EmblemHealth, Doctors HealthCare Plans, Security Health Plan, & MedOrion: Rethinking CAHPS & Member Experience

EmblemHealth, Doctors HealthCare Plans, Security Health Plan, & MedOrion: Rethinking CAHPS & Member Experience

As CAHPS takes on greater weight in Medicare Advantage Stars, many plans still treat it as a score to manage rather than an experience to design. This conversation explores why that mindset may be holding plans back.

Instead of focusing on the survey itself, this discussion examines the operational and clinical moments that shape member perception all year long, when expectations are set, confusion is reduced or created, and trust in the health plan is either strengthened or lost.

From Annual Wellness Visits and HOS engagement to flu outreach, ANOC communications, mental health support, and site-of-care decisions, the episode looks at how everyday touchpoints influence how members experience the plan and how they ultimately respond to CAHPS.

For Medicare Advantage leaders, the message is clear: better CAHPS performance is often the result of better orchestration, better communication, and better guidance across the member journey.

Key Takeaways:

  • Why CAHPS should be viewed as a reflection of the member journey, not just a survey outcome
  • How key touchpoints across the year shape trust, perception, and experience
  • Where plans can improve navigation and communication to reduce member friction
  • How to think more operationally about member experience across Stars, quality, and care delivery

Audience:

This episode is designed for Medicare Advantage executives leading Stars, quality, member experience, and population health efforts. It will be especially relevant for Chief Medicare Officers, Stars and Quality leaders, Population Health and Care Management leaders, Network and Provider Performance executives, and others responsible for improving the member journey in ways that drive CAHPS performance.

 

 

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