CAHPS® Survey to Assess Medicare Advantage Members’ Experiences

February 24, 2023

Every year, some Blue Cross and Blue Shield of Illinois (BCBSIL) members receive a survey to collect information about their experiences with their health care providers, their Blue Cross Medicare AdvantageSM plans and their prescription drug plans. 

The Centers for Medicare & Medicaid Services (CMS) sends the Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey to a random sample of our members from March through June. Members are asked to rate their last six months of care. If your patients receive a CAHPS survey, please encourage them to respond. 

Why the CAHPS Survey Is Important
The survey identifies opportunities to improve member satisfaction. Results also affect the CMS Star Ratings, which rate Medicare Advantage plans on a scale from one to five stars. Our goal is to achieve the highest possible Star Rating for our plans.

How can you help improve member experiences year-round?

Provide needed care quickly and coordinate care with specialists.

  • Leave openings for sick visits and urgent appointments
  • Discuss how to access telehealth services and after-hours care
  • Follow up with members’ specialists to ensure continuity of care

Communicate clearly.

  • Ask members about their top health concerns
  • Keep conversations clear and simple
  • Follow up after urgent or emergency care

Keep members healthy.

  • Recommend and/or administer the flu shot during flu season
  • Educate members on preventive services, chronic conditions and ongoing care
  • Let members know whether you offer telehealth services that allow them to access care from home
  • Discuss the COVID-19 vaccine
  • Screen members for risk factors, like tobacco use, and recommend appropriate lifestyle changes
  • Complete and document any health assessments
  • Identify and follow up with members who haven’t visited in the past year

Learn more about the survey from CMS.

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.

 

Prescription drug plan is provided by Blue Cross and Blue Shield of Illinois, 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 plan depends on contract renewal.

HMO, HMO-POS and PPO plans provided by Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC). HMO plan provided by Illinois Blue Cross Blue Shield Insurance Company (ILBCBSIC). HCSC and ILBCBSIC are Independent Licensees of the Blue Cross and Blue Shield Association. HCSC and ILBCBSIC are Medicare Advantage organizations with a Medicare contract. Enrollment in HCSC's and ILBCBSIC’s plans depends on contract renewal. 

CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).