Annual Quality Surveys: What Medicare Members Need to Know

Annual Quality Surveys: What Medicare Members Need to Know

Feb 22 2022

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.

As a member of a Medicare Advantage plan, you might receive one or more surveys throughout the year that asks you to share your experience with your health plan and your health care.

Two of these surveys, the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and they Health Outcomes Survey (HOS) are especially important, because they’re managed by The Centers for Medicare and Medicaid Services. Here, we break down everything you need to know about these surveys, from when they’re fielded to why you should fill one out if you receive it.

What you should know 

The CAHPS and HOS surveys help CMS determine the quality of the care health care coverage companies provide to Medicare members. As Samantha Bartholomew, Stars Program Specialist at Priority Health says, the responses really do matter.

Person taking survey

“At Priority Health, we’re proud that more than 95% of our Medicare members would recommend us to their friends and family 1 . We believe a big part of that is because we truly listen to our members. The results of these surveys are used to measure our plan quality , tell us what we’re doing well and let us know where we can improve,” Bartholomew says.

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

“We feel good about having survey response rates higher than the national average with more than 50% of our Priority Health Medicare members responding to surveys. Because of this great feedback, our Medicare Advantage plans earned 4 and 4.5 out of 5 stars from CMS for 2022 2 . These ratings reflect 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 year:

CAHPS Survey

One survey you might receive in the spring 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

In the fall, 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 and 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 your Medicare plan and the service we provide. We want you to know that your responses help us serve you, our members, even better.,” Bartholomew says. “We’re able to make improvements to benefits and coverage based on feedback from surveys like these.”

Answer the questions specifically about your Medicare Advantage plan and your personal experience.

These surveys ask specifically about your experience with your Medicare plan and using your benefits to receive care. As you consider your responses, 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’s experience instead of their own, and that doesn’t provide CMS or health plans with the most accurate quality data.”

Medicare surveys

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. Medicare beneficiaries can rest assured that your health plan or CMS would never risk your personal information. 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,” Bartholomew says.

Priority Health wants all its Medicare members to know how grateful they are for regular, honest feedback.

“We know it takes time and we truly appreciate each and every survey that is completed. Your 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, your responses help us make sure you’re getting the care you need to stay your healthiest.”

1 – According to results from  2020 Consumer Assessment of Health Plan Providers and Systems survey

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

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