Getting the Best Out of Managed Care Fact Sheet 5: Consumer Surveys

Executive Summary

This fact sheet provides consumer-oriented information about finding and understanding consumer surveys of Medicaid managed care plans.

What can I learn from this fact sheet? 
This fact sheet will help you find consumer surveys of health plans. We will also give you some pointers on how to look at these surveys, get the information you need, and avoid getting misled by surveys.

What are consumer surveys? 

Consumer surveys are lists of questions that ask patients what they think about a health plan, a medical group, or a health provider. Health plans often will do a survey of their members to find out whether the members are happy with the services they get. You might also get consumer surveys from your doctor?s office or a medical group. They also want to know whether their patients are receiving good care and how to improve their services.
Consumer surveys are important for finding out about the quality of care. Instead of just looking at the numbers, the survey can find out what people really think. With consumer surveys, a health plan also can find out whether people have trouble getting access to care. Surveys can find out how much people know about staying healthy. This can be important for showing whether a plan is really educating people about healthy living.
Who uses consumer surveys? 
Consumer surveys are useful to employers and other purchasers who want to decide which managed care plans to buy. Consumers can use the surveys to decide which plan they want to use. Health plans use consumer surveys to see where they need to improve their services or see how particular medical providers are doing their jobs. Regulating agencies look at consumer surveys to monitor how well health plans are performing.
Are consumer surveys required? 
Most states do not require consumer surveys. However, federal law requires consumer surveys of people on Medicaid or Medicare under certain circumstances. Health plans may need to do consumer surveys in order to receive accreditation.
What kinds of consumer surveys are there? 
There are many different kinds of consumer surveys that will ask many different questions. One of the best-known consumer surveys is the Consumer Assessments of Health Plans Study (CAHPS). This survey is sponsored by the Agency for Healthcare Research and Quality (AHRQ), a federal agency. CAHPS tries to do three things:
  • Develop and test questionnaires from the consumer?s point of view;
  • Produce reports that consumers can easily understand; and
  • Figure out how useful the surveys are for consumers when they are choosing health plans and services.
Where can I get consumer surveys? 
If you have health insurance from your employer, you may be able to get copies of consumer surveys through your personnel or human resources department at work. If you have Medicare, you can contact the Centers for Medicare and Medicaid Services (CMS), the agency that oversees Medicare, for consumer surveys. If you have Medicaid, you might contact your state?s Medicaid agency to ask about consumer surveys. You can also ask your health care provider, health plan, or local health services provider to see if they have done any recent consumer surveys.
At the end of this fact sheet, we list numerous ways of Making Contact to get copies of consumer surveys.
Can I use two surveys to compare two health plans? 
You should be careful comparing different health plans with surveys of each. Did they both use the same survey format? If not, they probably asked different questions, and you cannot fairly compare the two surveys. You really cannot say that one survey is better than the other. They both may be good, but they may be looking for different information.
Can I use consumer surveys to see if a health plan has improved? 
One problem with surveys is that they are like taking a picture of a health plan at one point in time. They do not tell you what the health plan was like the day before, or whether it will be better or worse tomorrow. Few surveys follow patients over time to see if they stay satisfied or how they get treated as their health changes. As consumer surveys become more common, it may be possible to compare surveys for more than one year.
Why is it important to know who developed the survey and the survey?s purpose? 
If the survey were developed by an HMO to help it get more members, do you think it would be reliable? Do you think that it would report negative information?
Be cautious with surveys developed by the managed care industry, insurance companies, or an accreditation agency. They may be reporting useful information, but they may also be trying to make their industries or managed care plans look good. If an employer group, a state Medicaid agency, or a university school of public health develops and conducts the survey, it may contain more reliable information.
Why should I look at the questions the survey asks? 
The way questions are asked and the choices of answers make a big difference in survey results.

For some reason, if a survey asks, ?How would you rate your health plan?? a consumer will give a more critical answer than if the survey asks, ?How satisfied are you with your health plan?? Questions that just ask about your satisfaction with a health plan do not tell as much as questions that ask you to describe your experiences with the health plan.

Also look at the choices of answers to questions. If you can choose several answers like ?excellent,? ?very good,? and ?satisfactory,? you will get a wider range of results than a survey that just offers ?excellent? and ?satisfactory? as possible answers. You should be a little skeptical when a survey does not include ?unsatisfactory? or ?poor? as possible answer choices.
Are there surveys that include questions that are important to people with special needs? 
Yes. The CAHPS survey has supplemental questions that ask about services that are particularly important to people with chronic illnesses or special needs and to Medicaid and Medicare beneficiaries. With other surveys, look at the questions to see whether they ask about health care services that are important to your needs.
Family Voices, a national grassroots organization of parents of children with special needs, has also developed surveys to determine how well health plans are serving children with special needs.

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