The Blue Cross and Blue Shield of Texas (BCBSTX) Medicaid mission is “To promote the health and wellness of our members and communities through accessible, cost-effective quality health care.” One of the ways BCBSTX assesses for quality healthcare is by conducting an annual Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey. The primary focus of the survey is to assess STAR, STAR Kids and CHIP members’ experience with BCBSTX and its providers.
Beginning in March, surveys will be mailed to members, and they will rate their last six months of healthcare with BCBSTX. Here are some examples of the CAHPS survey questions.
- Getting Needed Care – Ease of getting necessary care, tests, or treatment needed. Getting appointments with specialists as soon as needed.
- Getting Care Quickly – Received care as soon as needed when care was needed right away. Received check-up/routine appointment as soon as needed.
- Provider communication - Provider showed respect, spent enough time with our member, listened carefully and explained things in a way our member could understand and was aware of care received from other providers.
- Customer Service – Customer service provided information or help. Customer Service treated our member with courtesy and respect.
- Flu vaccination – Did our member get a flu shot in the last year.
- Smoking Cessation – Provider asked if our member smoke or use tobacco and if so, advised you to quit and discussed strategies.
Good News!
- Getting Needed Care rating remains above the required 80%, although it decreased by four percent in 2022 to 82%
- Overall Rating of Health Plan continues to improve in 2022 to 72.3%
- Discussion of Cessation Medications improved 31% percent in 2022 to 48.5%
- Discussion of Cessation Strategies improved nine percent in 2022 to 51.5%
While we have made great strides, there are areas for improvement. Provided below are those areas where we were below the national performance average or where we scored lower than in previous years. BCBSTX would like to ask for your help in improving these categories:
How can you Impact Member Satisfaction? |
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Best Practice |
Help your patients get care quickly
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Assist your patients with getting the care they need
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Communicate with your patients
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Care Coordination |
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Resources
Reference and review the BCBSTX Preventive Care Guidelines (PCGs), Clinical Practice Guidelines (CPGs), and Texas Health Steps THSteps for Medical Providers, which includes all current vaccine schedules, ImmTrac2 and other important guidance for treating your patients.