MedOrion Blog

How much Influence Do You Really Have on CAHPS and HOS Surveys?


Why members’ most recent experience determines their attitude towards your health plan and what you can do about it.

Behavioral Scientist Dr. Nehama Lewis threw our tech team a bone during a recent meeting about CAHPS and HOS surveys. She said, “Perception is not a good way to go”, and explained that people tend to judge a health plan’s performance based on their most recent personal experience. What’s more, branding is a poor predictor because it does not change the personal experience. In this blog, we’ll explain why.

To influence the outcome of your surveys, the plan should provide all the information relative to the member’s concerns in a way that genuinely improves their personal experience. Your ability to provide accurate information across a continuum of care determines a member’s motivation to rate the experience.

This means that you must be able to communicate in a way that addresses the individual’s personal concerns, and aim for the best possible experience, i.e., personalized, quick, and efficient. In simple terms, if the member’s last engagement was months ago and their concern was not addressed, you can expect that they will answer according to their level of satisfaction or worse, skip the questions altogether.

“Where data is a science, experience is the formula.”

What can you do to improve the outcomes?

Simple. Use the data you already have to identify who is not maximizing their in-plan benefits. MedOrion’s 360-degree single member view lets you see the when and the why so that you can find ways to engage members with helpful services links and references.

If they choose to make use of the benefit, the result should be a positive experience which will improve your score, too. How they rate you depends on their most recent experience. They still have the choice to forgo the benefit, but they are also less likely to blame the plan.

Satisfaction is everyone’s business but what’s your strategy?

We often refer to members’ engagement with e-commerce models because the link between action and perception is similar. For example, uses data to help members take actions that are helpful for them. Did you book a flight? Recommend a car. Staying overnight? Recommend an accommodation. Fly often with this airline? Become a member. They build loyalty by offering complementary services to the travel experience without talking about the flight at all. To impact perception, you must impact the experience. Having a great looking brand is not enough to make – and keep – members happy.

Similarly, once you know that a person has a prescription to fill, MedOrion can help them to get a better personal experience rather than talking about the brand. A better experience will eventually lead to better affinity with the brand without you having to splurge on awareness campaigns.

What can you do now to impact 2022 surveys?

As the standard for measuring member’s plan perception and reporting on the quality of service received, the CAHPS survey covers five different categories, each offering distinct insights as to how your plan is performing and how to improve communication with clients.

To impact member experience and drive action with in-plan benefits, you have to address the full spectrum behind the CAHPS questions all year round. In fact, if you want to see a change in twelve months, your best bet is to start now.

Why? Because you know what members need to do and because MedOrion has done the math.

Using MedOrion’s AI capabilities with data, you can map member activity to understand their most recent experience using the 360° single member view and then use the insights to create personalized, action-driving communications that address their personal needs over time. MedOrion’s Persuasion AI engine can optimize and engineer the data, allowing you to apply this technique at scale to get members to do the very things that you need them to do to impact CAHPS ratings in 2022.

Member experience does not begin in the boardroom

Consider medication adherence, a common barrier among millions of members for a variety of sensible reasons. MedOrion’s Behavioral SaaS takes you through the logic behind their reasoning and decision-making, or lack thereof, for example:

  • they do not have access to preferred pharmacy
  • they are not subscribed to mail orders
  • they don’t fill their prescription on time

Health plan marketers can then use these insights to communicate with members who are not on mail order, or had no prior knowledge that mail orders were available to them, as well as reach out to those individuals who don’t fill their prescriptions on time, or don’t go to the pharmacy simply because their preferred pharmacy is a few miles out of the given service radius. What’s the next step?

  • provide access to their preferred pharmacy with nearby recommendations
  • send a personalized message offering free 90-day refills
  • send a link to subscribe and join mail order services

MedOrion’s Behavioral SaaS helps you to understand the number of people that did take action as a result of the new messaging, allowing you to measure pre and post outreach campaign how many members joined 90-day refills, subscribed to mail orders, and updated their preferred pharmacy list.

These are just a few examples and only one measure among several in the CAHPS surveys and it is this kind of strategy that leads to bigger outcomes and positive personal experiences.

Dr. Lewis affirms that influencing people to action changes member experience more than branding; you are communicating in a way that makes the practice of digital therapeutics much more personal, effective, and measurable. The next CAHPS survey that makes its way to a member’s inbox should be as easy to answer as it was to make the fresh cup of coffee in their hands.