CAHPS Health Plan Survey
The CAHPS Health Plan Survey is a tool for collecting standardized information on enrollees' experiences with health plans and their services. Since its launch in 1997, this survey has become the national standard for measuring and reporting on the experiences of consumers with their health plans.
For over two decades, health plans, public and private purchasers, and other organizations have been using the survey results for important purposes:
- To monitor the performance of health plans and reward plans for high-quality care.
- To support consumers in assessing the quality of health plans and choosing the plans that best meet their needs.
- To identify the strengths and weaknesses of health plans and target areas for improvement.
Learn more about using Health Plan Survey data.
Get the Health Plan Survey 5.0 and 5.1
There are two versions of the Health Plan Survey:
- New: Health Plan Survey 5.1
- Health Plan Survey 5.0
Both versions include standardized instruments for enrollees in Medicaid and commercial health plans. Instruments are available for adult (18 and older) and child populations. The Child Survey asks parents or guardians about the healthcare experiences of children 17 and younger.
The 5.1 version of the Health Plan Survey updates the 5.0 version to acknowledge the various ways in which enrollees may receive care: in person, by phone, or by video.
- Review the Adult Medicaid Survey 5.1 (English) (PDF, 263 KB)
- Review the Child Medicaid Survey 5.1 (English) (PDF, 268 KB)
The ZIP file includes the Adult and Child Medicaid and Commercial instruments in English only (Word and PDF).
- Review the Adult Medicaid Survey 5.0 (English) (PDF, 290 KB)
- Review the Child Medicaid Survey 5.0 (English) (PDF, 369 KB)
The ZIP file includes the Adult and Child Medicaid and Commercial instruments in English and Spanish (Word and PDF).
Administering the CAHPS Health Plan Survey
Guidance for using the CAHPS Health Plan Survey (ZIP, 2.5 MB) includes information about:
- Preparing a questionnaire,
- Drawing a sample of potential respondents,
- Collecting the survey data,
- Tracking responses, and
- Using the survey results to report patient experience measures.
This guidance is based on the survey developers' extensive research into best practices in survey design and administration as well as analyses of data collected during field tests. AHRQ does not require the use of a specific methodology for sampling or survey administration.
Users of this survey may also want to consult the following guidance:
Quality Measures From the Health Plan Survey 5.0/5.1
All current versions of the CAHPS Health Plan Survey 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.
Supplemental Items for the Health Plan Survey
To customize their survey instruments, users of the Health Plan Survey may add optional supplemental items that address a variety of topics.
Some supplemental items are designed to be incorporated into the survey as a set. They address the following subjects:
Variations on the Health Plan Survey
The National Committee for Quality Assurance (NCQA) and the Centers for Medicare & Medicaid Services (CMS) use the CAHPS Health Plan Survey to meet their respective needs.
- NCQA's version of the Health Plan Survey. 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 5.0H, CAHPS 5.1H).
- Medicare version of the Health Plan Survey. 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.
Aggregated Results for the CAHPS Health Plan Survey
The CAHPS Health Plan Survey Database aggregates survey results voluntarily submitted by various sponsors, including State Medicaid agencies, state Children’s Health Insurance Programs (CHIP), and individual health plans that administer the survey instrument. AHRQ’s CAHPS Data Tools and annual Chartbooks are designed to facilitate comparisons of survey results.
Participation in this database is free and open to all users of the Health Plan Survey. All participants receive a private, customized feedback report that compares their results to overall findings. Learn about participating in the Health Plan Survey Database.
FAQs About the Health Plan Survey
Why does the CAHPS Health Plan Survey ask respondents to continue answering questions even if they think they are not in the sampled health plan?
Health plan members don’t always recognize the name of their plan. This can happen because health plans change their names or because they are commonly known by a name other than the official one. In addition, the exact name of a plan is often not salient for people who have little need for healthcare.
If respondents don’t recognize the health plan’s name, the survey invites them to fill in what they think is the name and complete the questionnaire with that plan in mind. This approach allows the survey sponsor to make eligibility decisions based on other data and minimizes the potential loss of valid information.
Why doesn't the Health Plan Survey's definition of primary care providers include nurses?
The CAHPS Health Plan Survey includes some questions about the personal doctor, defined as the "one you would see if you need a checkup, want advice about a health problem, or get sick or hurt." While nurses are critical to healthcare and function as primary care providers in some systems of care, the personal doctor is universal across systems of care.
Because of the prevalence and importance of care provided by nurses, however, the CAHPS research team is considering different approaches to this issue for future versions of the survey.
How many completed surveys are needed for analysis of the CAHPS Health Plan Survey?
The recommended number of completed questionnaires for the CAHPS Health Plan Survey is 300 per health plan.
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 healthcare. Over time, the survey has evolved in response to changes in healthcare delivery and health plan structures, research findings, and feedback from key stakeholders.
- In October 2020, the CAHPS Consortium released the 5.1 version of the Health Plan Survey.
- In May 2012, the CAHPS Consortium released the current 5.0 version of the Health Plan Survey.
The National Quality Forum (NQF) first endorsed the CAHPS Health Plan Survey as a measure of health plan quality in July 2007. In January 2015, the NQF renewed its endorsement of the 5.0 version of the CAHPS Health Plan Survey through its Person and Family Centered Care Measures maintenance process.
Learn about the most recent developments in the Health Plan Survey.