The QHP Enrollee Survey assesses the enrollee’s experience with their Qualified Health Plan (QHP) offered through the Health Insurance Marketplace. All Qualified Health Plans are required to conduct the survey through a CMS-approved survey vendor using a standardized survey protocol. Results from the survey are included in the Quality Rating System (QRS). The QRS assigns each QHP a Star Rating of 1 to 5 stars.

Guidance and Assurance with SPH Analytics

Healthcare doctor with patient

SPH Analytics is a CMS-approved survey vendor for the QHP Enrollee Survey. With more than two decades of experience conducting healthcare surveys and multiple survey provider accreditations, we have the experience and expertise to help you meet this important survey requirement.

Plans receive ongoing guidance and assurance when they partner with SPH to conduct their QHP Enrollee Surveys.

  • CMS-approved survey vendor
  • More than two decades of experience and expertise
  • Personal guidance each step of the way
  • Actionable information for performance improvement

Survey Objective

Information obtained from this survey is intended to help consumers choose a health plan, provide QHPs with actionable information for measurable improvement, provide accreditation organizations with information to regulate and accredit plans, and provide data for consumer research.

Survey Details

Survey design: The questionnaire is based on the Medicaid CAHPS 5.0 with additional and supplemental questions.

Eligible members: Adults enrolled at least 6 months with no more than one 30-day break in enrollment.

Sampling: Product level sampling (HMO, PPO, etc.) offered by a particular issuer in a particular state.

Methodology: Survey methodology includes mail, phone, and web protocols.

Database: Plans will provide survey vendors with an audited database and vendors will pull the sample.

Plan requirement: QHPs with at least 500 enrollees are required to conduct the survey.

Reliable experience for your reporting requirements

Rely on SPH Analytics for the experience you need to measure and report your QHP’s member satisfaction.

SPH Analytics has more than 25 years of experience driving quality program success. We have the experience and expertise clients trust to improve clinical care, enhance patient experience, and reduce costs to meet the Triple Aim.

Helpful Resources on this Topic

Brochure - Member Experience Survey Solutions
Webinar Recording: Payer Provider Collaboration to Achieve the Triple Aim
Webinar Recording: Meeting NCQA's New PHM Accreditation Category

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