Do Experience Surveys Tell the Real Story?

Perceptions of health care quality are not necessarily reality. How Medicare Advantage members respond to CAHPS survey questions about Getting Needed Prescription Drugs doesn’t correspond to adherence to maintenance medications. This example is diabetes medications, but it holds true for other medications measured for the Stars program. In some states, such as Pennsylvania and California, the perception and reality seem to match. In Massachusetts and Minnesota… are they just complainers?

Medication Adherence for Diabetes Medications compared to Medicare Advantage members saying they get the prescription drugs they need, by state.

Like many others I am concerned, with recent developments, about health care becoming less reality-based. Perceptions of trends in health care must be validated with actual data. The fact that precise measurement is difficult and health care data is extremely dirty is not a reason to throw up your hands. I’ve spent years creating measures, analyzing data, and finding results that others have thought impossible to obtain. It just takes research, knowledge, and work.

If you are looking to find the reality behind the health care trends that you’re seeing, send me a note. I’d love to help. I have consulted with groups in every part of the health care system to help delve into data about health care quality and satisfaction. 

As for the complainers in my home state of Massachusetts, I don’t think that the survey results are necessarily about actual medication access. Education is a confounding factor. More highly educated people are:

• More critical of health care on surveys, and

• More likely to be adherent to medications.

  
  

The most educated state in the country just happens to be Massachusetts. The perception may just be a perception.

The charts you see come from a database I created from eight years of detailed Stars results and December, 2024 enrollment by plan. I enlisted an AI model to help find more information about the plans to look at for-profit vs. non-profit ownership. The results are population-weighted averages by plan within each state.

If you have any questions, please leave a comment or contact me directly at inquiry@kwbellconsulting.com.