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CAHPS: How to Plan for 4x Weighted Stars Measures 

Earlier this month, we noted that October is the month for Medicare advantage in our discussion of the 2021 CMS Star Ratings release. Last week saw the other major Medicare Advantage event of the month, with the start of the Annual Election Period. As plans enter the member acquisition and retention season and all efforts are focused on maximizing plan growth, they hope to finish 2020 in a strong position ahead of OEP and to start 2021 with more returning and new members.  

 That period of time, when plans traditionally begin onboarding new members and welcoming returning ones, will be more important this year than ever before.The reason why is simple: the impression new members get of your plan, and the validation (or lack thereof) that returning members feel about their decision to stay, will now impact a lot more than retention. The 2021 CAHPS survey for Medicare will feed into Stars measures that are 4x weighted for the first time ever, and those Member Experience measures will comprise the largest component of plans’ overall ratings.  

Returning members, who are receiving marketing materials and outreach right now, will be responding to questions as soon as February 1st 2021 on the CAHPS survey. Those questions cover 6-month periods. This means member experiences occurring right now may impact these high-weight measures for the 2021 survey and 2023 Stars. 

From Campaigns to Relationships 

All plans understand new member onboarding and returning member outreach is crucial during the months of AEP and OEP. But the changes coming in 2021 mean following the traditional playbook this year could hurt performance, as members receive high touchpoints and support from October to January, only to have the cadence of plan communication go “back to normal” just before CAHPS surveys begin to be fielded. Viewing enrollment, retention, and onboarding as discrete “campaigns” misses the opportunity to see this time period as the beginning (or new chapter) of a relationship between the plan and member.  

That relationship must be nurtured and supported all year to maximize member satisfaction and experience, not just these traditionally-important months.  

 mPulse helps many of our Medicare partners with new member onboarding and navigation, but our plan experience solution also supports ongoing, year-round touchpoints and conversations to continually connect members with relevant benefits, resources and tools to keep the member connected to their plan, and maintain that relationshipWhether you work with us or not, this year-round approach is increasingly becoming the standard for MA plans as member experience and orientation becomes a priority for quality teams as much as it is for member services, marketing, and retention departments.  

Connecting with members about their benefits year-round is one part of the relationship-based approach to member experience. But like any relationship, it has to be a two-way street. That means plans must find ways to listen more to members and help them feel heard. Many have already started, going beyond grievance/complaint tracking and proxy CAHPs surveys to create more conversations with their members.  

Several MA plans we work with use automated check-ins – sometimes related to an event like a provider encounter or a customer service call, sometimes just because they haven’t heard from the member in a while  where they can get the pulse of large populations. With strong Natural Language Understanding and response handling, they can hear common questions and concerns then serve up relevant resources and tools – connecting a member who waited on hold with a call scheduling tool, for instance. And asking for feedback at scale on conversational channels means that member feedback can be analyzed for sentiment, intent, or keyword to help make more informed and member-centric decisions.  

The changes to the CAHPS measure weights mean that every member touchpoint, or lack thereof, is now a key opportunity for Quality Improvement as the relationship between members and plans takes a central role in performance. Your strategies and communication plan for member onboarding is likely finalized. But now is the time to think about “what’s next?” to continually strengthen that relationship and keep members engaged with their plan throughout the CAHPS season and beyond.  

Want to learn more about how we can help? Check out our CAHPS Solution.


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