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- Scoring and Star Ratings Page Updated
- New Web Page Added: Other Analytic Information
- 2018 Between-Contract Variances for Reported Measures Are Available
- MA & PDP CAHPS Survey Exception Request Form Is Now Available
- MA & PDP CAHPS Survey Quality Assurance Protocols & Technical Specifications V11.0 - Technical Corrections and Clarifications
Welcome to the Medicare Advantage and Prescription Drug Plan (MA & PDP) CAHPS Web site. Check back frequently to review updated information. The Home Page of the MA & PDP CAHPS Web site contains an overview of the program. Topics include program background, data collection overview, public reporting and use of the Medicare CAHPS survey data, information about the survey, information for participation, contact information, and internet citation.
The Centers for Medicare & Medicaid Services (CMS) is committed to measuring and reporting information from the consumer perspective for Medicare Advantage (MA) and Prescription Drug Plan (PDP) contracts. The Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS®) surveys are a set of surveys sponsored by CMS that collect information to fulfill a requirement of Congress (under the Balanced Budget Act of 1997 and Medicare Modernization Act of 2003). The surveys provide information to Medicare beneficiaries on the quality of health services provided through MA and Medicare and Part D programs. Consumer evaluations of health care, such as those collected through the Medicare CAHPS® surveys, measure important aspects of a patient's experience that cannot be assessed by other means.
The surveys have been rigorously developed and tested to assess the experiences of beneficiaries who receive health care through the Medicare Fee-for-Service (FFS), MA and PDP programs. The Medicare CAHPS Surveys are part of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) initiative, a family of surveys developed by a consortium of researchers from American Institutes for Research, Harvard Medical School, Yale University, the RAND Corporation, and RTI International under a cooperative agreement between CMS and the Agency for Healthcare Research and Quality (AHRQ), a component of the U.S. Public Health Service. For more information about the CAHPS Project, please go to http://go.cms.gov/cahps.
Since 1998, CMS has conducted the Medicare CAHPS surveys annually with a sample of Medicare beneficiaries at least 18 years of age, currently enrolled in a Medicare Advantage contract for six months or longer, and who live in the United States. Surveys of beneficiaries enrolled in FFS were added in 2001 and surveys of PDP enrollees were added in 2007. Traditionally, CMS has paid for all data collection activities and has contracted with a single contractor for data collection. Beginning in 2011, CMS required all MA and PDP contracts with at least 600 enrollees to contract with approved survey vendors to collect and report CAHPS survey data following a specific timeline and protocols established by CMS. The CAHPS surveys will be conducted at the contract level for Medicare Advantage only (MA), Medicare Advantage Prescription Drug (MA-PD), and Stand-Alone Prescription Drug plans (PDPs). CMS will provide the sample for each contract. The Medicare CAHPS surveys will continue to be conducted on an annual basis.
The Medicare CAHPS surveys produce comparable data on the patient's experience of care that allow objective and meaningful comparisons between MA and PDP contracts on domains that are important to consumers. The survey data are publicly reported by contract. The results from the Medicare CAHPS surveys are published in the Medicare & You handbook and on the Medicare Options Compare Web site (www.medicare.gov). Public reporting of the survey results is designed to create incentives for contracts to improve their quality of care and also serves to enhance public accountability in health care by increasing the transparency of the quality of care provided by Medicare contracts. The measures derived from the surveys are used by beneficiaries to help choose an MA or PDP contract, help contracts identify areas for quality improvement, and allow the public and research community to assess Medicare program performance. Medicare administrators and policymakers also rely on the measures to manage the program; devise, implement, and monitor quality improvement efforts; and make policy decisions.
The Medicare CAHPS Survey includes three versions of the questionnaire: Medicare Advantage (MA-Only), Medicare Advantage Prescription Drug plan (MA-PD), and Stand-Alone Medicare Prescription Drug Plan (PDP). Although all three versions have a nearly identical set of core questions, each version also includes additional questions and response categories related to the enrollees' experiences in their own particular contract type.
The MA-Only questionnaire includes the following domains: Your Healthcare in the Last 6 Months, Your Personal Doctor, Getting Healthcare from Specialists, Your Health Plan, and About You.
The MA-PD questionnaire includes the following domains: Your Healthcare in the Last 6 Months, Your Personal Doctor, Getting Healthcare from Specialists, Your Health Plan, Your Prescription Drug Plan, and About You.
The PDP questionnaire includes the following domains: Your Prescription Drug Plan, and About You.
Many of the items in the MA & PDP CAHPS Survey are preceded by screener questions. This allows only those beneficiaries for whom the item is relevant to answer the questions associated with the screener questions.
For scoring and reporting purposes, some questions are combined into the following 6 composite measures:
- Getting Needed Care
- Getting Appointments and Care Quickly
- Doctors Who Communicate Well (reported to contracts – not reported to consumers)
- Customer Service
- Getting Needed Prescription Drugs (MA-PD and PDP)
- Care Coordination
In addition to the publicly reported composite measures listed above, the survey questionnaires include several publicly reported “member overall” ratings based on a 0-10 scale, where 0 is the lowest rating and 10 is the highest:
- Rating of Health Plan
- Rating of Health Care Quality
- Rating of Drug Plan (MA-PD and PDP)
The MA & PDP CAHPS Survey also includes the following single item measures, which are publicly reported:
- Annual Flu Vaccine
- Pneumonia Vaccine (reported to contracts – not reported to consumers)
The Medicare Advantage and Prescription Drug Plan CAHPS Survey is administered using only a mixed mode data collection protocol that includes two survey mailings and telephone follow-up of non-respondents to the mailed questionnaire.
To participate in MA & PDP CAHPS Data Collection, all survey vendors must meet certain Survey Program Minimum Business Requirements and must be in compliance with the protocols in the Medicare CAHPS Survey Quality Assurance Protocols & Technical Specifications. In addition, survey vendors must submit a Participation Application Form to the MA & PDP CAHPS Project Team annually for approval.
Please note: At a minimum, a survey vendor's Project Manager, Mail Survey Supervisor and Telephone Survey Supervisor are required to participate in the Medicare CAHPS Training. MA and PDP contracts are not required to attend training.
View or download a copy of the Minimum Business Requirements.
This web page includes MA & PDP CAHPS informational webcasts and educational resources. Webcasts and educational resources cover topics of interest to vendors who administer the survey and health and drug plan staff who use the data collected by the survey. Please click the link provided or the Webcasts and Educational Resources navigation button on the left to learn more.
CMS and the MA & PDP CAHPS Project Team continually analyze MA & PDP CAHPS data. To make locating our MA & PDP CAHPS research easier, we have added a bibliography of publications from the MA & PDP CAHPS Project Team. This bibliography was updated on December 1, 2020.
- For information and technical assistance, contact the MA & PDP CAHPS Project Team via email at MA-PDPCAHPS@hsag.com or by calling toll free at 1-877-735-8882.
- To communicate with CMS staff, please email: MP-CAHPS@cms.hhs.gov
Please use the following citation when referencing material on this web site. [www.MA-PDPCAHPS.org] Centers for Medicare & Medicaid Services, Baltimore, MD. Month, Date, Year the page was accessed. www.MA-PDPCAHPS.org.
For information about the availability of auxiliary aids and services, please visit: https://www.medicare.gov/about-us/nondiscrimination/nondiscrimination-notice.html.
This page was last modified on 1/15/2021