Provider Corner - October 2025

The Consumer Assessment of Healthcare Providers and Systems (CAHPS) is an annual survey sent to members/patients to measure satisfaction with their providers and healthcare systems. The goal of CAHPS is to capture accurate and complete information about the member-reported experiences.

The CAHPS survey measures how well healthcare providers coordinate care among different services and specialists. The survey measures timely follow-up, management of care and provider awareness. Care coordination is essential to patients receiving effective care and can aid in avoiding complications, decreases hospital readmission and improve the overall patient experience.

Tips to help patients coordinate their care:

• Ensure that there are open appointments for patients recently discharged from facility.
• Review patient’s medical records for other specialty practices they have visited.
• Assist patients with scheduling tests.
• Call patients post-visit to ensure that they are scheduled for test or specialist visits.
• Encourage patients to contact the health plan to see if they qualify for a Case Manager to help navigate the coordination of their health care.

Care Coordination for members leads to better disease management, fewer medical errors, and reduces hospital readmissions. Patients experience a smooth transition in their healthcare journey with a reduction of waiting times and easier access to necessary services.

For more information on Care Coordination, visit Behavioral Health | Buckeye Health Plan and review our Coordination of Care Tip Sheet.

Healthcare Effectiveness Data and Information Set (HEDIS) is a set of standard performance measures developed by the National Committee for Quality Assurance (NCQA), which allows direct, objective comparison of quality across health plans. NCQA develops HEDIS measures through a committee represented by purchasers, consumers, health plans, providers and policy makers. This allows for standardized measurement, reporting and accurate, objective side-by-side comparisons.

The BPD: Blood Pressure Control for Patients with Diabetes HEDIS Measure tracks the percentage of adult members ages 18–75 with diabetes (types 1 and type 2) whose blood pressure was adequately controlled (140/90 mmHg) in the measurement year.

HEDIS Improvement Tips:

• If the member’s initial blood pressure is high, repeat the blood pressure later in the visit. You may use the lowest systolic and diastolic blood pressure results for the visit to represent that day’s visit BP results.
• Do not include BP reading taken at an inpatient or ED visit, diagnostic test/procedure or by the member using manual BP cuff and stethoscope.
• BP reading can be used from a common low-intensity or preventative procedure such as vaccinations, TB test, IUD insertion, eye exam with dilating agents, wart removal, injections (e.g. allergy, steroid, Depo-Provera).
• Ensure member is relaxed and have time to sit after transferring to an exam room, not speaking during reading, patients’ legs are uncrossed, and their feet are flat on the floor. Be sure the patient’s arm is resting at chest height, on a table or supported in some way.
• Educate patients on medication adherence, maintaining a log of at-home blood pressure reading and bringing to each visit.

The BPD measure is important for complication prevention, serves as key performance indicator in healthcare assessment, encourages better management practices, and emphasizes patient education about the importance of healthy lifestyle choices to achieve better overall health outcomes.

For More Information about HEDIS, For more information, please review our HEDIS | Buckeye Health Plan website page and view our HEDIS Provider Reference Guide.