Consumer Assessment of Healthcare Providers and Systems (CAHPS®)
What is CAHPS®?
CAHPS® is a standardized and validated patient experience survey created by the Agency for Healthcare Research and Quality (AHRQ) and required for San Francisco Health Plan to maintain accreditation by the National Committee for Quality Assurance (NCQA). The purpose of the survey is to gauge patients’ experiences with the health care they have received.
How Does it Work?
San Francisco Health Plan (SFHP) takes part in in the CAHPS® survey each year from February through May. A NCQA-certified, third-party vendor administers the survey using a random sample of the full member population, including both adult and child Medi-Cal members. Participation is voluntary and anonymous.
What Does it Measure?
CAHPS® covers topics that are most important to patients. The survey focuses on quality measures such as ease of access to health care services and information, as well as communication skills of providers.
| Measure Domain | Survey Question “In the last 6 months…” |
|---|---|
| Access to Care | When care was needed right away, how often did you get care as soon as you needed? How often did you get an appointment for a check-up or routine care as soon as needed? How often was it easy to get the care, tests, or treatment you needed? How often did you get an appointment with a specialist as soon as needed? |
| Provider Communication | How often did your doctor explain things in a way that was easy to understand? How often did your doctor listen carefully to you? How often did your doctor show respect for what you had to say? How often did your doctor spend enough time with you? |
| Coordination of Care | How often did your doctor seem informed and up-to-date about the care you got from other health providers? |
| Rating of Physicians and All Healthcare | Rate your personal doctor on a scale of 1 to 10. Rate your specialist on a scale of 1 to 10. |
| Rating of Health Plan and Healthcare | Rate your health plan on a scale of 1 to 10. Rate all of your health care on a scale of 1 to 10. |
| Customer Service and Health Plan Forms | How often did customer service give you the help and information you needed? How often did customer service treat you with courtesy and respect? How often was it easy to fill out the forms your health plan gave you? |
Every year, SFHP shares CAHPS® survey results with each medical group in its network. This gives providers:
- A chance to collaborate with SFHP to enhance patient experiences where needed
- A way to view the health care experience from the patient’s perspective
- The potential to positively impact the patient-provider relationship
Why Does it Matter?
- CAHPS® is part of the Healthcare Effectiveness Data and Information Set (HEDIS) measurement system. It makes up roughly 1/3 of the NCQA score and factors into both the Medi-Cal rates setting and auto-assignment for health plans.
- CAHPS® is used by Centers for Medicare & Medicaid Services (CMS) and Medicare Advantage plans to calculate star ratings.
- In 2024, CAHPS® makes up 20 percent of Department of Health Care Services (DHCS) quality withhold for health plans, and in 2025 is projected to increase to 30 percent.
- Starting in 2024, SFHP includes specific CAHPS® measures in its Provider Improvement Program (PIP). This ties financial payment to performance and incentivizes providers to prioritize improvements to these measures.
Improving CAHPS® Performance – Resources for Providers
CAHPS® is a registered trademark of the AHRQ. They offer extensive resources related to the survey on their website, including resources to help providers improve the patient experience and CAHPS® scores: