Data on Health and Well-being of American Indians, Alaska Natives, and Other Native Americans. CAHPS Health Plan Survey Response Data

12/01/2006

Sponsor: U.S. Department of Health and Human Services (DHHS)/Agency for Healthcare Research and Quality (AHRQ)
Description: The Consumer Assessment of Healthcare Providers and Systems (CAHPS) program develops and supports the use of a family of standardized surveys that ask consumers and patients to report on and evaluate their experiences with health care. CAHPS surveys include ratings of personal doctors and other health care staff, as well as an overall rating of the health plan and ask patients and consumers to report on their experiences with health care services. CAHPS sponsors include various public and private organizations that fund the administration of a CAHPS survey by collecting data from consumers and patients of a particular health plan.

There are two data sets available to researchers. The core database consists of responses to the CAHPS Health Plan Survey. Participating sponsors submit these data at the individual respondent level in accordance with specifications provided by the CAHPS Database. All health plan identifiers are removed from the public use database. Respondent records contain a unique health plan ID so responses from each health plan can be grouped together, but health plans can not be identified. The data also do not include respondent names, addresses, telephone numbers, and member ID numbers. Certain survey administration data (e.g., mode of administration, survey language) and descriptive information (e.g., state) may also be included in this data set. The second database is the Survey Administration and Health Plan Characteristics Data. This data set includes information regarding survey administration, such as mode of administration, response rates, and dates of survey completion, as well as descriptive information relating to each of the sampled units (e.g., health plan products), such as type of organization, size of enrollment, tax status and ownership, and location.

Relevant Policy Issues: Measurement of Health Status and Factors Contributing to Measured Health Disparities.
Data Type(s): Survey
Unit of Analysis: Individual
Identification of AI/AN/NA: Race is self-reported, using the following question:

What is your race? Please mark one or more.

  • White
  • Black or African-American
  • Asian
  • Native Hawaiian or other Pacific Islander (NH/PI)
  • American Indian or Alaska Native (AI/AN)
  • Other
AI/AN/NA Population in Data Set: Number of Records per Year by Type of Plan

Adult Commercial Plans:
2005: Out of 123,272 records, 1,745 are AI/AN and 1,006 are NH/PI
2004: Out of 111,680 records, 1,745 are AI/AN and 942 are NH/PI
2003: Out of 114,063 records, 1,390 are AI/AN and 888 are NH/PI
2002: Out of 94,546 records, 1,286 are AI/AN and 744 are NH/PI
2001: Out of 165,500 records, 2,732 are AI/AN and 1,294 are NH/PI

Child Commercial Plans:
2005: Out of 2,661 records, 28 are AI/AN and 9 are NH/PI
2004: Out of 7,024 records, 77 are AI/AN and 29 are NH/PI
2003: Out of 1,866 records, 30 are AI/AN and 2 are NH/PI
2002: Out of 5,600 records, 106 are AI/AN and 22 are NH/PI
2001: Out of 9,913 records, 153 are AI/AN and 118 are NH/PI

Adult Medicaid Plans:
2005: Out of 32,115 records, 1,011 are AI/AN and 194 are NH/PI
2004: Out of 59,515 records, 1,982 are AI/AN and 1,188 are NH/PI
2003: Out of 39,275 records, 1,143 are AI/AN and 211 are NH/PI
2002: Out of 48,109 records, 1,942 are AI/AN and 1,681 are NH/PI
2001: Out of 45,127 records, 1,596 are AI/AN and 1,875 are NH/PI

Child Medicaid Plans:
2005: Out of 40,204 records, 1,184 are AI/AN and 1,354 are NH/PI
2004: Out of 86,159 records, 2,291 are AI/AN and 806 are NH/PI
2003: Out of 31,082 records, 1,153 are AI/AN and 1,079 are NH/PI
2002: Out of 60,534 records, 2,018 are AI/AN and 472 are NH/PI
2001: Out of 36,940 records, 1,322 are AI/AN and 268 are NH/PI

State Childrens Health Insurance Program (SCHIP):
2005: Out of 1,252 records, 5 are AI/AN and 4 are NH/PI
2004: Out of 16,657 records, 359 are AI/AN and 143 are NH/PI
2003: Out of 19,061 records, 402 are AI/AN and 132 are NH/PI
2002: Out of 18,910 records, 349 are AI/AN and 203 are NH/PI
(SCHIP data were not collected in 2001.)

