U.S. Office of Personnel Management - Ensuring the Federal Government has an effective civilian workforce

Each year Federal Employees Health Benefits (FEHB) plans with 500 or more subscribers mail the Consumers Assessment of Healthcare Providers and Systems (CAHPS) to a random sample of plan members. For Health Maintenance Organizations (HMO)/Point-of-Service (POS) plans, High Deductible Health Plans (HDHP) and Consumer-Driven Health Plans (CDHP), the sample includes all commercial plan members, including non-Federal members. For Fee-for-Service (FFS)/Preferred Provider Organization (PPO) plans, the sample includes Federal members only. The CAHPS survey asks questions to evaluate members' satisfaction with their health plans independent vendors certified by the National Committee for Quality Assurance administer the surveys.

OPM reports each plan's scores on various survey measures by showing the percentage of satisfied members on a scale of 0 to 100. Also, we list the national average for each measure. Since we offer HMO plans, FFS/PPO plans, HDHP, and CDHP plans, we compute a separate national average for each plan type.

Survey findings and member ratings are provided for the following key measures of member satisfaction:

• Overall Plan Satisfaction - This measure is based on the question, "Using any number from 0 to 10, where 0 is the worst health plan possible and 10 is the best health plan possible, what number would you use to rate your health plan?" We report the percentage of respondents who rated their plan 8 or higher.
• Getting Needed Care - How often was it easy to get an appointment, the care tests, or treatment you thought you needed through your health plan?
• Getting Care Quickly - When you needed care right away, how often did you get care as soon as you thought you needed? Not counting the times you needed care right away, how often did you get an appointment at a doctor's office or clinic as soon as you thought you needed?
• How Well Doctors Communicate - How often did your personal doctor explain things in a way that was easy to understand? How often did your personal doctor listen carefully to you, show respect for what you had to say, and spend enough time with you?
• Customer Service - How often did the written materials or the Internet provide information you needed about how your health plan works? How often did your health plan's customer service give you the information or help you needed?
• Claims Processing - How often did your health plan handle your claims quickly and correctly?
• Shared Decision Making - Did your doctor talk with you about the pros and cons of each choice for your treatment or health care? When there was more than one choice for your treatment or health care, did your doctor ask which choice was best for you?

In evaluating plan scores, you can compare individual plan scores against other plans and against the national average. Generally, new plans and those with fewer than 500 FEHB subscribers do not conduct CAHPS. Therefore, some of the plans listed in the Guide will not have survey data.