficult to improve CAHPS scores. This article will uncover some of the challenges with improving CAHPS scores and five tech-enabled ways providers and health plans can improve the patient experience.

In this article, we discuss:

• Why CAHPS Surveys are Important
• Challenges to Improving CAHPS Scores
• 5 Tech-Enabled Ways to Improve CAHPS Scores
• Medication Optimization and CAHPS Scores

Why CAHPS surveys are important

Surveys are important for patient feedback because they allow health plans and providers to see what’s important to their patients. The CAHPS survey can be an effective tool to improve the quality of patient care through a variety of ways.

Improving health outcomes and adherence.

Health plans can use CAHPS health plan surveys to promote a deeper understanding of the patient experience and identify gaps in care. Research has shown when the quality of healthcare delivery improves, the patient has a better care experience and better outcomes. Healthcare consumers with positive healthcare experiences are associated with improved adherence, better health outcomes, increased patient safety, and decreased costs.

Supporting patients in making informed decisions about their care.

Now more than ever patients are encouraged to be engaged in their care. As patients become more involved in their healthcare decisions, they rely on publicly available information for guidance on where, when, and how to receive care. The Agency for Healthcare Research and Quality (AHRQ) publicly releases the CAHPS survey, so patients have a place to compare survey results and find answers to questions about health plan services.

Enhancing a healthcare organization’s reputation.

The healthcare landscape is competitive, and health plans must put their best foot forward. Medicare Star ratings are a way for patients to compare the quality of care and performance of Medicare Advantage plans and Medicare Part D prescription drug plans. Health plans must have a strong Star rating. Data shows approximately 90% of consumers enrolled in Medicare Advantage plans that offer prescription drug coverage chose plans that received four or more stars. It is also believed that customer experience measures will continue to carry an important and increasing weight in the determination of overall Star ratings.

Challenges to improving CAHPS scores

Despite CAHPS surveys providing critical information about patient care, improving CAHPS scores has traditionally proven to be challenging.

Timeliness of CAHPS survey results

CAHPS surveys are often administered by mail, which means the patient experience survey data is not readily available. Given that survey results can take up to eight weeks, by the time the provider or health plan is aware of a problem, it could be too late to address it with the patient.

Frequency of CAHPS survey results

CAHPS surveys are also conducted annually, which means health plans are implementing patient quality improvement programs from retrospective data. As the pandemic demonstrated, patient needs and experiences can drastically vary from year to year, which could impact the relevance of the CAHPS survey results.

Standardized content

When the Agency for Healthcare Research and Quality (AHRQ) launched the CAHPS survey in 1995, they noticed existing patient experience surveys varied from health plan to health plan. The CAHPS surveys provide a way for comparative survey results through a standardized context. However, this format doesn’t allow for additional, personalized survey questions.

Declining survey response rate

Studies that have utilized CAHPS survey results show only a fraction of patients provide feedback. The most recent 2021 Medicare Advantage CAHPS survey saw a national response rate as low as 36%; a stark contrast to the 2001 response rate of almost 84%.

Participation Bias

Studies have also shown certain patient subgroups are less likely to respond to paper CAHPS surveys. Non-white, lower-income, and limited English-proficient patients in particular encounter greater barriers to answering the questionnaires. If the CAHPS survey results are not representative of various populations, health plans miss out on a diverse set of patient needs, opinions, and experiences.

5 Tech-Enabled Ways to Improve CAHPS Scores

In response to growing concerns from CAHPS survey users, AHRQ is researching ways to modernize the patient survey. As the new approach to CAHPS surveys takes shape, health plans can use technology to identify and implement ways to increase scores.

Predictive Analytics

Retrospective data has its disadvantages, however, predictive analytics can learn from the pain points, downward trends, and barriers to care identified in the patient surveys. An artificial intelligence platform can integrate all this data into predictive analytics that can identify members at high risk of having a negative patient experience.

Integrated patient data

The best patient-centered care has a full picture of the patient. Patient-centered data is often available in a disconnected way, where health teams must pull data from multiple sources to gain a deeper understanding of patient needs. Health plans with internal, centralized data that are readily accessible and easy to use can quickly respond to CAHPS surveys with a meaningful action plan.

Member engagement

Communication is often noted by patients as impacting CAHPS survey scores. Health plans that understand their members’ individual preferences related to the manner and frequency of communications can gain meaningful insight into their members’ needs. Targeted, omnichannel communication strategies can have a greater impact while reducing member friction. Health teams empowered with information are also well-positioned to intervene when patients need it most.

Provider engagement

Health teams often work in a silo, creating gaps in care and contributing to adverse patient outcomes. Improved patient outcomes are a team effort, which requires healthcare professionals to work together. Health plans should have a platform that allows for collaboration between providers, pharmacists, and other healthcare professionals when creating care plans.

Telehealth services

Patients don’t just rely on how well a provider executes their job when rating a health plan. Quality is, in fact, a measure of access to care. Access to care is another important patient-centered measure that impacts CAHPS scores. It’s no secret that disparities in access to care exist, and telehealth services have become an additional way for patients to gain access to care.

Medication Optimization and CAHPS Scores

Medication optimization can improve patient outcomes and enhance satisfaction

Most treatment plans - an estimated 80% - include medications. So, improving CAHPS scores cannot be done without improving medication management.

An effective medication optimization program can improve members’ health outcomes by addressing medication-related problems, improving access to care, and reducing healthcare utilization.

Patients with worse health outcomes - for example, those who had two or more visits to the emergency department - are more likely to report poor satisfaction scores.
Arine's medication optimization has been shown to reduce ED utilization by 47%.

Coordinated medication outreach and member satisfaction

Another way medication optimization can affect CAHPS is through care coordination. Research has shown that better care coordination can increase patient satisfaction. In one study, researchers found that improved care coordination could mean better communication between doctors’ visits or simply preventing a fragmented patient experience. Another study including patients with diabetes, found a robust positive relationship between care coordination and patient satisfaction with overall care (OR 1.78) and the way care was organized (OR 1.98).

A strong medication intelligence platform can help support coordinated and efficient outreach to patients and enhance members’ satisfaction. For instance, Arine’s platform enables care teams to improve coordination by:

Gathering all information in a single place where all care team members - providers, pharmacists, and other HCPs - can view the same 360-degree insights for each member. It enables them to address multiple topics in a single patient outreach, thus improving the patient experience.

Standardizing workflows while allowing personalization of the information for the individual member. The platform assigns and prioritizes actions for particular care team members so that outreaches are as impactful as possible and well-coordinated.

Continuously updating data and workflows in the platform ensures that care team members always have the latest information when they reach out to patients. This can also support improved member satisfaction.

The average member may sometimes feel bombarded with calls from their health plans. Indeed, such phone calls are usually in addition to calls from their healthcare providers and their pharmacies.

Using a complete medication intelligence platform like Arine’s, health plans can engage patients meaningfully while reducing the number of outreaches and increasing member satisfaction.

Reach for the best Star rating

CAHPS survey results are an important part of the Star measure and are seen as a reflection of the effort an organization puts into its patient experience. A strong medication optimization program can support both improved patient outcomes and member satisfaction. Arine's platform can be a valuable tool to help health plans on their journey to improved Star ratings and CAHPS scores. Review Arine’s Case Study on VNS Health to learn more about how Arine’s platform can enhance Star ratings and help your patients get and stay well: