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August 2018
Recommendations for improving Medicare Advantage patient satisfaction
Practices with a high level of patient satisfaction benefit from patients who are more loyal and more likely to follow treatment plans. And practices with satisfied patients typically have higher levels of employee satisfaction and less employee turnover.**
CMS patient satisfaction surveys
Each spring, the Centers for Medicare & Medicaid Services measures patient satisfaction and outcomes with two separate surveys:
- Consumer Assessment of Healthcare Providers and Systems — CAHPS assesses quality of care from a health plan member’s perspective.
- Health Outcomes Survey — HOS measures patient-reported health outcomes.
CMS sends these annual surveys to a sampling of Medicare Advantage members by a certified survey vendor.
Results and recommendations for your practice
Based on results of the 2017 surveys, key areas that need improvement for both CAHPS and HOS surveys follow. We’ve included a detail of each measure, patient survey questions for your information, as well as recommendations that can help your practice achieve higher patient satisfaction.
CAHPS survey findings
Three key areas for improvement:
- Administering the annual flu vaccine during flu season.
- Ensuring that patients see the doctor or other health care practitioner within 15 minutes of an appointment time.
- Sharing test results with patients promptly.
CAHPS measure: Annual flu vaccine
Patient survey question |
Recommendation for providers |
Have you had a flu shot since July 1, 2018? |
Administer flu shot after July 1, 2018, and before Feb. 1, 2019. |
CAHPS measure: Getting appointments and care quickly
Patient survey questions |
Recommendations for providers |
In the last six months, how often did you see the person you came to see within 15 minutes of your appointment time? |
If you’re behind schedule, have the front office staff update patients often and explain why. Patients are more tolerant of delays if they know the reasons. Show respect to the patient if you’re behind schedule and apologize. |
In the last six months, when you needed care right away, how often did you get care as soon as you thought you needed it? |
Ensure that a few appointments are open each day for urgent visits, including post-inpatient-discharge visits. |
In the last six months, not counting the times when you needed care right away, how often did you get care as soon as you thought you needed it? |
Offer appointments with a nurse practitioner or physician’s assistant to patients who want to see you on short notice. Ask patients to make routine checkup and follow-up appointments in advance. |
CAHPS measure: Overall rating of health care quality
Patient survey question |
Recommendation for providers |
Using any number between zero and 10, where zero is the worst health care possible and 10 is the best health care possible, what number would you use to rate all your health care in the past six months? |
Ask patients how they think you could improve their health care. |
CAHPS measure: Care coordination
Patient survey questions |
Recommendations for providers |
When you visited your personal doctor for a scheduled appointment, how often did he or she have your medical records or other information about your care? |
Before walking in the exam room, read the current complaints and decide if anything needs a follow-up from previous visits. |
When your personal doctor ordered a blood test, x-ray or other test for you, did someone from your personal doctor’s office follow up to give you those results? |
When ordering tests, let your patients know when they can expect results. Implement a system to ensure prompt notifications of results. |
Did your personal doctor talk to you about all the prescription medicines you were taking?
Did you get the help you needed from your personal doctor’s office to manage your care among these different providers and services?
How often did your personal doctor seem informed and up to date about specialist care? |
Ask your patients if they saw another provider since you last met with them.
If you know patients received specialty care, discuss their visit and if the specialist prescribed any added medication. |
Health Outcomes Survey findings
Three key areas for improvement:
- Discussing the risk of falls with patients
- Advising on physical activity
- Inquiring about bladder control
HOS measure: Reducing the risk of falling
Patient survey questions |
Recommendations for providers |
Did you fall in the last 12 months?
Did you talk to your doctor about falling or problems with balance or walking? |
Some things your patients might do to reduce the risk of falling are:
- Using a cane or walker
- Engaging in an exercise or physical therapy program
- Having a vision or hearing test
- Improve home safety
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HOS measure: Improving or maintaining physical health
Patient survey questions |
Recommendations for providers |
During the past four weeks, has pain stopped you from doing things you want to do?
Have you had any of the following problems with your work or other regular daily activities because of your physical health?
- Accomplished less than you would like
- Didn’t do work or other activities as carefully as usual
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Identify ways to improve the pain problem.
Determine if your patient could benefit from a consultation with a pain specialist or rheumatologist.
Consider physical therapy, cardiac or pulmonary rehabilitation when appropriate. |
HOS measure: Improving bladder control
Patient survey questions |
Recommendations for providers |
In the past six months, have you accidentally leaked urine?
How much of a problem, if any, was the urine leakage for you?
Have you received other treatments for your current leakage problem? |
When talking to patients, note that urinary leakage problems can be common as we grow older, but there are treatments that can help. This opens the conversation if they’re too embarrassed to bring it up.
Do they have leakage problems? Discuss potential treatments options, such as medications, exercises and surgery. |
HOS measure: Improving or maintaining mental health
Patient survey questions |
Recommendations for providers |
Have you had any of the following problems with your work or other regular daily activities because of emotional problems?
- Accomplished less than you would like
- Didn’t do work or other activities as carefully as usual
- Didn’t have a lot of energy or felt sad or depressed most days
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Empathize with the patient.
Consider therapy with a mental health professional when appropriate.
Offer ideas to improve mental health: Take daily walks, socialize, stay involved with family, own a pet, do crossword puzzles, volunteer, attend church, go to senior community centers or try meditation.
Since loss of hearing can be isolating, consider a hearing test when appropriate. |
HOS measure: Monitoring physical activity
Patient survey question |
Recommendation for providers |
In the past 12 months, did you talk with a doctor or other health care provider about your level of exercise of physical activity?
In the past 12 months, did a doctor or other health care provider recommend starting, increasing or maintaining your level of exercise or physical activity? |
Offer physical activity suggestions based on the patient’s ability.
Offer ideas for where patients can engage in activities such as senior classes at the Area Agency on Aging, YMCA and community centers. These also offer opportunities for social interaction. |
Do you have feedback?
If you have any suggestions for how we can improve the patient care experience, send an email to Laurie Latvis at LLatvis@bcbsm.com.
**Edgman-Levitan, Susan and others. The CAHPS Ambulatory Care Improvement Guide: Practical Strategies for Improving Patient Experience. Agency for Healthcare Research and Quality. December 2017.
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