CAHPS & HOS

CAHPS (Consumer Assessment of Healthcare Providers and Systems) and HOS (Health Outcomes Survey) are two crucial measures that impact the Star Ratings of Medicare Advantage plans. While CAHPS focuses on members’ experiences with healthcare providers and health plans, HOS evaluates each member’s perception of their physical and mental health over time.  CAHPS and HOS will soon be the primary contributors to nearly a third of a Medicare Advantage plan’s overall Star Rating. 

Icario offers tailored solutions designed to boost CAHPS and HOS survey results, significantly improving Star Ratings, member experiences, and financial results simultaneously.  

Why CAHPS & HOS Matter

Improving CAHPS and HOS scores can have tremendous impacts on your plan. For example:  

• Medicare Advantage Quality Bonus Payments have more than quadrupled since 2015.  
• CAHPS scores were the main contributor to poor performances by H-Plans in 2024 Star Ratings.  
• CMS and NCQA base ratings on double-weighted scores for CAHPS.  

In 2025, CAHPS and HOS will account for nearly 1/3 of a plan’s Medicare Advantage Star Rating.  

Learn about CAHPS strategies for 2025 and beyond in our recent webinar, Feedback Matters: Why CAHPS is Still King.

More Plans Choose Icario for CAHPS & HOS  

Icario leverages data from over 100 million member touchpoints to enhance CAHPS and HOS performance. We combine a unique whole person approach to data with the latest predictive analytics. As a result, Icario ensures high survey completion rates and improved member satisfaction while maintaining strict adherence to regulatory compliance.  

Behavioral Science-Driven Improvement Strategies 

Our predictive behavioral science tools optimize outreach and reward sequences, motivating members to take action and engage, such as completing pre-CAHPS and pre-HOS surveys. By understanding the key factors that influence member satisfaction and health outcomes, we design highly targeted interventions for each component of CAHPS and HOS. 

Personalized Member Engagement 

Icario’s proprietary engagement platform integrates whole person data to tailor touchpoints and interventions. Using omnichannel outreach, we engage members in the least abrasive and most effective ways, ensuring they complete surveys and other desired actions. This personalized approach increases member satisfaction and encourages positive health behaviors, directly impacting CAHPS and HOS performance. 

Comprehensive Member Feedback Analysis 

Utilizing advanced data analytics, we uncover trends and identify areas for improvement. These insights inform tailored interventions and optimize engagement strategies, enhancing final CAHPS and HOS results. This approach helps plans deliver meaningful member experiences and improve performance metrics. 

Measurable Results in CAHPS & HOS 

Our CAHPS & HOS programs consistently deliver measurable results for Medicare Advantage plans. By improving member satisfaction, health perception, and overall outcomes, Icario partners consistently achieve higher Star Ratings. 

Pre-CAHPS Survey Programs

Shed Light on Member Satisfaction to Improve CAHPS Scores​

Challenge

A group of forward-thinking Blues plans wanted to understand Medicare Advantage member satisfaction better—and boost future CAHPS scores​. To do that, they needed more feedback from a larger percentage of their members.

Approach

To meet the plans’ goals, Icario designed an innovative pre-CAHPS survey program to capture member experiences early and proactively impact satisfaction​. Both traditional and digital outreach were used as part of an omnichannel approach to engage plan members, including questions designed to mimic actual CAPHS surveys to gain additional insights. A personalized action plan was sent to each member who completed the survey.

Results

Icario’s program achieved extraordinary outcomes for this group of plans, including:

• Challenge
  A group of forward-thinking Blues plans wanted to understand Medicare Advantage member satisfaction better—and boost future CAHPS scores​. To do that, they needed more feedback from a larger percentage of their members.
• Approach
  To meet the plans’ goals, Icario designed an innovative pre-CAHPS survey program to capture member experiences early and proactively impact satisfaction​. Both traditional and digital outreach were used as part of an omnichannel approach to engage plan members, including questions designed to mimic actual CAPHS surveys to gain additional insights. A personalized action plan was sent to each member who completed the survey.
• Results
  Icario’s program achieved extraordinary outcomes for this group of plans, including:

  2x

  higher completion rate than projected

  35%

  of overall responses came from digital outreach

  84%

  of respondents rated their health plan ​ a 7 or above

2x

higher completion rate than projected

35%

of overall responses came from digital outreach

84%

of respondents rated their health plan ​ a 7 or above

Improving Quality & HOS 

Medicare Advantage

Challenge

A Medicare Advantage plan serving around 1 million members wanted to improve its quality and HOS scores after experiencing a severe decline in healthcare utilization.

Approach

In response, Icario created a unique program to deploy personalized, targeted communications to high-risk, non-compliant members, including 8 weeks of content designed to engage members and positively impact the plan’s HOS scores.

Results

Icario’s HOS program exceeded all KPI goals, achieving an outstanding 172% ROI.​ In addition:

• Challenge
  A Medicare Advantage plan serving around 1 million members wanted to improve its quality and HOS scores after experiencing a severe decline in healthcare utilization.
• Approach
  In response, Icario created a unique program to deploy personalized, targeted communications to high-risk, non-compliant members, including 8 weeks of content designed to engage members and positively impact the plan’s HOS scores.
• Results
  Icario’s HOS program exceeded all KPI goals, achieving an outstanding 172% ROI.​ In addition:

  88%

  of members rated their physical and mental health as improved in the program’s final week

  6,000+

  care gaps were closed

  86.5%

  overall participation rate

88%

of members rated their physical and mental health as improved in the program’s final week

6,000+

care gaps were closed

86.5%

overall participation rate

Our Approach to CAHPS & HOS  

Pre-CAHPS & Pre-HOS Surveys 

Pre-CAHPS and pre-HOS surveys provide valuable insights into a plan’s current performance and areas for improvement. Baseline data on member satisfaction and perception allow us to identify areas for improvement and tailor effective interventions quickly.  

Predictive algorithms help create personalized member action plans for everyone who completes the survey.  This builds deeper trust between each member and their plan and delivers better results when it’s time for the official CAHPS and HOS surveys.  

 8-Topic Member Connection Series  

Our member connection series delivers uplifting, positive content on health, wellness, and social topics to improve each member’s perception of their physical and mental health. Proactive outbound calls and personalized messaging improve the relationship between member and plan, resulting in higher response rates when it really matters.  

Rewards & Incentives

Icario rewards and incentives are powerful tools tailored to member population preferences and needs. As a result, members are highly motivated to provide valuable feedback and engage quickly with plan initiatives.   

Smarter engagement starts here.

Discover how our platform drives health action and improves outcomes with personalized, data-driven solutions.

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More Engagement Programs

Health Risk Assessments

Rewards & Incentives

Gaps in Care