How do CAHPS and HEDIS differ, and what roles do they play in plan evaluation?

• A. CAHPS and HEDIS measure the same aspects of care and have identical roles.
• B. CAHPS measures patient experience; HEDIS evaluates clinical performance; both inform accreditation, reporting, and consumer choice.
• C. CAHPS evaluates clinical performance; HEDIS measures patient experience; neither informs accreditation.
• D. CAHPS is used for provider credentialing; HEDIS is used for marketing campaigns.

Answer: (C)

CAHPS and HEDIS address different aspects of quality and combine to inform how plans are evaluated. CAHPS collects patient-reported experience data through surveys, capturing how patients perceive their care—things like communication with providers, access to services, and overall satisfaction. HEDIS uses standardized clinical performance measures drawn from medical records and claims to assess the actual quality of care delivered, such as preventive services, chronic disease management, and health outcomes. In plan evaluation, both sets of data matter: accreditation processes and public reporting often rely on HEDIS for objective quality metrics and on CAHPS for patient experience insights, and together they influence consumer choice by providing a fuller picture of a plan’s performance. So the best depiction is that CAHPS measures patient experience, HEDIS evaluates clinical performance, and both inform accreditation, reporting, and consumer choice.