Consumer Assessment of Healthcare Provider and Systems (CAHPS) Resource Guide

  • How you can improve the patient experience

    The CAHPS survey asks patients annually to rate their provider care and health plan.

    The details

    Each spring, a random group of health plan members gets a survey with 60 questions. Health plans don’t see any member or provider names in the survey.

    The impact

    When patients have a good experience, they’re more likely to stay, follow clinician advice, and get healthier.

    The roadmap

    Member responses help health plans focus on ways to make their experience better.

  • Making healthcare work better for your patients

    • Aligns with our company purpose
    • Employer groups ask for it
    • Supports total cost of care
    • Includes NCQA and CMS strong performance incentives

    CAHPS measures overview

    The CAHPS survey asks patients to rate their care and health plan through four provider-driven measures:

    1. Getting needed care

      How often patients got care, tests, or treatment and how easy it was to see a specialist.
    2. Getting care quickly
      How often patients could get routine or urgent care when needed.
    3. Coordination of care
      How well providers help patients with things like test results, prescriptions, and using the healthcare system.
    4. Rating of personal doctor
      How patients feel about their doctor’s time, listening, friendliness, and wait time.

  • Top 3 survey tips:

    • Standardize care to boost survey responses
    • Communicate clearly with patients
    • Make service excellence a priority

    Let's work together

    We consistently partner with providers to improve patient experience by:

    • Meeting quarterly to share member feedback and trends
    • Creating custom patient feedback reports that match your goals
    • Sharing best practices to improve CAHPS performance

  • Consistency, communication, and care

    Measure #1: Getting needed care

    We ask patients: How often was it easy to get care, tests, or treatment and see a specialist when needed?

    How you can improve this measure

    • Work with office staff to coordinate specialty appointments for urgent cases.
    • Encourage patients to register for access to their member portal.
    • Make it easy for patients to locate office hours and options outside of office hours.
    • Offer appointments or refills via text and/or email.

    Measure #2: Getting care quickly

    We ask patients: How often did you receive urgent or routine care as soon as you needed it?

    How you can improve this measure

    • Accommodate patients with same-day appointments for urgent visits.
    • Offer appointments with a nurse practitioner or physician assistant.
    • Keep patients informed, offer to reschedule.
    • Provide educational offerings for patient access and front office staff.

    Measure #3: Coordination of care

    We ask patients: Did your doctor have your health info and help you manage your care when needed?

    How you can improve this measure

    • Encourage office staff engagement with the patient.
    • Monitor prior authorization and referral practices.
    • Make sure there are open appointments for patients recently discharged from a facility.
    • Use processes for patients to easily and securely access test results.

    Measure #4: Rating of personal doctor

    We ask patients: Using a scale from 0 (worst) to 10 (best), how would you rate your doctor?

    How you can improve this measure

    • Leave a positive impression with every patient interaction.
    • Ask if the patient's questions were answered and include them in next steps.
    • Train staff to handle sensitive issues.
    • Treat patients with empathy--make eye contact, listen, and understand.

  • Patient experience program

    CAHPS gives you insights into your patients’ experience with tailored patient data and consultation.

    Data we can share includes:

    • Member feedback
    • Provider ratings
    • Clinic net promoter score (NPS)
    • CAHPS key performance indicators (KPIs)

    To get started, email us at CustomerExperience@Premera.com.