Improving CAHPS Performance with Predictive Analytics

This case study outlines a partnership between a leading managed care organization and mPulse, focusing on enhancing member experience and health outcomes through innovative technology. The objective of the partnership was to leverage predictive modeling to identify at-risk members who were likely to provide negative responses in CAHPS performance measures, including Plan Satisfaction, Drug Plan Satisfaction, Access, and Provider Satisfaction. The organization deployed predictive models on data from over 541,000 members across 13 health plans to segment members based on their likelihood of responding negatively. Targeted outreach was conducted, with high-risk members receiving direct contact from plan representatives, while lower-risk members were engaged through direct mail. Following these interventions, a mock CAHPS survey was conducted to evaluate the success of the outreach efforts. The results indicated significant improvements in various performance measures, demonstrating the effectiveness of predictive analytics in enhancing member satisfaction and CAHPS performance.