Read About the Health Plan Survey

The Health Plan Survey asks enrollees about their recent experiences with health plans and their services. This standardized survey was designed to support consumers in assessing the performance of health plans and choosing the plans that best meet their needs. Health plans can also use the survey results to identify their strengths and weaknesses and target areas for improvement.

The current Health Plan Survey is version 5.0. The legacy survey – version 4.0 – remains available. Both versions include instruments for Medicaid and commercial health plans.

To ensure that survey results are comparable across users, every CAHPS Health Plan Survey starts with a set of "core" items that everyone uses. Users can then customize their survey by adding supplemental items.

CAHPS Health Plan Core Questionnaire plus CAHPS Supplemental Items equals Customized CAHPS Survey

Quality Measures from the Health Plan Survey

All versions of the CAHPS Health Plan Surveys produce the following measures of patient experience:

  • Getting needed care
  • Getting care quickly
  • How well doctors communicate
  • Health plan customer service
  • How people rated their health plan

Review measures from the CAHPS Health Plan Survey.

Versions of the Health Plan Survey

Different versions of the Health Plan Survey meet different needs. The versions vary by:

  • Population (adults or children).[1]
  • Source of coverage (commercial insurance, Medicaid, or Medicare).
  • Use for health plan accreditation by the National Committee for Quality Assurance (known as the HEDIS version).

Commercial and Medicaid Surveys

The surveys for commercial and Medicaid plans are exactly the same except for the time referent:

  • The commercial questionnaire asks patients about their experiences in the previous 12 months.
  • The Medicaid questionnaire asks them about their experiences in the previous 6 months.

Questions specific to the Medicaid population are available in a set of supplemental items that survey sponsors may choose to add to their questionnaires. Also, the child version of the Medicaid Survey includes the Item Set for Children with Chronic Conditions.

Both surveys are available for downloading: Get Health Plan Surveys and Instructions.

NCQA's Health Plan Survey

The National Committee for Quality Assurance (NCQA) asks all plans seeking accreditation or providing quality measures (HEDIS) for public reporting to submit the results of a modified version of the CAHPS Health Plan Survey. This modified survey is designated with an "H" after the version number (e.g., CAHPS 4.0H).

Learn more about NCQA's version of the Health Plan Survey.

Medicare's Health Plan Survey

The Centers for Medicare & Medicaid Services (CMS) has conducted the CAHPS Health Plan Survey with Medicare beneficiaries since 1998. The Medicare Survey includes versions for Medicare Advantage plans (including PPOs), Prescription Drug Plans, and the fee-for-service program.

Learn more about the Medicare version of the Health Plan Survey.

Supplemental Items for the Health Plan Survey

The Health Plan Survey includes a variety of optional, supplemental items that survey sponsors may add to questionnaires for adults and children. Learn more at http://www.ahrq.gov/cahps/surveys-guidance/item-sets/index.html

Brief History

Released in 1997, the Health Plan Survey is the first product of the Agency for Healthcare Research and Quality’s efforts to develop standardized surveys of consumers’ experience with health care. Since that time, this survey has become the national standard for measuring and reporting on the experiences of enrollees with their health plans. The National Quality Forum endorsed the 4.0 version of the survey as a measure of health plan quality in July 2007. Sponsors of this survey include health plans, State agencies that purchase and regulate health care, and Federal agencies, such as the Department of Defense and the Centers for Medicare & Medicaid Services.

Over time, the survey has evolved in response to research findings and feedback from key stakeholders. The 5.0 version of the Health Plan Surveys was released in May 2012. The National Quality Forum renewed endorsement of the 5.0 version of the CAHPS Health Plan Survey in January 2015 through NQF’s Person and Family Centered Care Measures maintenance process. Users also continue to have access to the 4.0 version. The CAHPS Consortium no longer supports the 3.0 version of the survey.

Learn about the most recent developments in the Health Plan Survey.

[1] Enrollees 18 and over complete the adult questionnaire; for those 17 and younger, a parent or guardian completes the questionnaire.

Page last reviewed May 2016
Page originally created October 2011
Internet Citation: Read About the Health Plan Survey. Content last reviewed May 2016. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/cahps/surveys-guidance/hp/about/index.html