Nationwide Adult Medicaid CAHPS

In 2014 and 2015, NORC at the University of Chicago conducted the Nationwide Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey for Adults Enrolled in Medicaid, known also as the Nationwide Adult Medicaid CAHPS. This survey, sponsored by the Centers for Medicare & Medicaid Services (CMS), is the first of its kind. It captured baseline national and state-level estimates of adult Medicaid enrollees’ experiences with the health care system beginning in 2014, when many Affordable Care Act provisions took effect. The rigorous CAHPS survey design, data collection effort, analytic plan, and strategy for documentation and dissemination of findings are critical to facilitating quality improvement efforts for the adult Medicaid population at the state and national levels.

NORC and its partner Thoroughbred Research Group sampled approximately 1.5 million Medicaid beneficiaries nationwide and administered a multi-mode (mail/telephone) CAHPS questionnaire. The samples were stratified into four subgroups:

  • Adults who are dually eligible for Medicare and Medicaid;
  • Adults with disabilities who are not dually eligible for Medicare and Medicaid;
  • Adults who are neither dually eligible nor individuals with disabilities, and who are enrolled in a comprehensive managed care organization; and
  • Adults who are neither dually eligible nor individuals with disabilities, and who obtain care from a fee-for-service provider or are enrolled in primary care case management.

The survey has produced measures of timely access to care, barriers to care, satisfaction with providers, ratings of customer service, and the accessibility and usability of program information and materials, among other important topics for adults in Medicaid fee-for-service and managed care delivery systems.

This project provides CMS with uniform national figures on the health care experiences and related impressions of the adult Medicaid population. It also gives comparable information for beneficiaries in all states across different program models. Results from this work will inform the development of standard measures anchoring a robust health care quality strategy for the adult Medicaid population, in alignment with HHS’ National Quality Strategy’s three-part aim of achieving better care, healthier people and communities, and more affordable care.

Beyond conducting this national survey, NORC also provided access to and facilitated the use of the first-ever NAM CAHPS survey data files. NORC met with federal and non-federal stakeholders to develop an analytical framework for the survey. Based on the needs of these stakeholders, NORC conducted robust analysis of the survey results and developed several analytic products to support researchers and policy analysts at the state and national level including:

  • Limited Data Sets (LDSs) that are being disseminated by CMS
  • An interactive data dissemination website to provide analysts access to the summary tables, charts and maps
  • Reports and substantive briefs summarizing the survey findings, such as an issue brief on smoking and tobacco cessation
  • Public Use File (PUF) to provide states with microdata beyond the customizable data summary tables available on the website

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