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Staying Competitive in 2021 With CAHPS® Updates: Part 2

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Last time on the blog, I continued my December webinar conversation on the critical changes ahead for Medicare Advantage (MA) organizations. With the 2021 Consumer Assessment of Healthcare Providers and Systems (CAHPS®) measures weighing four times more than they were previously, MA healthcare providers’ focus this year must be stellar patient experiences. With a confident understanding of what will be changing and how it could impact MA organizations, it is time to devise tactics for success and organization-wide customer service standards.

Assembling an Improvement Team

Much of value-based care implementation begins with establishing a reliable team that assures the completion of vital steps, monitors progress, and serves as critical resources for other staff members. For MA initiatives, I recommend creating an “Improvement Team” of people from the organization who demonstrate the necessary skillsets and, most importantly, the right mindset. Along with being subject matter experts, members of this team should be respected throughout the organization and fluent in their viewpoints. They are the go-to individuals for the rest of the staff members to look for feedback, advice, and engagement.

An Improvement Team should represent the various areas of the patient experience and have front desk staff members, care managers, call-center representatives, and others. Designating a person of influence in your organization as a champion or sponsor for a team can create momentum and help remove barriers. Clinical leaders will ensure initiatives work well within provider workflows and integrate seamlessly into their day-to-day. Improvement Teams should use reporting tools to identify areas that need work and revisit best practices to address shortfalls. It could be as simple as introducing an annual customer service training for staff to review critical workflows.

Setting Customer Service Standards

We have touched on some proven success strategies and the importance of member feedback, but a beneficial, basic concept to drive improvement is setting organization-wide customer service standards. Most people have an idea of what customer service looks like in other industries, but what about healthcare? I break down healthcare customer service into five categories: communication, responsiveness, cleanliness, collaboration, and follow-ups.


Many patients do not enjoy going to the doctor, so communicating with them warmly from the beginning impacts how they will feel throughout the visit. Nurse practitioners and providers must let the patients know what to expect and inform them if unexpected events occur. For example, if the clinic runs behind schedule, staff should be upfront about it, so patients are not left wondering what is taking long or believing their time is not as important. When conversing with patients, providers should be present and talk with them, not at them, and show empathy by using phrases like “I hear you” or “I understand your concern.”


Being responsive boils down to the ease of access patients have to services and people. How easy is it for them to reach a nurse, physician, or another person they need? Facilities should consider simplifying overly complicated phone menus and creating user-friendly portals. It can also help to remind patients that they can see nurse practitioners to address many of their needs if their physician is busy.

Demonstrating responsiveness also means paying attention to diversity and cultural needs in patient care administration. Staff can show acknowledgment and sensitivity to other cultural perspectives by employing members of the local community and bilingual individuals to aid in communicating with non-English speakers.


Pre- and post-COVID, cleanliness will always remain essential to demonstrate an above and beyond effort to maintain a healthy care environment. However, it is especially important in COVID-19 times, as many people are still hesitant about returning to healthcare offices. Frequent, routine cleaning should be a part of any customer service plan.


Patients who feel consulted about their care tend to have a better healthcare perception overall. Collaboration in the exam room between the provider and patient should center on shared decision-making around care plans, treatment options, and long-term goals. One way to address this is by adopting the “ask-tell-ask” method.

Ask-tell-ask is asking the patient what they know or want to know about their treatment recommendations, telling them in plain language, free of medical jargon, and asking them what they think, testing for understanding. Since providers’ workflows are heavily task-oriented and often require multitasking, they should be sure to make eye contact with patients and use phrases like “for you” and “with you” so they feel like they have their full attention.

Follow Up

Follow-ups are simple and go hand-in-hand with communication. Patients who feel that their care team is engaged and “on the ball” tend to have a more positive perception of their care. To show that engagement investment in their health outcomes, an email or phone call from the facility to a patient checking in and willing to answer any questions can go a long way in their experience.

Join Us Next Month

With a reliable improvement team and airtight customer service standards, MA organizations will have a great foundation to stay competitive this year and in years to come. Join me on February 17th at noon central time for my follow-up presentation to discuss the 2022 Advance Notice released from CMS. The presentation will be around 30 minutes in length, allowing time to ask questions at the end. All registrants will receive a recording of the presentation via email if they cannot attend live.

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Cindy Dyer is a Product Manager at Lightbeam.

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