Enhancing Quality Through Member Engagement

June 21, 2019 Anne Davis

Continue the Quality Journey with HOS/CAHPS

As we head into the second half of the year, however, there’s no need to take your eye off the quality ball. Why not turn your attention to member satisfaction and engagement? Engaged members drive improvement in quality metrics. In addition, they make healthier choices and live longer lives.

HOS/CAHPS measures make up 36% of Part C and 27% of Star Ratings and they play a central role in differentiating Four-Star and Five-Star plans. Many health plans would love to move those measures, but they find it hard to do so because member perceptions are hard to understand and even harder to influence.

Best Practices for Quality Measure Improvement

The good news is that developing and implementing a member satisfaction and engagement strategy can help. Here are our “Six for Six” – six best practices to move the needle on HOS/CAHPS scores and other quality measures that you can implement in the final six months of the year:

  1. Survey your membership. The end of the summer is the perfect time to survey members. You still have time to make a “quality push” that will impact ratings, close care gaps, and prepare the organization for a strong start to 2020.
  2. Engage the entire organization in quality. Quality isn’t a one-department job. Leadership commitment is essential. Involvement from all functional areas is also important, since HOS/CAHPS are all about relationships between members, providers, and plans. Take a closer look at how your plan communicates between departments, as well as with external partners.
  3. Invest in customer service. Every interaction with your members is an opportunity to meet their needs and enhance the member experience. The customer service team represents the face of the organization, so think about hiring candidates with a service-orientation and training existing staff to delight members.
  4. Use mock surveys. Organizations with successful, year-round quality programs often use “mock surveys” that are similar to HOS/CAHPS. These are a great way to gather timely, member-level results. HMS works with health plans to develop customized question sets. These enable plans to identify and address areas that require prompt attention.
  5. Take action. With detailed, member-level survey responses and feedback, HMS can help your organization make meaningful changes now that will positively impact your ratings and customer satisfaction for years to come.

The most effective quality programs last all year long, identifying members who need routine tests and exams and working with the people who are most willing to engage with feedback. Member engagement strategies can help by arming your organization with specific insights about what members like about your programs and what changes they’d like to see. This information enables you to create action plans and bring your teams to the next level in quality and member satisfaction.


To learn more about increasing HOS/CAHPS scores, check out this eBook for actionable tips to improve your Star Rating!

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