Boosting Member Satisfaction: Strategies to Improve CAHPS Performance
Boosting Member Satisfaction: Strategies to Improve CAHPS Performance
CMS rightfully places an ever-growing emphasis on member satisfaction, causing major shifts in health plans’ Star Ratings results. That’s one reason we’ve decided to host a special webinar on the topic of CAHPS insights, featuring experts from Florida Blue, CareSource, and Jefferson College of Population Health. During this enlightening session, our panel of experts discussed actionable strategies for improving CAHPS scores using advanced technology.
If you missed the webinar, you’ll find the recording here, and keep reading to learn how health plans can exceed member expectations by choosing the right tools and mindset.
Why Focus on CAHPS results?
The short answer is “Because CMS Star Ratings do,” and indeed, these results’ influence on the overall Star Ratings outcome can significantly impact a health plan’s financial viability and competitiveness. But the real reason is that CAHPS serves as a key indicator of member satisfaction, offering critical insights into how health plans are perceived by current and prospective customers. By identifying gaps and opportunities within the member journey, health plans can address underlying issues that impact CMS results across the board.
Addressing Barriers to Member Satisfaction
Improving CAHPS scores requires acknowledging the barriers and considerations that impact member satisfaction. Some of these barriers are hidden from plain sight and require in-depth analysis of member behaviors in order to uncover them. They typically fall into three main categories:
- Communication gaps: Communication issues are responsible for up to 70% of poor handover treatment outcomes. Misunderstandings about a certain treatment’s benefits or a lack of clarity in communication can frustrate members. Clear, accessible information is essential to bridging this gap.
- Access to care: Limited provider availability or difficulties navigating the healthcare system can leave members feeling unsupported. Addressing these issues requires both systemic changes and targeted interventions.
- Social determinants: Socioeconomic factors often influence how members interact with their health plans and providers. From logistics to trust issues, members’ background impacts many factors and plays a key role in influencing choices. Recognizing and addressing these issues is crucial to creating more balanced experiences for all members.
Technology that takes the above factors into account is a powerful solution, and our test group results show that personalized member engagement improves satisfaction and CAHPS scores. By turning data and behavioral insights into targeted communication strategies, health plans can segment members based on their behaviors and tailor their approach to address individual needs and preferences.
Technology plays a significant role in this process. Tools like behavioral science-based AI, predictive analytics, member segmentation, and more enable health plans to connect with members more effectively by providing actionable insights.
The Role of Health Equity in CAHPS
Health equity is another critical component to consider on the journey toward improving member satisfaction. Last year, a report by Deloitte found that more than 80% of healthcare organizations consider improved health equity a top-10 goal, an approach we absolutely agree with. It was interesting to reveal survey results during the panel, which showed that most participants are less familiar with health equity index shifts.
CAHPS scores often highlight disparities in care, particularly for underserved populations. Using data to identify where inequities exist and tailoring interventions to meet multiple groups’ unique needs is critical. By doing so, health plans can ensure that all members, regardless of their background, have equal access to quality care.
Beyond CAHPS: The Future of Member Experience
CAHPS should be viewed as part of a broader strategy for evaluating member satisfaction. For example, incorporating additional metrics like Net Promoter Score (NPS) and customer satisfaction surveys to gain a holistic view of their performance. Continuous tracking and benchmarking allow organizations to assess the effectiveness of their strategies and spot areas for further improvement.
The healthcare industry is at a turning point, with member satisfaction becoming an even greater focal point in the years to come. Health plans can stay prepared by:
- Investing in advanced technologies that enable real-time engagement and data-driven decision-making.
- Embedding health equity into their strategies to address systemic barriers.
- Remaining agile and responsive to the evolving expectations of their members.
The path to improved CAHPS scores is both a challenge and an opportunity. By focusing on the member experience and addressing barriers head-on, health plans can create lasting value for their members and achieve their organizational goals, keeping everyone happy and satisfied.