4 Steps to Take During and After the CAHPS Blackout Period

May 9, 2024


With the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and blackout period well underway, health plans should focus on member experience initiatives to deploy once the blackout period is over. Lay the groundwork now for success during the next CAHPS survey by taking this time to consolidate, optimize and mobilize member experience data.

Leverage the time between the CAHPS survey and the release of final scores to implement forward-thinking member experience improvements.

Adapting to the CAHPS Timeline

The Centers for Medicare & Medicaid Services (CMS) prohibits health plans from asking members CAHPS-related questions four weeks prior to, during and four weeks after the survey is administered. This typically ranges from about February 1 to June 30. During this period, plans cannot conduct mock-CAHPS, outbound calls or any other patient experience surveys to gauge member sentiment.

Despite these limitations, plans should still focus on member engagement and satisfaction. Educating members about benefits, improving patient experiences, facilitating appointment scheduling and resolving issues around access to care are all viable activities during the blackout period that could contribute to positive member satisfaction scores. Getting an early start on CAHPS also minimizes investments during end-of-year efforts to direct resources to more pressing issues. 

While plans cannot ask CAHPS-specific questions, they can use Pulse Surveys to identify the root causes of negative member experiences. Plans may conduct these surveys throughout the year get immediate answers, maximize data collection and stay ahead of CAHPS challenges.

CAHPS Timeline

Once the blackout period ends, health plans have eight months to initiate strategies to impact the next CAHPS survey. The first few months before results are released are an excellent time to map out CAHPS strategies, restart surveying with mock-CAHPS and implement long-term member experiences initiatives. When official scores are released, plans should consult with CAHPS strategists to review the results and prepare tactics to address wide-spread challenges. Healthmine's expert advisors are well-equipped to provide CAHPS guidance and have worked with plans of all sizes to improve CAHPS scores. 

Get Ahead of CAHPS Challenges in 4 Steps

Jump start CAHPS strategies with a four-step guide to improving member experiences over the remainder of the year.

1. Consolidate Member Data

The blackout period gives plans a break from survey administration to refine their internal processes and systems to better manage member data. Member experiences are time-sensitive and require immediate action to maintain or increase positive experiences. The better insight a plan has into real-time member feedback, the more effectively it can address challenges before they impact CAHPS scores.

These member records should focus on creating whole-person views that include:

  • Clinical information
  • Survey responses
  • Social determinants of health
  • Best contact information
  • Communication preferences

2. Close Member Experience Blind Spots

From July to February, plans should collect member feedback through surveys, provider data and interactions with health plan staff. However straightforward or complex a member’s feedback is, it should be logged in a central record and evaluated to determine the appropriate solution.

Large-scale surveys like mock-CAHPS can provide a high-level view of contract performance, while hyper-specific Pulse Surveys are excellent for developing a deeper understanding of member feedback. When backed by strategic insights from behavioral scientists, pulse surveys can ask the right questions to capture the most meaningful responses. Both mock-CAHPS surveys and Pulses should be deployed in tandem and strategically to close as many data gaps as possible and support ongoing CAHPS improvements.

Outside of CAHPS-specific questions, plans may still conduct other surveys to access supplementary information, such as social need screenings and health risk assessments, to support better member experiences.

3. Segment Your CAHPS Influencers

Stratifying member populations based on their predicted responses to CAHPS challenges enables plans to determine where to focus resources and staff to maximize CAHPS scores. Historic data, mock-CAHPS and Pulse Surveys can help divide members into positive and negative responders based on their sentiments around specific CAHPS measures. Once these groups are identified, plans can determine the appropriate response to address each groups’ priorities and challenges.

Here are four risk levels to help prioritize interventions:

  • High risk: A member is likely to respond negatively to four or more CAHPS measures.
  • High moderate risk: A member is a high risk of responding negatively to one or two CAHPS measures.
  • Low moderate risk: A member is a moderate risk of responding negatively to multiple CAHPS measures.
  • Low risk: A member is a low risk of responding negatively to all CAHPS measures.

With Healthmine, plans can use predictive analytics to stratify member populations into these risk levels without the need for manual data crunching.

4. Tactically Engage Members and Resolve Issues

Each risk level presents a different opportunity to increase measure scores. Members with strong opinions about their plans, whether positive or negative, will need to be identified. However, plans should prioritize moderate members who are on the cusp of swaying in either direction. By providing the right messaging at the right times, plans can secure easy, affordable CAHPS wins among these risk levels.

To have the strongest impact on all CAHPS measures, focus on these interventions first:

  • Member awareness: Members who rate their plans positively are the key to bolstering survey response rates. They may be perfectly happy to share their opinions in the official survey but may lack awareness to understand why it’s important. Educating these members about the CAHPS survey, in accordance with CMS’s guidelines, allows plans to increase member health literacy and response rates.
  • Personalization: Personalizing outreach is important to improving responses from members who are dissatisfied, unengaged or under-engaged. The more seen and heard a member feels, the more likely they will respond positively to the official survey.
  • High-tough outreach: Dissatisfied members will have specific grievances and need to be addressed on a member-by-member basis. Outbound calls, live agents and providers will play an important role in resolving conflicts before the official survey. Plans should also not shy away from directly asking how they can do better and what services they can provide to improve experiences.

Take Control of CAHPS Performance Today

The countdown to end of the CAHPS blackout period is slowly ticking away, but use this time to your advantage and go into the next CAHPS survey with a head start. Accessing an integrated platform enables plans to speed up this process and deliver a more unified CAHPS response throughout the year.

Healthmine’s Quality Relationship ManagementTM (QRMTM) equips health plans with all the tools they need to make a powerful impact on member experiences at scale. Designed to consolidate all member data, outreach and experiences into one system, QRM unites teams under a single control tower to efficiently identify and address grievances. When leveraged alongside a year-round CAHPS playbook, plans can coordinate engagement and experience improvements while eliminating costly and duplicate outreach.

Start building data driven CAHPS campaigns in just 90 days and make the most of the rest of the year. Contact us for a demo.

Healthmine is the leading member engagement and rewards solution focused on empowering people to take the right actions to improve their health.

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