The Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores are a vital component in evaluating the quality of healthcare services. They impact Medicare Advantage plans’ star ratings and associated bonuses, and also serve as an essential measure of member satisfaction and trust. Improving CAHPS scores requires a nuanced understanding of member-centric engagement strategies, which starts with developing a deep understanding of an individual member.
By demonstrating such an understanding through consistent, personalized interactions across all channels and touchpoints, health plans build strong, trust-based relationships with members – a key metric for enhancing CAHPS scores.
Trust as a Foundational Element of Higher CAHPS Scores
Beyond the financial incentives associated with the bonuses from higher Medicare Advantage star ratings, CAHPS scores are an important gauge of overall satisfaction and trust in healthcare services. Trust, in turn, is beneficial because a member who trusts his or her health plan is more likely to engage in healthier and cost-saving behaviors such as scheduling preventive screenings or opting for home delivery services.
Plans build trust through positive interactions with members. Every phone call, automated message, online session and in-person visit is an opportunity to influence a member’s perception. But more than just stringing together a series of positive interactions, trust is solidified through consistent personalization. The member should be made to feel that a health plan is communicating consistently, addressing the member’s individual needs, independent of channel.
A high CAHPS score reflects that consistency, because it is a measure of overall satisfaction versus a single set of communications. It is the member’s positive reaction to consistent personalization across the member journey.
Build Member Trust Through Data
The pressing need for health plans to deliver a personalized CX across the member journey calls for a robust and up-to-date single view of the member as well as more advanced omnichannel capabilities. For health plans and healthcare organizations, the most comprehensive solution is a customer data platform (CDP). A CDP provides a single view of the member by aggregating member data from every source, continually applying data quality processes as soon as new data is being brought in, dynamically segmenting audiences and activating member cohorts through seamless connections to every end channel.
Personalizing the member experience using a single member view that is updated in real time gives health plans the ability to meet a member with a relevant, personalized experience the moment a member engages regardless of the channel. The interaction will reflect a deep understanding of the member journey because the single view contains all relevant member data. Far more than claims information and a medical history, the single view or Golden Record includes all known devices and IDs, preferences, behaviors, social and even social determinants of health (SDoH) data. Everyone with access to the updated Golden Record will know, for instance, whether the member is due for a screening, has an open claim, has a change in dependents or any other relevant information – at the moment of engagement.
Everyone who interacts with a member – a care navigation coordinator, a call center rep, a billing agent, a marketer – has a precise understanding of the contour of a member journey and is able to use that knowledge to help guide the journey to a mutually beneficial outcome. The member is satisfied and is guided toward better outcomes. The health plan reduces costs and enhances trust. A personalized journey, for example, might show empathy for how a member is coping with a chronic condition. Or by acknowledging a past health event such as a child’s injury. Or anticipating that a member needs help with transportation for a certain preventative screening of medical procedure.
Improve Scores Through Dynamic Segmentation
A CDP serves another important function. It provides health plans with the ability to identify and analyze reasons for a low CAHPS scores and take preventive measures. By building segments of members who have provided low ratings, a health plan can use a CDPs automated machine learning capabilities to analyze areas of dissatisfaction, and then test different personalization tactics to see where gains can be made.
CAHPS scores are more than just a measure of member satisfaction; they reflect the quality of interactions and trust between healthcare providers and their members. By adopting a member-centric approach, focusing on personalized communication, and utilizing data effectively, healthcare organizations can enhance their CAHPS scores and build stronger relationships with their members. This not only improves financial outcomes but also fosters a more positive and trusting environment for healthcare delivery.
Redpoint Global has partnered with Engagys, a healthcare consumer engagement consulting and advisory services firm, to assist health plans with maximizing the value of their member data. We are bringing together data-driven technology with best-in-class, personalized engagement solutions to help increase member satisfaction – and improve CAHPS scores. For more on how Redpoint and Engagys can help you maximize member engagement, using your own data, click here.
