Medicare Managed Care CAHPS^®: A Tool for Performance Improvement

Area of Science:

• Health Services Research
• Quality Improvement
• Health Policy

Background:

• The Balanced Budget Act of 1997 established the Medicare+Choice (M+C) program.
• M+C expanded Medicare beneficiaries' access to diverse health plan options beyond traditional fee-for-service.
• Managed care plans became a significant component of Medicare.

Purpose of the Study:

• To describe the Consumer Assessment of Health Plans Study (CAHPS) survey.
• To explain the application of CAHPS surveys within Medicare managed care (MMC) settings.
• To explore the implications of CAHPS data for enhancing the quality of care in Medicare programs.

Main Methods:

• The study focuses on the CAHPS survey instrument.
• It details the administration of CAHPS to beneficiaries in Medicare managed care plans.
• Qualitative discussion on the utility and interpretation of CAHPS results.

Main Results:

• CAHPS surveys provide a standardized method for assessing beneficiary experiences.
• Data from CAHPS can identify areas of strength and weakness in MMC plan performance.
• The survey facilitates comparisons across different managed care organizations.

Conclusions:

• The CAHPS survey is a valuable tool for monitoring and improving the quality of Medicare managed care.
• Findings from CAHPS can inform beneficiaries' health plan choices.
• Continued use of CAHPS is recommended for ongoing quality improvement initiatives in Medicare.