lunes, 20 de abril de 2020

CAHPS Health Plan Survey | Agency for Health Research and Quality

CAHPS Health Plan Survey | Agency for Health Research and Quality

AHRQ News Now

CAHPS Health Plan Survey

The CAHPS Health Plan Survey is a tool for collecting standardized information on enrollees' experiences with health plans and their services. Survey results can be used to:
  • Support consumers in assessing the performance of health plans and choosing the plans that best meet their needs.
  • Identify the strengths and weaknesses of health plans and target areas for improvement.
Since its launch in 1997, this survey has become the national standard for measuring and reporting on the experiences of consumers with their health plans. A version of this survey is conducted in almost every State in the U.S. Sponsors of this survey include health plans, State agencies that purchase and regulate health care, and Federal agencies, such as the Department of Defense and the Centers for Medicare & Medicaid Services.
The Health Plan Survey 5.0 includes standardized instruments and optional supplemental items that can be administered to adults and children enrolled in Medicaid and commercial health plans. The surveys for commercial and Medicaid plans are the same except for the time referent:
  • The commercial questionnaire asks enrollees about their experiences in the previous 12 months.
  • The Medicaid questionnaire asks about experiences in the previous 6 months.
To be accredited by the National Committee for Quality Assurance, health plans must submit the results of a modified version of the commercial questionnaire. The Centers for Medicare & Medicaid Services also administers a version of the CAHPS Health Plan Survey designed for Medicare beneficiaries. More information about these two versions is provided below.
Learn more about this survey:

Get the Health Plan Survey

Download the Health Plan Survey 5.0 and Instructions (ZIP, 5.7 MB)
  • Medicaid and commercial survey instruments in English and Spanish (Word and PDF),
  • guidance on administering the survey, including a sample telephone script and sample letters, and
  • information about the survey measures.
Information in the guidance documents is based on the survey developers' extensive research into best practices in survey design and administration as well as analyses of data collected during the field testing of each instrument. AHRQ does not require the use of a specific methodology for sampling or survey administration.
For quick access to the survey and recommended administration methods:
Users of this survey may also want to consult the following guidance:

Quality Measures From the Health Plan Survey 5.0

All versions of the CAHPS Health Plan Survey produce the following measures of patient experience:
  • Getting needed care.
  • Getting care quickly.
  • How well doctors communicate.
  • Health plan customer service.
  • How people rated their health plan.

Supplemental Items for the Health Plan Survey

To customize their survey instruments, users of the Health Plan Survey may add optional supplemental items that address a variety of topics.
Some supplemental items are designed to be incorporated into the survey as a set. They address the following subjects:
Read about supplemental items designed to support use of a previous version of the Health Plan Survey (4.0) to improve enrollee experience: Supplemental Items To Support Improvement in Health Plan Quality.

    Other Versions of the Health Plan Survey

    The National Committee for Quality Assurance (NCQA) and the Centers for Medicare & Medicaid Services (CMS) use the CAHPS Health Plan Survey to meet their respective needs.
    • NCQA's version of the Health Plan Survey. NCQA asks all plans seeking accreditation or providing quality measures (HEDIS) for public reporting to submit the results of a modified version of the CAHPS Health Plan Survey. This modified survey is designated with an "H" after the version number (e.g., CAHPS 5.0H).
    • Medicare version of the Health Plan Survey. CMS has conducted the CAHPS Health Plan Survey with Medicare beneficiaries since 1998. The Medicare Survey includes versions for Medicare Advantage plans (including PPOs), Prescription Drug Plans, and the fee-for-service program.

    Using Health Plan Survey Data

    Health plans, State agencies, public and private health care purchasers, and many other organizations use the Health Plan Survey for several purposes.
    • Compare survey data to aggregated results: Using data voluntarily submitted by survey sponsors around the country, AHRQ's CAHPS Database reports scores that can be used to assess the overall performance of different kinds of health plans and to analyze the performance of a single health plan relative to appropriate benchmarks.
    • Improve enrollees' experiences with health plans: AHRQ offers a variety of materials to support survey users in identifying opportunities for improvement and tracking progress towards goals.
    • Report health plan survey scores to consumers: AHRQ offers specific guidance on reporting the results of CAHPS surveys as well as more comprehensive guidance on reporting quality information to consumers in TalkingQuality.

    Brief History

    Released in 1997, the Health Plan Survey is the first product of the Agency for Healthcare Research and Quality's efforts to develop standardized surveys of consumers' experience with health care. Over time, the survey has evolved in response to changes in health care delivery and health plan structures, research findings, and feedback from key stakeholders. In May 2012, the CAHPS Consortium released the current 5.0 version of the Health Plan Survey; the 4.0 and 3.0 versions of the survey are no longer supported.
    The National Quality Forum (NQF) first endorsed the CAHPS Health Plan Survey as a measure of health plan quality in July 2007. In January 2015, the NQF renewed its endorsement of the 5.0 version of the CAHPS Health Plan Survey through its Person and Family Centered Care Measures maintenance process.

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