CAHPS the Consumer Assessment of-Health Plans Survey. This survey is conducted annually by the EQRO. Capitation Payment – a payment the State makes periodically to the MCO on behalf of each beneficiary enrolled under this Contract and based on the actuarially sound capitation rate for the provision of services under the State plan. The State makes the payment regardless of whether the particular beneficiary receives services during the period covered by the payment. Cardiac Rehabilitation - A comprehensive outpatient program of medical evaluation, prescribed exercise, cardiac risk factor modification, and education and counseling that is designed to restore members with heart disease to active, productive lives. Choice counseling- the provision of information and services designed to assist beneficiaries in making enrollment decisions; it includes answering questions and identifying factors to consider when choosing among managed care plans. Choice counseling does not include making recommendations for or against enrollment into a specific MCO. Clinical Edit – a process for verifying that a member’s medical condition matches the clinical criteria for dispensing a requested drug. Clinical Edits must be based on evidence-based clinical criteria. Cold-Call Marketing – any unsolicited personal contact by the MCO with a potential member for the purpose of influencing the potential member to enroll in that particular MCO. Cold Call Marketing includes, without limitation: Common area (Marketing) – any area in a provider’s facilities that is accessible to the general public. Common areas include, without limitation: reception areas, waiting rooms, hallways, etc. Complaint – an expression of dissatisfaction made about an MCO decision or services received from the MCO when an informal grievance is filed; some complaints may be subject to appeal. Consultant/Consultant Affiliates – any corporation, company, organization, or person or their affiliates retained by the Department to provide assistance in this project or any other project; not the MCO or subcontractor. Corrective Action – an improvement in a business process that may be required by the Department to correct or resolve a deficiency in the MCO’s processes or actions. Covered Services (Contract Services) - health care services the MCO must arrange to provide to Medicaid members, including all services required by this contract and state and federal law, and all Value-Added Services negotiated by the MCO and the De...
CAHPS. Currently, the State and CMS separately administer CAHPS. This creates inefficiencies for the MSHO Plans and burden for the MSHO Enrollees that are asked to respond to surveys that overlap significantly. The State and CMS will collaborate on the administration and results of CAHPS surveys, including by:
a. Streamlining the number of CAHPS surveys administered by using a single CAHPS at the plan (PBP) level that meets both State and Federal requirements.
b. Sharing individual level survey data from CMS with the State, so that the same Enrollee is being sampled only once for both the state and Federal surveys. Sharing would be subject to applicable privacy laws and to the completion of a Data Users Agreement by the State. This will allow the State to conduct State-specific analyses on CAHPS results, including for State initiatives to monitor and reduce health disparities.
c. CMS would also allow the State to add a limited number of additional questions to the survey.
CAHPS. The Consumer Assessment of Healthcare Providers and Systems is a standardized survey of patients’ experiences with ambulatory and facility-level care established by the Agency for Healthcare Research and Quality.
CAHPS. ECHO - The Contractor shall not survey the EMG population.
CAHPS. Consumer Assessment of Healthcare Providers and Systems CFR – Code of Federal Regulations CHIP – Children’s Health Insurance Program CMO – Care Management Organization CMS – Centers for Medicare & Medicaid Services DCH – Department of Community Health EQRO – External Quality Review Organization
CAHPS. The Medical Center’s rating of the measure, “Would you recommend this hospital to your friends and family?” for the Consumer Assessment of Healthcare Providers and Systems
1) HAC- Value Based Purchasing (VBP) measures that reduce Hospital Acquired Conditions (HAC)
2) HRRP- Value Based Purchasing (VBP) measures that reduce readmissions in the Hospital Readmission Reduction Program (HRRP).
CAHPS. CAHPS stands for Consumer Assessment of Healthcare Providers and System. Throughout the country, CHAPS is used to measure patient satisfaction. There are measures that fall within patient satisfaction such as, “Would you recommend our hospital to your friends and family”.
CAHPS. CMS gathers consistent patient experience survey information from all hospitals. These ratings are publicly reported. The ratings account for 25 percent of CMC’s Value Based Purchasing and directly impact Medicare payments. CMC utilizes a third party vendor, Press-Xxxxx, to survey patients and determine CMC’s CAHPS scores. CAHPS can be accessed electronically and are regularly reported. Handwashing compliance is determined by trained secret shopper observers. Isolation protocol compliance is determined by independent observation and documentation audits.
