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Five questions with Bob Crawford: The role of customer experience
 In an article in the November-December issue of Hospital and Physician Update, we briefly addressed the role that customer experience — in particular, the CAHPS® survey* results — played in our 2022 Medicare Star Ratings from the Centers for Medicare & Medicaid Services. We wanted to take a deeper dive into the importance of customer experience and our CAHPS performance, so we talked with Bob Crawford, vice president of Corporate Marketing and Customer Experience, to get some answers.
1. How does customer experience relate to health care providers?
While Blue Cross Blue Shield of Michigan focuses on the overall experience of its members and group customers, health care providers only have control over one aspect of the customer experience: the experience of their patients. For providers, their customer is, in effect, their patient.
Much like our participating providers, Blue Cross looks at the member, or patient, as being at the center of what we do. We’re committed to working collaboratively with our providers to improve the member experience across the continuum of care. Collectively, we all benefit if the patient gets the quality, evidence-based care that meets their expectations for convenience, cost and quality.
2. What does the CAHPS survey determine?
The CAHPS survey asks patients about their experience with their health care providers and their health plan to determine their overall experience.
3. What role do customer experience and the CAHPS survey play in Medicare Star Ratings?
Customer experience is playing an increasingly important role in Star Ratings. When determining ratings, the weight given to the CAHPS survey is increasing this year from 23% to 35% of the overall rating. This makes CAHPS crucial to Star performance.
4. How would you describe CAHPS?
One way to describe CAHPS is that it’s intended to capture the patient perception of their experience as opposed to looking at claims or medical record reviews. For example, if you’re trying to determine if an older adult got a flu shot during the prior flu season, the CAHPS survey result would indicate how they answered the question, not by validating their flu shot status through claims. The respondent must remember they got the shot and respond as such on the survey.
What many people don’t realize is that about half of the CAHPS survey questions are based on a patient’s experiences with their provider. For example, their perception of whether:
- They were able to get appointments quickly.
- Their provider’s office followed up with test and lab results in the time frame they expected.
- Their appointment wait time met their expectations.
- The provider reviewed medications with them and spent enough time with them.
- Their care was coordinated among their primary care doctor and other providers.
5. What do we need to do going forward to improve our Medicare Star Ratings?
Improving patient perceptions of their care and their health plan is paramount. That means Blue Cross needs to work even more collaboratively with providers to simplify the patient experience from the patient’s perspective and to help them navigate the health care system. We need to try to keep the complexities of the system — and the frustrations that sometimes accompany our processes and policies — from the patients as much as possible.
The bottom line: Making sure that health plans and providers work closely together so that patients feel valued and cared for.
*CAHPS®, which stands for Consumer Assessment of Healthcare Providers and Systems, is a registered trademark of the Agency for Healthcare Quality and Research. | 