In today’s healthcare landscape, member experience isn’t just a buzzword, it’s a key driver of Medicare Star Ratings and quality bonus payments (QBPs). While health plans have long focused on improving CAHPS and HOS scores, one critical piece of the puzzle often goes underutilized: providers.
Why Provider Engagement Matters
Providers play a pivotal role in shaping member experiences and influencing key quality measures. Research consistently shows that positive patient experiences lead to better clinical outcomes, higher satisfaction scores, and greater patient loyalty. Yet, many health plans struggle to bridge the gap between member perceptions and provider-driven improvements.
The good news? Engaged providers are the key to success. By aligning member experience initiatives with existing quality efforts, such as preventive screenings and medication adherence, plans can proactively improve Star Ratings while strengthening provider relationships.
A Playbook for Success: Proven Strategies for Provider Engagement
mPulse’s Playbook lays out actionable steps to help plans implement and sustain a provider-driven member experience program, including:
1. Engaging and Educating Providers
- Communicate the ‘why’ behind member experience and its impact on quality ratings.
- Make it easy for providers to integrate member experience efforts into their daily workflows by offering administration support, such as member outreach.
2. Leveraging Data & Advanced Analytics
- Use predictive modeling to identify high-impact providers and at-risk members.
- Integrate member experience insights into existing provider performance reporting.
3. Optimizing Member Communication
- Align member experience messaging with preventive care and medication adherence programs and outreach strategies.
- Equip providers with targeted, scalable recommendations to improve patient engagement.
4. Deploying Targeted Interventions
- Address access barriers by improving appointment scheduling and wait time communication.
- Enhance provider touchpoints through simple, high-impact perception-based strategies.
Driving CAHPS Excellence: A Health Plan’s Playbook
Ready to Drive CAHPS Excellence? Download mPulse’s Health Plan Playbook for Engaging Providers and Enhancing Member Experience!
From Awareness to Accountability: A Phased Approach
Improving CAHPS and HOS scores is a marathon, not a sprint. The Playbook provides a step-by-step roadmap to help plans move from provider education to quality-driven accountability measures, ensuring sustained improvements.
In this resource, you’ll uncover the following key steps to success:
✔ Communicate the importance of member experience and provider impact.
✔ Prioritize high-impact providers for targeted outreach.
✔ Provide regular, actionable reporting to guide improvement efforts.
✔ Reduce provider burden by aligning initiatives with existing clinical priorities.
✔ Incentivize engagement with pay-for-performance strategies based on real survey data.
✔ Share best practices across the provider network to foster widespread adoption.
Unlock the Full Potential of Your Provider Network
Providers are the missing link in many plans’ member experience strategies. By implementing a proactive, data-driven approach, plans can improve CAHPS and HOS scores, enhance patient satisfaction, and secure higher Medicare Star Ratings.
Ready to transform your member experience strategy? Download mPulse’s Provider Playbook for Medicare 5-Star Quality Ratings.