Geographic Scope: The geographic scope of CAHPS is national. The data files also include a state indicator. Some state-level analysis may be possible, but will depend on the number of records available for each state. State coverage varies from year to year, depending on which providers submit data for inclusion in the CAHPS Database. Details of the number of records per state are available in the CAHPS Health Plan Survey Chartbook, which is released on an annual basis and can be accessed at: https://www.cahps.ahrq.gov/content/NCBD/Chartbook/2005_Chartbook.pdf
Date or Frequency: Schedules for collecting CAHPS data vary by sponsor. The CAHPS Database is compiled every year, collecting data from health plans that have completed data collection in the past 12 months. Data are currently available from 2001 to 2005 (SCHIP data are available from 2002 to 2005). Data from 1998 to 2000 also exist in the CAHPS Database, but the quality of the data cannot be assured, and the CAHPS staff advises against using these data.

Beginning in 2006, the CAHPS Database will be expanded to include CAHPS Hospital Survey data, and will eventually be further expanded to include CAHPS Clinician and Group Survey Data. These survey data will all include unique respondent identifiers as well.

Aggregation: Researchers who are interested in combining multiple years of data for aggregation should consider that the basic reporting unit for CAHPS is the provider, even though the survey is at the individual respondent level. Across multiple years there will be differences in the providers submitting data; for example, in one year more large providers may submit and in another more Western providers. An aggregated data set will not necessarily be representative of the population by year or in combination. These differences in providers by year cannot be described, as the provider-level unique ID number is not consistently assigned from year to year. Also, each year, the data from the CAHPS surveys are case-mix adjusted in order to create the CAHPS benchmark. Researchers should consider re-running the case-mix adjustment (called the CAHPS Macro) on data aggregated across multiple years.
Data Collection Methodology: Data collection methodology varies by the CAHPS sponsor or vendor administering the CAHPS survey. Some information on the mode of data collection is included in the public use data set (e.g., each completed survey is coded either M = mail complete, T = telephone complete, or I = Internet complete).

Additionally, the CAHPS Program provides the following guidelines for sponsors concerning data collection: A mixed-mode data collection protocol involving both mail and telephone is more likely to achieve a desired response rate than will either mode alone. Research conducted by the CAHPS grantees shows that differences in the types of responses collected by these different modes are minimal (these differences are called mode effects), so telephone and mail can be used together with confidence.

Participation: Optional, without incentives
Response Rate: Response rates are calculated and provided by the different CAHPS survey vendors and sponsors who submit data to the CAHPS Database. The 2005 CAHPS Database self-reported response rates vary by sponsor and range from 14 percent to 71 percent. The breakdown of response rates by population type are as follows:
Adult Commercial: 19% - 71%
Adult Medicaid: 17% - 59%
Child Medicaid: 14% - 50%
Sampling Methodology: Sampling methods for CAHPS vary by sponsor. CAHPS provides guidelines for selecting a sample, including determining eligibility, calculating the estimated sample size needed for general reporting, and creating a frame of all covered lives or sampling policyholders only.
Strengths: Some CAHPS data sets contain a large number of AI/AN/NA respondents. Data are collected on key policy issues, including self-reported health status. There are multiple years of data available.
Limitations: The CAHPS survey is not administered in a consistent fashion. Instead, the CAHPS Database is a collection of surveys administered at the level of health plans. As such, not all health plans participate each year, so the mix of plans will vary across years. Additionally, sampling and data collection methods vary by plan, as plans hire vendors to administer the survey and these methods will vary by vendor.
Access Requirements and Use Restrictions: To access these data, researchers must submit a data release agreement and a description of the proposed research, as well as IRB clearance documentation.
Contact Information: Contact Dale Shaller, Managing Director, with any questions about the CAHPS Database and data requests.
Email: d.shaller@comcast.net
Phone: (651) 430-0759

Send proposals for data access and signed Data Use Agreements to:
CAHPS Project Staff
Westat
1650 Research Boulevard
RA1159
Rockville, MD 20850
Fax: (301) 251-1500

The CAHPS Database website is located at:  https://www.cahps.ahrq.gov/content/ncbd/ncbd_Intro.asp?p=105&s=5

Reports of Interest: Research Brief: Racial and Ethnic Disparities in the Experiences of Health Care Consumers. Published in November 2005 by the National CAHPS Benchmarking Database, under AHRQ Contract Number 290-0I-0003. Written by Karen Onstad.

 

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