CMS Star Ratings Matter: Survey to Assess Medicare Advantage Members’ Experiences
As a Medicare provider, you play an important role in an annual survey to assess our members' experiences with their health plans and prescription drug services. The Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey will be sent to a random sample of members enrolled in our Blue Cross Medicare AdvantageSM and/or prescription drug plans. The survey will be conducted from March through June 2020. If your patients receive a CAHPS survey, please encourage them to respond.
The CAHPS survey evaluates how our members interact with their health plan, including with you, their Medicare provider. Survey results identify opportunities to improve member satisfaction. Results also affect the Centers for Medicare & Medicaid Services (CMS) Star Ratings, which rate Medicare Advantage plans on a scale from one to five stars. More information on the Star Ratings is available on the CMS Medicare website .
CAHPS Survey Questions
The CAHPS survey asks members to rate their last six months of care. Examples of survey topics and questions include:
- Getting needed care – Did you receive the care you felt you needed quickly and were you able to get urgent appointments with a specialist if needed?
- Provider communication – Did your provider show respect, spend enough time and explain things in a way you could understand?
- Customer service – Did you receive helpful information from office staff?
- Care coordination – Was your provider informed and up-to-date about the care you received from other providers?
- Flu vaccination – Did your provider educate you on the benefits and importance of a yearly flu vaccination?
- Smoking cessation – Did your provider ask if you smoke or use tobacco and if so, advise you to quit and discuss medications and strategies?
How You Can Help Improve Members' Experiences
You and your staff can help improve members' experiences year-round. Questions to consider include:
- Do you or your office staff assist patients in scheduling appointments with specialists?
- Are urgent care walk-in appointments available in the morning and evening hours?
- Do you spend time explaining things to patients in a way they can easily understand?
- Do you provide patients with educational materials?
- Do you discuss treatment and medication options with patients?
- Do you educate patients about preventive illnesses?
This information is for informational purposes only and is not a substitute for the sound medical judgment of a provider. Members are encouraged to talk to their provider if they have any questions or concerns regarding their health.
HMO, PPO, and HMO Special Needs Plans provided by Blue Cross and Blue Shield of New Mexico, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), an Independent Licensee of the Blue Cross and Blue Shield Association. HCSC is a Medicare Advantage organization with a Medicare contract and a contract with the New Mexico Medicaid program. Enrollment in HCSC's plans depends on contract renewal.
Prescription drug plans provided by Blue Cross and Blue Shield of New Mexico, which refers to HCSC Insurance Services Company (HISC), an Independent Licensee of the Blue Cross and Blue Shield Association. A Medicare-approved Part D sponsor. Enrollment in HISC's plans depends on contract renewal.
CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).