The applicability of the Consumer Assessments of Health Plans Survey (CAHPS) to Preferred Provider Organizations in the United States: a discussion of industry concerns.
OBJECTIVE
This paper examines the applicability of a leading patient survey, the Consumer Assessments of Health Plans Study (CAHPS), to Preferred Provider Organizations (PPOs) in the United States.


METHODS
Elite interviews were conducted with users of the CAHPS survey in PPO settings.


METHODS
Study participants attended either the California Healthcare Foundation Quality Performance Measurement in Preferred Provider Organizations Forum or the National Conference to Examine PPO Quality. Eleven representatives of state and federal government health care purchasers, commercial PPO plans, and survey vendors were included.


METHODS
The interview included 21 questions addressing experiences with and concerns about using the CAHPS survey in PPO settings.


RESULTS
Respondents raised concerns about the influence of out-of-network care on CAHPS reports and ratings of PPO health plans. Suggestions were made for additional PPO-relevant items such as after-hours care, numbers and types of specialists in the PPO network, and disease management.


CONCLUSIONS
Modifications to some of the CAHPS survey items are needed to address concerns of users about their applicability in PPO settings.
Morales
Leo S
LS
RAND Corporation, Santa Monica, CA, USA. morales@rand.org
Elliott
Marc
M
Brown
Julie
J
Rahn
Christina
C
Hays
Ron D
RD
D003256:Community Participation; D003625:Data Collection; D006801:Humans; D011243:Preferred Provider Organizations; D014481:United States