member engagement

Talking CAHPS: Changing member perception & behavior

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  • Written by Dan Ready

In this series of interviews, we look at the three key elements of a CAHPS improvement strategy. I sat down with Lisette Roman, Decision Point’s Director of Analytics, to learn how to beat CAHPS through data insights.

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. But having the right information to improve performance on CAHPS can be challenging. Here at Decision Point, we have developed a data-driven solution to boost survey performance. In this series of interviews, we look at three key elements of a CAHPS improvement strategy. For the third and final edition, we focus on elevating member perception and changing member behavior.

So far we’ve covered understanding personas and identifying the right members to target. What can plans do once they’ve targeted those members to change member behavior and perception to the extent that it impacts performance on CAHPS?

Ultimately, we’re trying to change the future; to intervene with a member so that his or her likely negative response becomes a positive response. This requires some skilled engagement – knowing what the member’s issues are when reaching out to that member, reaching out in the right way, and resolving his or her issues. Sometimes it’s as simple as helping a member to understand the plan benefits because they were unaware of their $0 copays or another perk the plan offers. With some education, we can change a member’s impression of the plan and better engage them in their care.

We typically work with our health plan partners to understand what resources are available and then match those resources to the right members, as I started to discuss last time. Does the plan have a call center and a dedicated team who can have these sometimes tricky conversations? Is the budget this quarter pushing towards more mailers than live calls? We’re able to help in a couple ways. First, knowing the type of member that is more receptive to certain types of outreaches (live calls, mailers, SMS, etc.). Second, knowing what types of outreaches are effective at different points over the course of the year.

Can you say more about the timing of outreaches to impact CAHPS?

Sure. These conversations about CAHPS related issues should be timed as per of a year-round strategy. First, just in time before CAHPS season and second, integrated into existing outreaches over the calendar year.

The ‘just in time’ outreach is what many of our clients are already doing: timing some sort of outreach for the January/February period before official CAHPS season opens in March. The difference between what our clients used to do and what they can do with Decision Point intelligence is they can now target their resources to the highest risk members.

The year-round outreaches are all about integrating these members that are high risk for CAHPS into outreaches that are already planned for the year. In other words, we can identify members that are likely to rate the plan negatively on CAHPS who are also likely to voluntarily leave the plan come next open enrollment period. We can also identify members likely to rate the plan negatively on CAHPS who also are at high risk for not adhering to their medications. Why not accomplish two things at once? This is just one example of the many opportunities for efficiency in member outreaches that we can create with our data and insights.

What else should folks know about how we can help with CAHPS performance?

Too often I think organizations feel like they are powerless to impact CAHPS. In our experience, that’s not the case at all. We’re seeing our clients move Star ratings across multiple measures each year. And what’s even more exciting is that the insights we’re providing to these plans about their population are leading to other interesting projects, as well. For example, we’re working with a plan now to leverage CAHPS insights to improve their Net Promoter Score. At the end of the day, CAHPS is all about consumer experience, and we’re learning from our clients all the time about how the information we provide them has led to results in related areas.

Thank you for joining us throughout this series - we hope we helped to shed some light on the ways in which health plans can maximize their performance on CAHPS by leveraging deep data insights. As always, please feel free to reach out if you have any questions, comments, or feedback. We’d love to hear from you.