ie-message
  • CAHPS and HOS have shown a downward trend compared with overall improvement in Star ratings

  • Member experience can be impacted at any of the multiple touchpoints in the healthcare system

  • Improve your member satisfaction with closed-loop interventions

    Request for Demo
  • CAHPS and HOS have shown a downward trend compared with overall improvement in Star ratings

  • Member experience can be impacted at any of the multiple touchpoints in the healthcare system

  • Improve your member satisfaction with closed-loop interventions

    Request for Demo
With 30% weightage in Star ratings, is member experience the elephant in the room that needs to be addressed?

Manage member's perception of care with Indegene Survey iQ Solution

Gauging member satisfaction and experience with care is definitely the trickiest aspect of measuring the Triple Aim goals.

Performance in survey - based satisfaction and outcomes measures like CAHPS and HOS can be primarily attributed to various functions in a health plan including customer service, providers, benefit design, PBM, and network management. Most importantly, people tend to remember negative experience like a rejected claim at the retail pharmacy, which colors their perception while responding to CAHPS survey questions.

Some of the CAHPS questions also require that members be sensitized about the right expectations. For example, members should be made aware that an oncologist appointment may require more than a day and they should appropriately answer "In the last 6 months, when you needed care right away, how often did you get care as soon as you thought you needed?"

Indegene collaboratively works with health plans to identify the right intervention for the right member at the right time, develop cohort-specific outreach scripts and workflows, and develop business rules using Health Risk Assessment, as well as clinical and claims data.

Programs
  • Off cycle truncated surveys
    Off-cycle truncated surveys

    Assess barriers, satisfaction and experience with care visit, doctor, and care received, gauge member perception and develop proxy scores to project Star ratings. Identify potential provider groups that need to manage member perception, solicit feedback from the practitioners, and develop an action plan to improve Star ratings.

  • Reminder messages
    Reminder messages

    Outreach members to influence their memory for measures like flu shots, and identify possible HOS cohorts to educate physicians about discussing physical activity, fall management, and urinary incontinence.

  • Provider education
    Provider education

    Offer personalized and data-driven education modules to providers, specifically to groups and IPAs that have a P4P or risk sharing agreement with the payer. Work with IPAs on seniors sensitivity training, and educate practitioners on formulary.

Programs
Off-cycle truncated surveys

Assess barriers, satisfaction and experience with care visit, doctor, and care received, gauge member perception and develop proxy scores to project Star ratings. Identify potential provider groups that need to manage member perception, solicit feedback from the practitioners, and develop an action plan to improve Star ratings.

Reminder messages

Outreach members to influence their memory for measures like flu shots, and identify possible HOS cohorts to educate physicians about discussing physical activity, fall management, and urinary incontinence.

Provider education

Offer personalized and data-driven education modules to providers, specifically to groups and IPAs that have a P4P or risk sharing agreement with the payer. Work with IPAs on seniors sensitivity training, and educate practitioners on formulary.

Benefits
done

Better engaged members

done

Improved awareness of services available

done

Managed member perception of healthcare