Special issues addressed in the CAHPS (TM) survey of Medicare managed carebeneficiaries

OBJECTIVES. This article describes the process through which the MMC survey was developed and examines issues in using this survey with Medicare benef iciaries that have implications for all CAHPS(TM) surveys. These include th e ability of Medicare beneficiaries to use MMC navigational features, wheth er access measures are meaningful for this population, and whether benefici aries' familiarity with managed care influences their health plan assessmen ts. BACKGROUND. The Health Care Financing Administration (HCFA) is mandated to provide comparative plan information, based partly on consumer surveys, to Medicare beneficiaries. The Consumer Assessments of Health Plans Study (CAH PS(TM)) is an integrated set of tested, standardized surveys of health plan enrollees. To meet its goal, HCFA has invested in the development of a CAH PS(TM) survey of beneficiaries enrolled in Medicare Managed Care plans (MMC ). METHODS, Cognitive interviews were completed with 31 Medicare beneficiaries . A field test also was conducted with beneficiaries to examine patterns of survey response. A sample of 956 eligible individuals was selected from si x health plans. Using a combination of mail and telephone data collection, 663 (69%) questionnaires were completed. This article provides selective re sults from these tests. RESULTS. The use of screening questions, skip instructions, and tailored "n ot applicable" response options appeared to facilitate the response task. S ome CAMPS(TM) access questions were not meaningful to Medicare beneficiarie s. The data do not support the need to adjust for length of plan enrollment . CONCLUSION. Analyses suggested changes to improve the MMC survey and to mak e other CAHPS(TM) surveys consistent with these changes.