CAHPS® Health Plan Survey 5.0 - Adult Commercial Survey
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  • 1. Our records show that you are now in {INSERT HEALTH PLAN NAME}. Is that right?
  • 2. What is the name of your health plan?
  • 3. In the last 12 months, did you have an illness, injury, or condition that needed care right away in a clinic, emergency room, or doctor’s office?
  • 4. In the last 12 months, when you needed care right away, how often did you get care as soon as you needed?
  • 5. In the last 12 months, did you make any appointments for a check-up or routine care at a doctor’s office or clinic?
  • 6. In the last 12 months, how often did you get an appointment for a check-up or routine care at a doctor’s office or clinic as soon as you needed?
  • 7. In the last 12 months, not counting the times you went to an emergency room, how many times did you go to a doctor’s office or clinic to get health care for yourself?
  • 8. Using any number from 0 to 10, where 0 is the worst health care possible and 10 is the best health care possible, what number would you use to rate all your health care in the last 12 months?
  • 9. In the last 12 months, how often was it easy to get the care, tests, or treatment you needed?
  • 10. A personal doctor is the one you would see if you need a check-up, want advice about a health problem, or get sick or hurt. Do you have a personal doctor?
  • 11. In the last 12 months, how many times did you visit your personal doctor to get care for yourself?
  • 12. In the last 12 months, how often did your personal doctor explain things in a way that was easy to understand?
  • 13. In the last 12 months, how often did your personal doctor listen carefully to you?
  • 14. In the last 12 months, how often did your personal doctor show respect for what you had to say?
  • 15. In the last 12 months, how often did your personal doctor spend enough time with you?
  • 16. Using any number from 0 to 10, where 0 is the worst personal doctor possible and 10 is the best personal doctor possible, what number would you use to rate your personal doctor?
  • 17. Specialists are doctors like surgeons, heart doctors, allergy doctors, skin doctors, and other doctors who specialize in one area of health care. In the last 12 months, did you make any appointments to see a specialist?
  • 18. In the last 12 months, how often did you get an appointment to see a specialist as soon as you needed?
  • 19. How many specialists have you seen in the last 12 months?
  • 20. We want to know your rating of the specialist you saw most often in the last 12 months. Using any number from 0 to 10, where 0 is the worst specialist possible and 10 is the best specialist possible, what number would you use to rate the specialist?
  • 21. In the last 12 months, did you get information or help from your health plan’s customer service?
  • 22. In the last 12 months, how often did your health plan’s customer service give you the information or help you needed?
  • 23. In the last 12 months, how often did your health plan’s customer service staff treat you with courtesy and respect?
  • 24. In the last 12 months, did your health plan give you any forms to fill out?
  • 25. In the last 12 months, how often were the forms from your health plan easy to fill out?
  • 26. 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?
  • 27. In general, how would you rate your overall health?
  • 28. In general, how would you rate your overall mental or emotional health?
  • 29. In the past 12 months, did you get health care 3 or more times for the same condition or problem?
  • 30. Is this a condition or problem that has lasted for at least 3 months? Do not include pregnancy or menopause.
  • 31. Do you now need or take medicine prescribed by a doctor? Do not include birth control.
  • 32. Is this medicine to treat a condition that has lasted for at least 3 months? Do not include pregnancy or menopause.
  • 33. What is your age?
  • 34. Are you male or female?
  • 35. What is the highest grade or level of school that you have completed?
  • 36. Are you of Hispanic or Latino origin or descent?
  • 37. What is your race? Mark one or more.
  • 38. Did someone help you complete this survey?
  • 39. How did that person help you? Mark one or more.

Supplemental Item Sets Hide Numbering

Click on items or set of items that you want to add.

    Access to Urgent Care
    • AC1. In the last 12 months, how many days did you usually have to wait for an appointment when you needed care right away?
    Access to Routine Care
    • AC2. In the last 12 months, how many days did you usually have to wait for an appointment for a check-up or routine care?
    Access to After Hours Care
    • AC3. In the last 12 months, did you need care for yourself during evenings, weekends, or holidays?
