When it comes to impacting and improving member experience measures, we can easily name more challenges than we can solutions. Blinded surveys, small sample sizes, black-out rules, and perception vs. reality are just a few of the historical challenges health plan partners have faced over the years. As if those weren’t enough, now we’re looking at new and increasingly difficult obstacles this year. Some challenges to keep in mind include the following:
- 4x weighting for the 2022 CAHPS survey to round out the increased weighting for the member experience measures which will account for over 50% of 2023 Star Ratings.
- Recently released Westat reports revealed an upward trend in CAHPS cut-points making it even harder to attain and maintain top performance.
- The Extreme and Uncontrollable Circumstances policy which allows plans to use the higher of the current year or the previous year’s Star Rating is expected to leave over-inflated performance in its wake, which will be difficult to maintain over the next several Stars years.
- NCQA’s extension of its HOS black-out period from four to eight weeks before, during and after fielding left some plans in the lurch and forced them to pivot or scrap their planned outreach and educational strategies.
- The temporary removal of HOS’ two 3x weighted process measures, Improving or Maintaining Physical Health and Improving or Maintaining Mental Health from the active page and onto the Display page for both the 2022 and 2023 Star Rating years. While it might be welcomed as a breather, it should not be an opportunity to lose focus, but instead an opportunity to re-evaluate your overall HOS strategy.
CMS isn’t backing down on its promise to lend a bigger voice to the beneficiary and each year the Medicare population continues to embrace and adopt digital communication and technology. It’s time to ditch obsolete legacy outreach programs and reimagine CAHPS and HOS engagement using the modern innovative trends and technology your members interact with daily. What consumers expect from their favorite brands, they’ll expect from healthcare.
mPulse, the leader in Conversational AI solutions for the healthcare industry, drives improved health outcomes and business efficiencies by engaging individuals with tailored and meaningful dialogue. mPulse combines behavioral science, analytics and industry expertise that helps healthcare organizations activate their consumers to adopt health behaviors.
With over a decade of experience, 100+ healthcare customers and more than 400 million conversations annually, mPulse has the data, the expertise, and the solutions to support your CAHPS and HOS engagement strategy.
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