member engagement

CAHPS: The new key to Star

  • Posted on

  • Written by Dan Ready

Recent CMS updates crown member experience and more specifically, CAHPS, as king. It's now more important than ever to deliver a top-tier member experience and elevate the perception of the plan in your members' eyes.

When CMS announced its Contract Year 2021 Star Ratings formula updates, the agency sent a clear message - positive member perception is now the most cruical ingredient to Star success.

Excelling on the CAHPS Health Plan Survey has incredible benefits. It leads to improved Medicare Star scores, increased revenue, and increased enrollment for a health plan organization. Over the years, these things have rung true, but now they’re truer than ever.

CAHPS and administrative measures will now be 2x-weighted for 2021 ratings and then doubled to a 4x-weight for the 2023 ratings. This will drive exponential ROI from all initiatives focused on the 2021 ratings since member experience initiatives that impact CAHPS and member perception have a long-lasting effect.

With CMS increasing the weight of these experience measures derived from the Consumer Assessment of Healthcare Providers & Systems (CAHPS) survey and having retired other measures such as the adult body mass index assessment, 32% of the Star rating will now represent member perceptions.

These updates put CAHPS front and center, giving HEDIS a backseat when it comes to obtaining Star success. In order to effectively improve member perception to elevate CAHPS ratings, health plans must be proactive in their planning and strategize heavily around member engagement initiatives that will be meaningful for their members.

To help with goal setting and member outreach planning, we’ve launched a CAHPS Outreach Calculator. The calculator should prove to be a useful resource when estimating the number of members your plan needs to engage with to meet your CAHPS rating goals.

Click here to access the calculator and discover what it will take for your organization to get to the next Star.