    • AC4. In the last 12 months, how often were you able to get the care you needed from a doctor’s office or clinic during evenings, weekends, or holidays?
    Access to After Hours Care
    • AC5. In the last 12 months, did you need to visit a doctor's office or clinic after regular office hours?
    • AC6. In the last 12 months, how often were you able to get the care you needed from a doctor's office or clinic after regular office hours?
    Access to After Hours Care
    • AC7. In the last 12 months, did you need care from your personal doctor during evenings, weekends, or holidays?
    • AC8. In the last 12 months, how often were you able to get the care you needed from your personal doctor’s office or clinic during evenings, weekends, or holidays?
    Wait Time for Appointment to Start
    • AC9. Wait time includes time spent in the waiting room and exam room. In the last 12 months, how often did you see your personal doctor within 15 minutes of your appointment time?
    • AC10. In the last 12 months, after you checked in for your appointment at your personal doctor’s office, how often were you kept informed about how long you would need to wait for your appointment to start?
    Contacting Doctor's Office With a Medical Question
    • AC11. In the last 12 months, did you contact your personal doctor’s office or clinic with a medical question during regular office hours?
    • AC12. In the last 12 months, when you contacted your personal doctor's office or clinic during regular office hours, how often did you get an answer to your medical question that same day?
    Contacting Doctor's Office With a Medical Question
    • AC13. In the last 12 months, did you contact your personal doctor's office or clinic with a medical question after regular office hours?
    • AC14. In the last 12 months, when you contacted your personal doctor's office or clinic after regular office hours, how often did you get an answer to your medical question as soon as you needed?
    • HL1. In the last 12 months, how often did your personal doctor ask if you had any questions about your health?
    • HL2. In the last 12 months, how often did your personal doctor use medical words you did not understand?
    • HL3. In the last 12 months, how often did your personal doctor talk too fast when talking with you?
    • HL8. In the last 12 months, how often did your personal doctor give you all the information you wanted about your health?
    • HL21. In the last 12 months, how often was the information you got from your health plan's customer service easy to understand?
    Health Literacy
    • HL4. In the last 12 months, did you talk with your personal doctor about any health questions or concerns?
    • HL5. In the last 12 months, how often did your personal doctor show interest in your questions or concerns?
    • HL6. In the last 12 months, how often did your personal doctor give you easy to understand information about these health questions or concerns?
    • HL7. In the last 12 months, how often did your personal doctor answer all of your questions?
    Health Literacy
    • HL9. In the last 12 months, did you see your personal doctor for a specific illness or for any health condition?
    • HL10. In the last 12 months, did your personal doctor give you instructions about what to do to take care of this illness or health condition?
    • HL11. In the last 12 months, how often were these instructions easy to understand?
    • HL12. In the last 12 months, how often did your personal doctor ask you to describe how you were going to follow these instructions?
    Health Literacy
    • HL13. In the last 12 months, did you start a prescription medicine?
    • HL14. In the last 12 months, how often did your personal doctor give you easy to understand instructions about how to take your medicines?
    • HL15. In the last 12 months, how often did your personal doctor explain the possible side effects of your medicines in a way that was easy to understand?
    Health Literacy
    • HL16. In the last 12 months, did your personal doctor order a blood test, x-ray, or other test for you?
    • HL17. In the last 12 months, before you had a blood test, x-ray, or other test, how often did your personal doctor explain what it was for?
    • HL18. In the last 12 months, how often was the explanation of what the test was for easy to understand?
    • HL19. In the last 12 months, when your personal doctor ordered a blood test, x-ray, or other test for you, how often did someone from your personal doctor's office follow up to give you those test results?
    • HL20. In the last 12 months, how often were the results of your blood test, x-ray, or other test easy to understand?
    Health Literacy
    • HL22. In the last 12 months, did you look for any information about how your health plan works?
    • HL23. Did you find the information you needed about how your health plan works?
    • HL24. Was the information about how your health plan works easy to understand?
    • HL25. Was there too much information about how your health plan works?
    • HL26. Was the information about how your health plan works confusing?
    Health Literacy
    • HL27. In the last 12 months, did you look for any information about your health plan's coverage and benefits?
