Hawaii Evaluates Medicaid Patients' Managed Care Experiences With AHRQ CAHPS
The Hawaii Department of Human Services uses the Consumer Assessment of Healthcare Providers and Systems (CAHPS®)—a standardized survey tool developed through a partnership with AHRQ and the Centers for Medicare & Medicaid Services—to collect and report patients' experience with their managed health care plans.
Anthea Wang, MD, MPH, Medical Director for the Med-Quest Division of the Hawaii Department of Human Services, is a member of the AHRQ-sponsored Medicaid Medical Directors' Learning Network, an AHRQ Knowledge Transfer Project. Though the CAHPS survey had been used since 2007 to better understand patient care experiences, she decided to use the survey findings for public reporting and pay-for-performance initiatives after speaking with colleagues in the Learning Network. She finds that the CAHPS Health Plan Survey's prescriptive instructions reduce the likelihood of bias and error.
The Hawaii Department of Human Services alternates annually between administering the adult and child versions of the CAHPS survey. The Department has experienced high response rates with the survey. For example, the child version of the survey conducted in 2009 yielded a response rate of 47 percent; in 2010, the adult version yielded a 53 percent response rate. The 2010 survey also included patients who are of older age/blind/disabled for the first time, as those patients were recently moved into managed care from fee-for-service programs.
Wang reports that a consumer guide-based on the adult CAHPS Health Plan Survey results, along with selected National Committee for Quality Assurance's Healthcare Effectiveness Data and Information Set measures-was developed and published on the Hawaii Department of Human Services Web site. The guide presents a side-by-side comparison of the performance of the various health plans in a way that is transparent and easily understood by users. Health plan members can use this information to choose plans that provide high quality care for themselves and their families. It includes three categories to rate "Patient Satisfaction with Access and Services," as follows:
- "Overall Satisfaction with Health Plan," which includes the CAHPS results for "Rating of Health Plan."
- "Doctors' Communication and Service," which includes CAHPS results for "Rating of Personal Doctor," "Rating of Specialist Seen Most Often," and "How Well Doctors Communicate."
- "Getting Care," which includes CAHPS results for "Getting Needed Care" and "Getting Care Quickly."
The consumer guide was sent to patients for open enrollment and is posted at http://www.med-quest.us/ManagedCare/consumerguides.html.
Hawaii's External Quality Review Organization, Health Services Advisory Group, Inc., participates in CAHPS User Network activities. Tim Laios, Executive Director of Informatics for the Health Services Advisory Group, reports, "The CAHPS User Network materials are very useful and are viewed as an excellent resource for those of us in the survey community."
CAHPS™ Health Plan Survey and Reporting Kit 2008. August 2010. Agency for Healthcare Research and Quality, Rockville, MD. https://www.cahps.ahrq.gov/cahpskit/Healthplan/HPChooseQx2.asp.