Definition

This indicator includes graphs showing the percentage of survey respondents who reported positive customer service experiences with their health plan.

Numerator

Number of survey respondents who indicated a positive response to customer service experiences.

Denominator

Number of survey respondents in Utah's Medicaid and commercial health plans.

Data Interpretation Issues

This is a composite measure. As such, the only way to create the overall category and state averages is to add all of the averages and divide by the number of plans. Please note that these are not true averages as we are not able to take into account response numerators, denominators, and enrollment sizes of individual plans.

Why Is This Important?

Experience is not the same as satisfaction. Patient experience surveys such as CAHPS sometimes are mistaken for customer satisfaction surveys. Patient experience surveys focus on how patients experienced or perceived key aspects of their care, not how satisfied they were with their care. Patient experience surveys such as CAHPS focus on asking patients whether or how often they experienced critical aspects of health care, including communication with their doctors, understanding their medication instructions, and the coordination of their health care needs. They do not focus on amenities. The Utah Department of Health and Human Services Office of Research and Evaluation implements and administers several different patient experience surveys. These surveys ask patients (or in some cases their families) about their experiences with, and ratings of, their health care providers and plans, including hospitals, home health care agencies, doctors, and health and drug plans, among others. The surveys focus on matters that patients themselves say are important to them and for which patients are the best and/or only source of information.

Other Objectives

Healthy People 2020 Objective AHS-6.1 Reduce the proportion of persons who are unable to obtain or delay in obtaining necessary medical care, dental care, or prescription medicines[[br]] '''U.S. Target:''' 9.0 percent

What Is Being Done?

The Utah Department of Health and Human Services Office of Research and Evaluation produces and releases a "Patient Experience Report of Utah Health Plans" every year with updated CAHPS survey results and other HEDIS (Healthcare Effectiveness Data and Information Set) measures. These can be viewed at [https://stats.health.utah.gov/about-the-data/health-plan-quality/].

Health Program Information

The Consumer Assessment of Health Plans Survey (CAHPS) assesses satisfaction levels of health plan enrollees' experiences. CAHPS surveys follow scientific principles in survey design and development. The surveys are designed to reliably assess the experiences of a large sample of patients. They use standardized questions and data collection protocols to ensure that information can be compared across health care settings. CAHPS surveys are developed with broad stakeholder input, including a public solicitation of measures and a technical expert panel, and the opportunity for anyone to comment on the survey through multiple public comments period through the Federal Register. In Utah, the survey is administered annually by the Utah Department of Health and Human Services, Healthcare Information and Analysis Programs.

Data Notes

Prior to 2020, odd-year surveys were conducted for adult enrollees of Utah health plans, while the even-year surveys were conducted for child enrollees. From 2020 on, surveys are being conducted for Medicaid enrollees for every year and both age groups. Commercial plans are continuing on the every-other-year basis. Medicaid is a source of health insurance coverage for Utah's vulnerable populations. Medicaid is a state and federal program that pays for medical services for low-income pregnant women, children, individuals who are elderly or have a disability, parents, and women with breast or cervical cancer. To qualify, these individuals must meet income and other eligibility requirements. Commercial health insurance is defined as any type of health benefit not obtained from Medicare or Medicaid plans. The insurance may be employer-sponsored or privately purchased. Commercial health insurance may be provided on a fee-for-service basis or through a managed care plan.   [[br]] [[br]]This measure was created by combining different questions about how often health plans provide customer service well. Enrollees replied "always", "usually", "sometimes", or "never". [[br]] [[br]] The percentage of respondents who replied "always" or "usually" was calculated for Medicaid and commercial plans to derive the values presented.

Data Source

Consumer Assessment of Health Plans Survey, Healthcare Information & Analysis Programs, Office of Research & Evaluation, Utah Department of Health and Human Services

Data Notes

Prior to 2020, odd-year surveys were conducted for adult enrollees of Utah health plans, while the even-year surveys were conducted for child enrollees. From 2020 on, surveys are being conducted for Medicaid enrollees for every year and both age groups. Commercial plans are continuing on the every-other-year basis. Medicaid is a source of health insurance coverage for Utah's vulnerable populations. Medicaid is a state and federal program that pays for medical services for low-income pregnant women, children, individuals who are elderly or have a disability, parents, and women with breast or cervical cancer. To qualify, these individuals must meet income and other eligibility requirements. Commercial health insurance is defined as any type of health benefit not obtained from Medicare or Medicaid plans. The insurance may be employer-sponsored or privately purchased. Commercial health insurance may be provided on a fee-for-service basis or through a managed care plan.   [[br]] [[br]]This measure was created by combining different questions about how often health plans provide customer service well. Enrollees replied "always", "usually", "sometimes", or "never". [[br]] [[br]] The percentage of respondents who replied "always" or "usually" for their child was calculated for Medicaid and commercial plans to derive the values presented.

Data Source

Consumer Assessment of Health Plans Survey, Healthcare Information & Analysis Programs, Office of Research & Evaluation, Utah Department of Health and Human Services

References and community resources

Utah Department of Health and Human Services, Office of Research & Evaluation, Healthcare Information & Analysis Programs: [http://stats.health.utah.gov/about-the-data/health-plan-quality/] [[br]] [[br]] Centers for Medicare & Medicaid Services: [https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/CAHPS/]