Annual Quality Surveys: What Medicare Members Need to Know

Annual Quality Surveys: What Medicare Members Need to Know

Mar 16 2020

Every year, Medicare members receive surveys asking: “how would you rate your health plan?” Taking the time to answer, and how you answer, is important.

Each spring, various surveys are sent to members of all Medicare Advantage plans throughout the U.S. asking them to rate their experiences with their health plan. These patient experience surveys are managed by The Centers for Medicare & Medicaid Services (CMS) and focus on whether or how often you experienced key aspects to staying healthy.

What you should know

These surveys are designed to help CMS determine the quality of the care health care coverage companies provide to Medicare members. And as Reva Sheehan, senior improvement specialist at Priority Health says, the responses really do matter—more than you may realize if you’re a Medicare beneficiary.

“At Priority Health, we’re proud that 97% of our Medicare members would recommend us to their friends and family1. We believe that’s because we truly listen to our members. We use the results of surveys to measure the performance of our quality initiatives, identifying what we’re doing well and areas where we can improve,” Sheehan says.

Ian Straayer, manager of Quality Improvement at Priority Health, adds that all Medicare beneficiaries—regardless of health plan—should take the time to fill out quality surveys to provide important feedback that helps all health plans and providers make improvements across 48 different categories of care.

“We feel good about having survey response rates higher than the national average with about 50% of our Priority Health Medicare members responding to surveys. Because of this great feedback, our Medicare Advantage plans earned 4 out of 5 stars from CMS for 2020. These ratings are a reflection of how well we take care of our members,” Straayer says.

Here are a few surveys Medicare members may receive in the mail over the next few months:

CAHPS Survey

One survey you might receive is the Consumer Assessment of Healthcare Providers and Systems Survey, or CAHPS. This survey asks questions about your experience with your health plan and your providers in areas like:

  • Getting needed care
  • Getting care quickly
  • How well doctors communicate
  • Health plan customer service
  • Health plan rating
  • Prescription drug plan rating

HOS Survey

Another survey to look out for is the Health Outcomes Survey, or HOS. This survey includes questions to see if your health care provider discussed key health topics with you. This is to ensure you are receiving the care you need to stay healthy. Topics include:

  • Fall prevention
  • Physical health
  • Mental health
  • Bladder health

What you can do as a Medicare member

If you receive a survey, fill it out—completely.

If you receive one of these surveys in the mail, please take the time to fill it out. Be sure to follow the survey directions and answer all questions as directed. Your responses will help CMS ensure you receive high-quality care.

Understand the rankings.

CMS holds a very high regard for these surveys and the rankings from Medicare beneficiaries. CMS will use your answers to help measure the quality of the care we provide. Know that your feedback has a big influence on the overall quality rating of your health plan.

“As a Priority Health member, you may receive surveys from CMS and from us asking you to rate our plan and the service we provide. We want you to feel confident that you made the smart choice-and if not, know that we listen through this survey and other ways to make improvements,” Sheehan says. “We’re able to make improvements to benefits and coverage based on feedback from surveys like these. So we would love for our Medicare members to call the number on the back of your card. We’re open 8 a.m. to 8 p.m., seven days a week and really want to hear their feedback.”

Answer the questions specifically about your Medicare Advantage plan.

These surveys ask specifically about your experience with your Medicare plan and using your benefits to receive care. So as you consider your responses, please make sure you’re thinking about your specific and current health plan. Straayer adds you should also respond to these surveys only about yourself, not others.

“We’ll hear from members that they have answered certain questions about a spouse or a friend who didn’t have a similar experience, and that doesn’t provide CMS or health plans with the most accurate quality data.”

How do I know this is safe?

With heightened awareness on safeguarding your personal information, it makes sense that you want to make sure you feel comfortable and safe completing them. Sheehan says Medicare beneficiaries can rest assured that your health plan or CMS would never risk your personal information and if you ever feel unsure, ask for a second opinion.

“These surveys will never require you to share your health information, like your health plan number, or personal information, such as your driver’s license or social security number. If you receive a survey and want to make sure it’s safe to complete, please call us. You can contact our Customer Service team using the number on the back of your membership card. We’ll be glad to help,” Sheehan says.

Both Sheehan and Straayer and the entire quality team at Priority Health want all Medicare members to know how thankful they are for regular, honest feedback.

“We know it takes time and so we truly appreciate each and every survey that is completed. Our members’ feedback helps us continue to provide the high quality care we’re known for, make improvements and help set the standard for Medicare health plans across the country. But, more importantly, their responses help us make sure our members receive the care they need to stay their healthiest.”

1 – July 2014 Priority Health Medicare research report by Kiekover Marketing

2 – Results for HMO-POS plans only. Every year, Medicare evaluates plans based on a 5-star rating system.