Feb 5 -- The Centers for Medicare & Medicaid Services (CMS) invites public comment by March 10, 2021 on the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey before OMB for approval for 2021-2024.
CMS conducts Medicare Advantage (MA), Medicare Part D, and Medicare Fee-For-Service (FFS) CAHPS to meet the requirement to conduct consumer satisfaction surveys regarding the experiences of beneficiaries with their health and prescription drug plans.
The primary purpose of the Medicare CAHPS surveys is to provide information to Medicare beneficiaries to help them make more informed choices among health and prescription drug plans available to them. Survey results are reported by CMS in the Medicare & You handbook published each fall and on the Medicare Plan Finder website. Beneficiaries can compare CAHPS scores for each health and drug plan as well as compare MA and FFS scores when making enrollment decisions. The Medicare CAHPS also provides data to help CMS and others monitor the quality and performance of Medicare health and prescription drug plans and identify areas to improve the quality of care and services provided to enrollees of these plans. CAHPS data are included in the Medicare Part C & D Star Ratings and used to calculate MA Star Ratings and Quality Bonus Payments. The Star Ratings program has led to health and drug plan quality improvement. For example, the average enrollment-weighted overall Star Rating for MA-PD contracts has increased from 3.92 in 2015 to 4.16 in 2020. In 2015 approximately 60% of MA-PD enrollees were in contracts with 4 or more stars; this has increased to 81% of enrollees in 2020.
The Medicare CAHPS survey is conducted annually. CMS is required to provide up-to-date information to Medicare beneficiaries each year prior to the annual enrollment period to help them make more informed plan choices. Additionally, the information is used by CMS for monitoring of plan quality and by plans to improve the health care and services they provide to their enrollees. Given the uses of the data, it is important that persons with Medicare, CMS, and others have current information about the experiences of persons enrolled in Medicare health and prescription drug plans. Provision of this information on an annual basis allows for the design of quality improvement initiatives on a timely basis and helps inform beneficiaries about the quality and performance of health and prescription drug plans at the time they make a health or drug plan selection each year.
The CAHPS survey results are disseminated through tools on www.medicare.gov – Medicare Plan Finder – that contain comparative information on prescription drug and health plans. The Medicare & You Handbook also contains some CAHPS information and instructions about how to obtain information on additional measures. The information is made available in the fall following each annual data collection, prior to the annual enrollment period.
Medicare health and prescription drug plans also receive plan-specific reports that contain detailed information on the CAHPS results for their plan for use in quality improvement initiatives. These reports include background information on the methodology and definitions used in CAHPS to assist them in understanding the information in their report.
CMS is requiring all MA-Only, MA-PD, and Stand Alone PDP contracts that have at least 600 eligible enrollees July of the previous year to participate in an independent third party vendor administration of this survey (hereinafter referred to as Medicare CAHPS). The Medicare CAHPS survey is also conducted among a sample of persons enrolled in Medicare FFS for purposes of allowing comparisons of measures obtained from the surveys. For the national Medicare CAHPS survey, the names and addresses of sampled beneficiaries shall be obtained from the Integrated Data Repository (IDR) on or shortly after January each year. Persons with Medicare 18 years old or older who have been continuously enrolled for 6 months or longer in the same Medicare contract and who are not institutionalized are included in the sampling frame. A random sample of between 600 and 800 eligible beneficiaries per reporting unit is selected depending on the size of the contract. Sample sizes are designed to produce estimates with a reliability of 0.8. Medicare health and prescription drug plans are surveyed at the contract organization level, and this level will also define the sampling and reporting unit. For Medicare FFS enrollees the sampling and reporting unit is defined at the state or sub-state level for large states. Most sampling units will have about 800 members. A small number of contracts with between 600 and 800 enrollees will have samples comprised of virtually all of their enrollees. If there are less than 600 eligible beneficiaries in an organization at the contract, the survey will not be required for that contract.
The survey is conducted through use of a randomized sample of Medicare enrollees as described above from sampling and reporting units in all 50 states, the District of Columbia, and Puerto Rico. Some states will be divided into smaller units if they have large numbers of enrollees. Because of changing enrollment patterns and the need to employ the most recent information available, sampling experts from RAND and Harvard will prepare the final sample design based on the current CMS enrollment databases available each year just prior to sample draw.
Demographic and geographic information on non-respondents is obtained from the sample frame at the time the sample is drawn and used in developing weights for preparing survey results that reflect the full Medicare population. Weighting is done on a stratified basis at the contract and geographic area level to further assure that the measures prepared from the survey results reflect the Medicare population. Case-mix adjustment methods are also employed for comparing performance between contracts.
Medicare Advantage and Prescription Drug Plan CAHPS (MA and PDP CAHPS) website: https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/CAHPS/MCAHPS
Fee-for-Service (FFS) CAHPS website: https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/CAHPS/FFSCAHPS
CAHPS submission to OMB: https://www.reginfo.gov/public/do/PRAViewICR?ref_nbr=202101-0938-013
Click on IC List for survey instruments, View Supporting Statement for technical documentation
FR notice inviting comment: https://www.federalregister.gov/documents/2021/02/05/2021-02439/agency-information-collection-activities-submission-for-omb-review-comment-request