October 01, 2022

Medicare Advantage: Updates to incentive programs

Program Overview

Each year, the Centers for Medicare & Medicaid Services (CMS) sends the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey and Healthcare Outcomes Survey (HOS) to UnitedHealthcare® Medicare Advantage plan members to gather insights into how they feel about their patient experience (PX). We conduct monthly PX surveys with your patients, and we share the results with you, so you can better understand your patients’ perceptions.

Getting Needed Care category

Getting Needed Care is the first of 3 categories in the PX survey that we conduct monthly with Medicare Advantage members. In Question 1 of this category, we ask your patients to rate how easily they were able to make appointments and receive care in a timely manner. Earlier this year, we introduced new wording changes* to Question 1 on the PX survey that may have impacted responses from your patients. 

New target scores

To help ensure that your target scores are fair and attainable, and account for the possibility of lower scoring, we’re decreasing the Getting Needed Care category Star ratings by 2 points as shown in the following table:

Getting needed care 3-Star rating 4-Star rating 5-Star rating
Original score 92 94 96
New score 90 92 94

These new target scores are effective immediately for the following incentive programs:

  • Medicare Advantage Primary Care Physician Incentive (MA-PCPi) program
  • Medicare Advantage Advanced Primary Care Physician Incentive (MA-APCPi) program 


To learn more about patient experience scores and how we use them, check out the 2022 Patient Experience Guidebook or view our self-paced Patience Experience interactive guide.

We’re here to help

For more information about the patient experience resources available to you and to receive your monthly scores, please contact your UnitedHealthcare representative.

* Previous Question 1: Did you experience any difficulty scheduling the appointment?
   Current Question 1: How easy was it to get an appointment with your personal doctor as soon as you needed it?

CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).

PCA-1-22-03027-M&R-News_ 09162022

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