Consumer Assessment of Healthcare Providers and Systems (CAHPS) Health Plan Survey, Version 5.0 (Medicaid and Commercial): Rating of Specialist

Identifying Attributes

Care Settings
Primary Care
Country
United States of America
Publishing Organisation
Medicaid, Centers for Medicare & Medicaid Services (CMS): Qualified Health Plan (QHP) Quality Rating System (QRS)
Type of Quality Indicator
Outcome
IOM Quality Dimension
Person-Centredness
Domain
Consumer Experience

Defining Attributes

Definition

The CAHPS Health Plan Survey is a survey that asks health plan enrollees to report about their care and health plan experiences as well as the quality of care received from physicians. This single rating is based on responses to the following statement: Rating of specialist

Numerator

The top box numerator for each of the four Overall Ratings items is the number of respondents who answered 9 or 10 for the item; with a 10 indicating the "Best possible."

Denominator

The eligible population for the survey includes all individuals who have been enrolled in a health plan for at least 6 (Medicaid) or 12 (Commercial) months with no more than one 30-day break in enrolment.

Exclusions

Individuals are excluded from the survey target population if: 1) They were not continuously enrolled in the health plan (excepting an allowable enrolment lapse of less than 30 days), 2) Their primary health coverage was not through the plan, 3) Another member of his or her household had already been sampled or 4) They had been institutionalised (put in the care of a specialised institution) or are deceased.

Use of Risk Adjustment
Yes
Risk Adjustments
Stratifications

None

Collection and Reporting Attributes

Type of Data Collection
Surveys
Data Collection Methods

Consumer Assessment of Healthcare Providers and Systems (CAHPS) Health Plan Survey. The survey is designed to be administered to includes individuals (18 and older for the Adult version) who have been enrolled in a health plan for a specified period (6 months or longer for Medicaid version, 12 months or longer for Commercial version) with no more than one 30-day break in enrolment.

Frequency of Data Collection
Frequency of Data Collection in Days
Reporting Methods
Reporting Frequency
Reporting Frequency in Days
Indicator Has Recommended Targets
No

Source and Reference Attributes

Evidence Source
Technical Specifications
Link to Measurement Tools
Quality Indicator Confirmed to be Part of a Program Used to Monitor Quality and Safety of Care Among Older People at a Population-Level between 2012-2022
Yes
Assessed by the Australian Consortium for Aged Care Collaborators as Generally Containing Good Properties (Importance and Scientific Acceptability)
No
Australian Consortium for Aged Care Endorsed
No
Identified by PHARMA-Care Project
No
Upload Date
02 December 2025