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    To accurately compare Medicare health plans, patient factors like health status and education must adjust survey results. Adjustments are small but important for fair comparisons.

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    Area of Science:

    • Health Services Research
    • Health Outcomes Research
    • Health Plan Performance Measurement

    Background:

    • Medicare Managed Care Consumer Assessment of Health Plans (MMC-CAHPS®) surveys assess health plan quality.
    • Comparisons of health plan performance require adjustment for patient characteristics.
    • Unadjusted data may inaccurately reflect health plan quality due to patient-level variations.

    Purpose of the Study:

    • To develop and evaluate a case-mix adjustment model for MMC-CAHPS® survey data.
    • To identify patient characteristics that significantly influence survey responses.
    • To ensure fair and accurate comparisons of Medicare health plan performance.

    Main Methods:

    • Developed a statistical model using self-reported data on health status, age, education, and assistance with the survey.
    • Incorporated regional interactions to account for variations in the association between patient characteristics and survey responses.
    • Analyzed the impact of the developed adjustment model on survey results.

    Main Results:

    • Patient characteristics such as health status, age, and education were associated with survey responses.
    • The influence of health and education on survey results varied significantly across different HCFA administrative regions.
    • The implemented adjustments were generally small but statistically significant, indicating they were not negligible.

    Conclusions:

    • Case-mix adjustment is crucial for valid comparisons of MMC-CAHPS® survey data.
    • A model incorporating regional interactions is recommended for accurate health plan performance assessment.
    • Adjustments, while often small, are necessary to account for patient-level factors influencing survey outcomes.