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CAHPS Survey's Importance to You

The 2021 CAHPS® (Consumer Assessment of Healthcare Providers and Systems) survey began delivering in February and will continue through May. Now is the time that providers and their care teams can make an impact on how patients may respond to the surveys.

Why is CAHPS important to providers?

  • CAHPS® survey scores are publicly reported and compared across the industry, influencing individuals to seek coverage and care from the highest performing physicians and health plans.
  • Trust and communication between providers and their patients can improve clinical outcomes, patient adherence, and patient safety.

What kind of questions are asked about providers?

  • Your patients may be asked questions related to how well their doctors communicate with them and if they feel their doctor listens and explains things in a way that is easy to understand.
  • They are also asked about the coordination of care between their PCP and specialists, as well as give an overall rating of their health care, their personal doctor, and their specialist.


What kind of questions are asked about timeliness of care?

  • Patients’ perception of the timeliness of getting the care they need is very important to keep in mind.
  • Your patients may be asked how often they were able to get care, tests or treatments or get an appointment they needed in a timeframe that was acceptable to them. Keeping the applicable appointment timeliness standards in mind is key in ensuring patients get the care they need in a timely manner.  
Tips for CAHPS

Action

Survey Category

Details

Remind members to complete the CAHPS Survey.

CAHPS Response Rate

  • CAHPS is distributed to members by line of business according to the timeline below:
    • Medicaid (Adult and Child): February – May
    • Medicare: April – June
    • Marketplace: February – May
  • Have front desk staff remind members/patients to complete the survey upon arrival to appointments.

Improve patient communication during office visits.

  • How Well my Doctor Communicates
  • PCP Rating
  • Specialist Rating
  • Ask members/patients if they understand the treatment plan and how to use medications at the end of visits.
  • Communicate changes in medications and treatment plans.

Monitor appointment time frames quarterly to determine whether they are within standard guidelines.

  • Getting Needed Care
  • Getting Care Quickly
  • Create reporting to monitor efficiency in obtaining appointments for well visits.
  • Consider alternatives when well visits exceed 6 – 8 week wait for well visit.

Update Buckeye on changes to your office as soon as possible.

  • Rating of Health Plan
  • Rating of PCP
  • Rating of Specialist
  • Getting Needed Care
  • Notify Buckeye Health Plan as soon as possible about changes in the following:
    • Office Hours
    • Provider Terminations
    • Updated telephone and/or fax numbers
    • Specialty Licenses or Special Experience.

     

HEDIS Measure Deep Dive: Appropriate Treatment for Upper Respiratory Infection

The Appropriate Treatment for Upper Respiratory Infection measure, or URI, is a metric derived from the percentage of members (three months and older) with a diagnosis of upper respiratory infection that did not result in an antibiotic event. Typically, antibiotics are not recommended for upper respiratory infection, as these are usually viral in nature. Research has shown that the use of antibiotics for diagnoses for which it is not appropriate or warranted, such as upper respiratory infection, is not only ineffective in reducing complications, but also increases medical costs by inducing side effects and resistance to antibiotics (Yoon et al., 2017 – view this .gov resource here). This measure is therefore inverted, meaning the less antibiotics providers prescribe in response to upper respiratory infections, the better.

To close the gap and thus improve HEDIS scores, this measure relies on provider prescribing practices to reflect an avoidance of antibiotic prescriptions in response to upper respiratory infection on or three days after the day of diagnosis.

Recommendations:

  • Providers are encouraged to educate members, parents, and caregivers on alternative remedies to antibiotics such as acetaminophen for fever, over the counter medicine for cough and inflammation, and rest and extra fluids for treatment.
  • Per the CDC, it is encouraged that providers promote appropriate antibiotic use to avoid antibiotic resistance. The CDC website has some very useful handouts for both patients and providers that talk about appropriate antibiotic use and includes resources such as specific antibiotic aware prescription pads for provider use.