Consumer assessments of care for children and adults in health plans: How do they compare?

OBJECTIVES: The Consumer Assessment of Health Plans Survey (CAHPS) includes an adult version and also a child version for parents or caretakers to rate children's care in health plans. This study examined how adult and child assessments differed in ranking health plans and explored whether the differences justified the additional cost and respondent burden in administering both surveys. METHODS: Data were from 136 commercial health plans participating in the National CAHPS Benchmarking Database, with 80,539 adults and 40,003 children. We compared mean assessments for adults and children on four global ratings and five composites, and determined respondent characteristics predictive of these assessments using regression analysis. We calculated correlations of plan mean scores for adults and children and kappa statistics for agreement when health plans are ranked as above average, average, or below average performers based on adult and child scores. RESULTS: CAHPS scores for children were significantly (P