When CMS announced its Contract Year 2021 Star Ratings formula updates, the agency sent a clear message - positive member perception is now the most crucial 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.
As many of us are aware, CMS is increasing the weighting of the CAHPS measures for its Medicare Star program. By 2023, the CAHPS measure grouping will be the single most important measure grouping for all of Medicare Star - CAHPS will account for 32% of Stars (contrasted with HEDIS which will account for 15% of Star and HOS which will account for 9% of Star). In fact, if CAHPS is grouped with all the Star member experience measures (such as members choosing to leave the plan and others), member experience as a group will account for 54% of Star. It is safe to say that plans that fail at member experience do not have a path of achieving or maintaining 4 or 5 Stars.
In the high stakes game of CAHPS where the game is made up of anonymous surveys, small sample sizes, and fragile member perception…Star scores rely heavily on the response of just a few members.
You’re lucky if your willing to respond satisfied members get surveyed. You’re not so lucky if they don’t.
Feel like the house is winning?
Our Talking CAHPS webinar series explores the nuances of CAHPS. Episode-by-episode we breakdown approaches from top health plans for defending and elevating CAHPS response scores.
There is no by-the-book approach for the “game” of CAHPS, but by the end of this series, there will be.
Join us on April 21st at noon EST as we kick off the series and dive into the world of CAHPS.