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HHS Launches Consumer Survey on Managed Care Experiences

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Medicare Patients Will Be Among the First to Benefit

Press Release Date: February 20, 1998

HHS Secretary Donna E. Shalala today launched a new nationwide effort to help patients rate their health plans and to help consumers choose among plans. The effort is built on a new survey tool, the Consumer Assessment of Health Plans (CAHPS®), that provides a consumers-eye view of the care and service they receive from health providers.

HHS' Agency for Health Care Policy and Research, which developed the new CAHPS® survey, today released the completed survey kit, which can be used by managed care plans, employers and others to obtain consumers' views of the care they are receiving.

At the same time, Secretary Shalala announced that Medicare enrollees in managed care plans will be among the first to benefit. Medicare will use CAHPS® this month to conduct the first-ever survey of beneficiaries in every Medicare managed care plan to assess their experiences with managed care.

In addition, the Office of Personnel Management will adopt CAHPS® for use by the Federal Employees Health Benefits Program. OPM will use CAHPS® to survey federal employees and report back the findings of the survey to them to help in the selection of health plans during federal open season.

"When you choose a health plan, you want to know how the plan really works for its patients. You want the kind of information you'd get from a friend or a trusted neighbor," Secretary Shalala said. "This survey lets patients share what only they know about the health plans where they're enrolled. It can help others make the right choice of health plan. And of course, it can help the providers improve their services, as well."

About 130,000 Medicare managed care enrollees should start to see the CAHPS® "Medicare Satisfaction Survey" questionnaires in the mail soon. Nancy-Ann Min DeParle, administrator of the Health Care Financing Administration which administers Medicare, urged beneficiaries to fill out the questionnaire, saying "the more responses we get, the more we can help all our beneficiaries make truly informed choices about managed care."

"Results of this survey will let beneficiaries make apples-to-apples comparisons of managed care plans," DeParle said. "It will let people find out in a clear, reliable way what other beneficiaries know about the health care plans available to them."

The Medicare questionnaire was developed as one part of the CAHPS® initiative in response to the unprecedented demand for consumer feedback on health plans in an increasingly competitive health care environment.

"CAHPS® provides scientifically based survey instruments for gathering and reporting how consumers perceive the quality of care they are receiving," said John M. Eisenberg, M.D., AHCPR's administrator. "Consumers can make choices based on what other people have said about the available plans, and they can look for features that are especially important to them and their families."

Dr. Eisenberg emphasized that some aspects of a plan's quality can be judged only by the consumers, such as how well the doctor communicates with patients, how easy it is to get urgent care, or how burdensome the paperwork is. CAHPS® will obtain this information from consumers and compile and release the results so that other consumers can use it to compare and choose the best health plan for their needs.

The CAHPS® kit contains a set of questionnaires that ask about consumers' experiences with their health plans; sample formats for reporting results to consumers; and detailed instructions to help implement the surveys and produce the reports. The questionnaires have been standardized so that assessments can be compared across health plans, across patient populations and over time. Health care purchasers implement the survey, produce the reports and provide results to consumers. CAHPS® also contains survey questions that address health care of children, people with chronic conditions, or other special populations.

With AHCPR funding and support, CAHPS® is being developed by a consortium led by Harvard Medical School, RAND and the Research Triangle Institute. The 5-year project is in its third year.

All of the CAHPS® products have been evaluated for their validity and tested at a number of demonstration sites to ensure accurate comparisons in real-world settings, including comparisons between managed care and fee-for-service settings, as well as within private and public insurance plans.

The CAHPS®-based Medicare questionnaire is to be returned by beneficiaries by May. Results are expected to be made available by November both in printed form and via the Internet.

Gathering and disseminating meaningful information about Medicare managed care comes at a particularly important time, said DeParle. Medicare has seen substantial growth in the number of enrollees signing up for HMOs and other managed care plans, with more than 6 million now enrolled in 427 plans, with growth rates of 25 percent a year for the past three years. Medicare enrollees can choose to receive health care service through traditional fee-for-service coverage or through managed care plans.

The Balanced Budget Act of 1997 further expands the types of managed care options that will be available in Medicare.

After this month's initial survey of a sample of managed care enrollees in each of the Medicare-qualified plans, HCFA will conduct similar research with Medicare beneficiaries in traditional fee-for-service medicine. Results of all these surveys will be widely distributed to beneficiaries and be available in charts comparing Medicare managed care plans on the Internet.

Note: HHS press releases are available on the World Wide Web at:

For additional information, please contact AHCPR Press Office: Karen Migdail, (301) 427-1855 (, or HCFA Press Office (202) 690-6145.

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