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Published Date: 2025-09-18
Medicaid CAHPS Satisfaction Scores are Here
Medicaid CAHPS Satisfaction Scores are Here
Analysis of Consumer Assessment of Healthcare Providers and Systems (CAHPS) Satisfaction Scores
Earlier this year, Highmark Wholecare distributed the CAHPS survey to a randomly selected cohort of its Medicaid members. This survey solicited detailed feedback regarding their health care experiences. The data derived from these surveys is pivotal for guiding strategic initiatives aimed at enhancing service delivery for our members.
Adult Medicaid Results
Adult members enrolled in the Medicaid plan reported varying degrees of satisfaction across different dimensions of their health care experiences. They exhibited high levels of satisfaction with nearly every element on the survey, as you will see below in Table 1.
Table 1: Adult Medicaid Comparative Analysis with Previous Year
| Category | Question | 2024 | 2025 |
| Getting Needed Care | Ease of getting necessary care, tests, or treatment needed | 87.70% | 86.60% |
| Got appointments with specialists as soon as needed | 84.20% | 85.40% | |
| Getting Care Quickly | Got care as soon as needed when care was needed right away | 85.10% | 86.60% |
| Got check-up/routine care appointment as soon as needed | 81.30% | 84.50% | |
| How Well Doctors Communicate | Personal doctor explained things in an understandable way | 93.60% | 96.10% |
| Personal doctor listened carefully to you | 92.00% | 94.20% | |
| Personal doctor showed respect for what you had to say | 94.70% | 97.60% | |
| Personal doctor spent enough time with you | 90.40% | 93.70% | |
| Customer Service | Customer service provided information or help | 82.20% | 86.40% |
| Customer service treated member with courtesy and respect | 95.00% | 96.60% | |
| Coordination of Care | Coordination of Care | 85.70% | 88.60% |
| Ease of Filling out Forms | Ease of Filling out Forms | 94.80% | 96.10% |
| Rating of Health Care | % Rating 9 or 10 | 57.50% | 58.10% |
| Rating of Personal Doctor | % Rating 9 or 10 | 65.40% | 76.20% |
| Rating of Specialist | % Rating 9 or 10 | 64.00% | 71.70% |
| Rating of Health Plan | % Rating 9 or 10 | 64.80% | 66.80% |
A comparison with the previous year’s data reveals notable increases in every category, excluding the sub-question for Getting Needed Care related to “Ease of getting necessary care, tests, or treatment needed.”
There are marked improvements in all categories, with the most notable increases for “Rating of Personal Doctor”, “Rating of Specialist”, and the “How Well Doctors Communicate” category of questions on the survey. Additionally, the “Coordination of Care” rating also showed notable improvement year-over-year, which is likely due to improved collaboration between providers. Highmark Wholecare would like to extend gratitude to all providers caring for our membership for their work in improving these results year-over-year. Your hard work and attentive care to the needs of your patients is both notable and very appreciated, and is evident in this year’s Adult CAHPS results.
Child Medicaid Results
Surveys were also disseminated to parents or guardians of members under 18 years old to gauge their perceptions of their child’s health care experiences within our health plan. The feedback indicated a range of experiences for children on the plan. Members were most pleased with “Customer Service”, which showed notable rate increases in both sub-questions related to the category. However, there have been notable rate decreases in a number of categories, most notably items related to “Getting Care Quickly”, “Rating of Provider”, and “Rating of Specialist.”
Table 2: Child Medicaid Comparative Analysis with Previous Year
| Category | Question | 2024 | 2025 |
| Getting Needed Care | Ease of getting necessary care, tests, or treatment child needed | 90.90% | 90.40% |
| Got child's appointments with specialists as soon as needed | 77.80% | 81.00% | |
| Getting Care Quickly | Child got care as soon as needed when care was needed right away | 95.70% | 89.60% |
| Child got check-up/routine care appointment as soon as needed | 85.90% | 83.90% | |
| How Well Doctors Communicate | Child's personal doctor explained things about health in an understandable way | 96.20% | 96.00% |
| Child's personal doctor listened carefully to you | 94.90% | 94.20% | |
| Child's personal doctor showed respect for what you had to say | 96.70% | 96.50% | |
| Child's personal doctor spent enough time with your child | 94.90% | 91.80% | |
| Customer Service | Customer service provided information or help | 80.10% | 92.60% |
| Customer service treated member with courtesy and respect | 96.10% | 97.70% | |
| Coordination of Care | Coordination of Care | 83.90% | 81.70% |
| Ease of Filling out Forms | Ease of Filling out Forms | 97.00% | 96.40% |
| Rating of Health Care | % Rating 9 or 10 | 72.10% | 69.30% |
| Rating of Personal Doctor | % Rating 9 or 10 | 77.40% | 73.70% |
| Rating of Specialist | % Rating 9 or 10 | 76.40% | 69.00% |
| Rating of Health Plan | % Rating 9 or 10 | 72.00% | 72.60% |
Key Areas for Improvement include:
- Getting Care Quickly: Focus on streamlining specialist referrals and appointments, addressing delays in care, and utilizing cultural competency resources.
- Rating of Personal Doctor and Rating of Specialist: Prioritize clear communication, active listening, timely follow-up, and patient education.
The CAHPS survey highlights that we've achieved a lot in 2025, but there are also some clear opportunities for us to make the patient experience even better. These strategies include fostering improved collaboration between care providers, addressing patient delays in care as quickly as possible, and continuing all the great work that has increased member satisfaction with care since the 2024 CAHPS results.
