Member Experience is…
All teams ultimately impact member experience, which is why this type of approach is necessary to achieve sustainable process improvement.
The methods of which a member could receive a member experience CAHPS survey from our vendor.
What are mail, phone and internet?
These Medicare Star measures are measured in part by complaints, voluntary disenrollment and appeals.
What is Admin/Ops?
“Just keep swimming” was the sage advice from a memorable fish who offered a lot to the movie experience, even if she often forgot everything else.
Who is Dori?
A team that supports members with telephonic nursing guidance and healthcare navigation education.
What is Case Management?
The Rolling Stones’ 1965 hit after a disappointing CAHPS survey result.
What is I Can’t Get No Member Satisfaction?
True or False. There is also a survey measuring outpatient mental health services.
What is True?
A member will file one of these when they do not agree with their health plan’s decision to deny coverage.
What is an Appeal?
Whitney Houston made clear her undying love for increasing the member satisfaction of her Bodyguard with this 1992 hit.
What is I Will Always Love You?
A non-member facing team that supports satisfaction with the development of materials that frame the member experience.
What is Marketing?
What a member travels from enrollment to receiving care.
What is the member journey?
Medicare: March-June; Medicaid & Commercial: January-May
What is when members complete a CAHPS survey?
Monitoring this type of disenrollment helps us to understand why members are choosing to leave the health plan.
What is Voluntary?
On a CAHPS rating question, Buzz Lightyear would have made this a response option after “Usually” and “Always”.
What is “To infinity and beyond!”?
A non-member facing team who impacts member experience by supporting accurate information in the Find-A-Provider (FAP) tool.
What is Operations?
The frontline team for helping improve the health of the communities we serve, one member at a time.
What is customer service?
This survey, which impacts Medicare Star Quality Ratings, measures health status as reported by Medicare members ages 65 and older.
What is the Health Outcomes Survey?
These are one of many teams at the health plan that meets members where they are and receives anecdotal information about member experience.
What is Case Management, Community Engagement, etc.?
Nirvana had member experience in mind when they released this odorous 1991 hit.
What is Smells Like Teen Spirit?
To help members get the care they need for a healthy pregnancy, this program for pregnant and new parents provides extra benefits and support, including rewards for attending prenatal and postpartum appointments.
What is Start Smart for Your Baby)
Lionel Ritchie’s 1983 hit stretched out for a full 365 days of measuring service quality.
What is All Year Long?
The member survey that’s modeled off CAHPS and fielded after CAHPS.
What is the Mock CAHPS survey?
A sign of dissatisfaction are these formal complaints that members submit directly to Centers for Medicare & Medicaid Services (CMS).
What are CTMs?
“The past can hurt. But the way I see it, you can either run from it, or learn from it.” Wise words about learning from CAHPS survey results from this classic Disney movie.
What is The Lion King?
It’s all about the member with this approach.
What is member-centric?