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. Survey results can be used to:
- Support consumers in assessing the performance of health plans and choosing the plans that best meet their needs.
- Identify the strengths and weaknesses of health plans and target areas for improvement.
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.
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 that can be administered to adults and children enrolled in Medicaid and commercial health plans.
Get the Health Plan Survey 5.1
The 5.1 version of the Health Plan Survey acknowledges the various ways in which patients may receive care: in person, by phone, or by video. Field testing of the 5.1 version has not been conducted by the CAHPS Consortium.
Download the survey:
|Population||Medicaid Survey||Commercial Survey|
Get the Health Plan Survey 5.0
The ZIP file includes:
- Medicaid and commercial survey instruments in English and Spanish (Word and PDF).
- Guidance on administering the survey, including a sample telephone script and sample letters.
- Information about the survey measures.
For quick access to the survey and recommended administration methods:
Users of this survey may also want to consult the following guidance:
Information in the guidance documents 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.
Quality Measures From the Health Plan Survey 5.0
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:
Other Versions of 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.
Using Health Plan Survey Data
A version of the CAHPS Health Plan Survey is conducted in almost every State in the U.S. Sponsors of this survey include health plans, private purchasers, State agencies that purchase and regulate healthcare, and Federal agencies, such as the Department of Defense and the Centers for Medicare & Medicaid Services.
These organizations use the Health Plan Survey for several purposes.
- Compare survey data to aggregated results: Using data voluntarily submitted by survey sponsors around the country, AHRQ's CAHPS Database reports scores that can be used to assess the overall performance of different kinds of health plans and to analyze the performance of a single health plan relative to appropriate benchmarks.
- Improve enrollees' experiences with health plans: AHRQ offers a variety of materials to support survey users in identifying opportunities for improvement and tracking progress towards goals.
- Report health plan survey scores to consumers: AHRQ offers specific guidance on reporting the results of CAHPS surveys as well as more comprehensive guidance on reporting quality information to consumers in TalkingQuality.
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 health care.
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 health care 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 health care. Over time, the survey has evolved in response to changes in health care 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.