Experience is the Strategy: How CAHPS is Won in the Moments that Matter

The Challenge: Every Interaction Shapes Trust

Member experience has become one of the most powerful drivers of Medicare Advantage Stars Performance. CMS continues to raise expectations for how members experience their health plan, placing greater emphasis on trust, access, communication and consistency across the entire journey.

CAHPS performance is no longer shaped by isolated touchpoints or seasonal outreach. It reflects how members feel about every interaction, across every channel, over time. There are no silver bullets. Sustainable CAHPS success is built through consistency, stability and brand credibility… doing the right thing, at the right time, for all members.

When experience efforts are disconnected from journey insights or only activated during survey season, plans risk missing the true drivers of member perception, loyalty and trust.

What Successful Plans Are Doing Differently

High-performing plans treat CAHPS as an always-on, insight-driven experience strategy rather than a one-time campaign. These organizations are:

• Using member journey insights to understand the triggers, transitions and barriers, such as network and benefit changes or service disruptions, where proactive outreach has the greatest impact.
• Delivering timely, personalized outreach through moment-based interventions thatfeel relevant and supportive. Real-time signals and operational data are used to trigger the right message, through the right channel, at the right time.
• Aligning the entire ecosystem around consistency, ensuring internal teams and vendor partners operate cohesively. These plans recognize that trust is cumulative. Every touchpoint, regardless of who delivers it, contributes to the survey response.

Three Priorities for Data-Driven CAHPS Improvement

Our Perspective

At ProspHire, we believe CAHPS improvement starts with trust and is sustained through disciplined, insight-driven execution. By connecting member journey data with operations and member experience strategy, plans can move beyond short-term survey tactics and build relationships that drive long-term loyalty and Stars performance.

Design Experiences That Members Remember

CAHPS results are shaped long before the survey arrives. Now is the time to rethink how journey insights, moment-based outreach and consistent experience delivery work together to build trust, elevate satisfaction and drive meaningful results.