Blue Cross offers resources in consulting support, tools and materials to improve patient experience CAHPS metrics in provider offices

Centers for Medicare and Medicaid Services has announced some key changes to the CMS star ratings formula for contract year 2021, which impact 2023 star rating scores. The changes put the spotlight and emphasis on Consumer Assessment of Healthcare Providers and Systems^® surveys. Beginning in the 2021 contract year, CAHPS measures represent 32% of the overall star rating. By 2023, the metric’s weighting will contribute 60% of the final rating for all Medicare plans.

With the CMS star ratings weightings shifting even more focus to CAHPS, Blue Cross continues to center efforts on improving consumer experience measures specifically related to the health plan questions. And with CAHPS measuring the patient experience across the continuum of care we are also supporting physician organizations and their provider offices to improve the metrics related to the patient experiences within their offices including:

• When you needed care right away, how often did you get care as soon as you needed?
• When you made an appointment for a checkup or routine care at a doctor’s office or clinic, how often did you get an appointment as soon as you needed?
• Did someone from the provider office review all your medications with you?
• Did you wait longer than 15 minutes to see the medical staff you came to see?

Since 2017, Blue Cross has been providing complimentary skilled customer experience consultants and best practice ideas to provider offices to help improve their patient experiences and ratings. These services are customized to meet the practice where they are in the patient experience improvement journey and offer training, working sessions, best practice tactic kit implementation and more to the practice. Training and working sessions we provide include:

• Patient Experience 101 — a mini immersion session
• Courteous and Respectful Service — an interactive session with a personal self-assessment tool
• Patient Experience Improvement session — a working session to understand and improve the experience from the patient’s perspective

Facilitating a patient experience improvement session uses a five-step, easy methodology that involves the whole staff and includes journey mapping the experience to identify gaps and opportunities, brainstorming ideas and creating an action plan. (Note: This process can support PCMH capability 4.23.) From our work with hundreds of practices and through our research, we have developed best practice idea “tactic kits” that we provide to the practice to implement. The kits include communication materials and tools to improve many of the patient experiences related to wait times, appointment accessibility, medication reviews and Rx refills, and test and lab follow up.

We help the practice develop a pre and post improvement patient experience measurement using survey kits, checklists and other tools that we provide for each office so they can continually monitor patient feedback.

For more information on how our resources can support your patient experience focus, and to schedule a session, contact Sandi Nielsen-Gessert at snielsen‑gessert@bcbsm.com.

Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.