    • HL28. Did you find the information you needed about your health plan’s coverage and benefits?
    • HL29. Was the information about your health plan’s coverage and benefits easy to understand?
    • HL30. Was there too much information about your your health plan’s coverage and benefits?
    • HL31. Was the information about your health plan’s coverage and benefits confusing?
    Health Literacy
    • HL32. In the last 12 months, did you look for any information from your health plan about how much you would have to pay for specific prescription medicines?
    • HL33. Did you find the information you needed about how much you would have to pay for prescription medicines?
    • HL34. Was the information about how much you would have to pay for prescription medicines easy to understand?
    • HL35. Was there too much information about how much you would have to pay for prescription medicines?
    • HL36. Was the information about how much you would have to pay for prescription medicines confusing?
    Health Literacy
    • HL37. Did you know you could make a complaint to your health plan about the care or services you received or decisions your health plan made?
    • HL38. In the last 12 months, did you look for any information about how to make a complaint to your health plan?
    • HL39. Did you find the information you needed about how to make a complaint to your health plan?
    • HL40. Was the information about how to make a complaint to your health plan easy to understand?
    • HL41. Was there too much information about how to make a complaint?
    • HL42. Was the information about how to make a complaint confusing?
    Health Literacy
    • HL43. Sometimes people need special services or equipment such as care from a specialist, physical therapy, a hearing aid, or oxygen. In the last 12 months, did you look for any information from your health plan about how much you would have to pay for special services or equipment?
    • HL44. Did you find the information you needed about how much you would have to pay for special services or equipment?
    • HL45. Was the information about how much you would have to pay for special services or equipment easy to understand?
    • HL46. Was there too much information about how much you would have to pay for special services or equipment?
    • HL47. Was the information about how much you would have to pay for special services or equipment confusing?
    Health Literacy
    • HL48. In the last 12 months, did you look for information from your health plan about how to stay healthy? Do not include information that was given to you at a doctor's office.
    • HL49. Did you find the information you needed about how to stay healthy?
    • HL50. Was the information about how to stay healthy easy to understand?
    • HL51. Was there too much information about how to stay healthy?
    • HL52. Was the information about how to stay healthy confusing?
    Health Literacy
    • HL53. In the last 12 months, did you visit your health plan's Website to look for information?
    • HL54. Was the information on your health plan's Website easy to understand?
    • HL55. In the last 12 months, was it easy to find the information you needed on your health plan's Website?
    • IN13. What language would you like to talk to your personal doctor in?
    Interpreter Services
    • IN1. An interpreter is someone who helps you talk with others who do not speak your language. In the last 12 months, did you need an interpreter at your personal doctor’s office?
    • IN2. In the last 12 months, during visits to your personal doctor’s office, how often did you get an interpreter when you needed one?
    • IN3. In the last 12 months, how often did this interpreter treat you with courtesy and respect?
    • IN4. Using any number from 0 to 10, where 0 is the worst interpreter possible and 10 is the best interpreter possible, what number would you use to rate this interpreter?
    Interpreter Services
    • IN1B. An interpreter is someone who helps you talk with others who do not speak your language. In the last 12 months, did you need an interpreter at your personal doctor’s office?
    • IN5. In the last 12 months, how often did you use a friend or family member as an interpreter when you talked with someone from your personal doctor’s office?
    • IN6. In the last 12 months, did you use a child younger than 18 to help you talk with someone from your personal doctor’s office?
    Interpreter Services
    • IN7. An interpreter is someone who helps you talk with others who do not speak your language. In the last 12 months, did you need an interpreter to talk with someone from your health plan?
    • IN8. In the last 12 months, how often did you get an interpreter to talk with someone from your health plan when you needed one?
    • IN9. In the last 12 months, how often did this interpreter treat you with courtesy and respect?
    • IN10. Using any number from 0 to 10, where 0 is the worst interpreter possible and 10 is the best interpreter possible, what number would you use to rate this interpreter?
    • IN11. In the last 12 months, how often did you use a friend or family member as an interpreter when you talked with someone from your health plan?
    • IN12. In the last 12 months, did you use a child younger than 18 to help you talk with someone from your health plan?