CMS Member Survey Experience
CMS develops and administers many different patient experience surveys. Surveys ask patients about their experiences with, and ratings of, their health care providers and plans, including hospitals, doctors, drug plans, and others.
CAHPS and QHP Enrollee Surveys
The Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey is a mandated regulatory/accreditation survey sent to a select number of Medicare and commercial members annually. CAHPS results are an integral part of the CMS Star ratings, Health Plan Accreditation, and NCQA Health Insurance Plan Ratings. As part of the new rating system for the Marketplace (Exchange) plans, members are surveyed using the Qualified Health Plan Enrollee Experience Survey (EES or QHP Enrollee Survey) which is similar to CAHPS. With the Federal Employee Program (FEP), members receive a similar version of the CAHPS survey, which is used by FEP to rate their members experience with the health plan. CAHPS/EES collects information on consumers’ experiences with their health plan, personal doctor, specialists, and health care in general and is used for CMS Star ratings. It has become the national standard for measuring and reporting on consumers’ experiences with their health plans.
The Medicare Health Outcomes Survey (HOS), utilized for CMS Star ratings, is a patient-reported outcomes measure used in Medicare managed care. According to CMS, the goal of the HOS program is to gather valid and reliable clinically meaningful data that have many uses, such as targeting quality improvement activities and resources; monitoring health plan performance and rewarding top-performing health plans; helping the Medicare-covered make informed health care choices; and advancing the science of functional health outcomes.