Pre-Conditioning for CAHPS Success: How Strategic Direct Mail Can Influence Survey Outcomes

Recent updates from the Centers for Medicare & Medicaid Services (CMS) have placed even greater emphasis on member experience measures within Medicare Advantage (MA) Star Ratings. With CAHPS (Consumer Assessment of Healthcare Providers and Systems) scores now contributing nearly 25% of a plan’s overall rating, the stakes for improving member satisfaction have never been higher. Plans achieving 4 or more Stars unlock not only valuable bonus payments but also enhanced competitive positioning in an increasingly crowded market.

Medicare Advantage now serves 33.8 million Americans, accounting for 55% of the Medicare-eligible population in 2024—a testament to the program’s rapid growth and increasing importance in the healthcare landscape. As enrollment rises, so do member expectations, with MA beneficiaries demanding more personalized and meaningful interactions with their health plans.

This dual pressure—meeting CMS benchmarks while fostering stronger member relationships—requires health plans to elevate communication strategies. One proven method is CAHPS pre-conditioning, which uses strategic direct mail to positively shape member perceptions before surveys are administered.

But how can health plans ensure members have positive perceptions during these pivotal surveys?

One effective approach is using thoughtful, strategic direct mail to shape member perceptions and experiences ahead of the CAHPS survey period. By delivering personalized, emotionally resonant messages, health plans can build trust, enhance satisfaction, and improve survey outcomes.

In this article, we explore the power of pre-conditioning through direct mail and outline actionable strategies for success.

Why CAHPS Pre-Conditioning Matters 

The CAHPS survey evaluates various aspects of a member’s experience with their health plan, from communication quality to access to care. While excellent service delivery is foundational, effective communication can amplify positive impressions. Here’s why pre-conditioning is crucial:

Influences Perceptions

Direct mail provides health plans with an opportunity to shape how members view their experiences, especially in the lead-up to CAHPS surveys. Research shows that 76% of members who received carrier outreach remain loyal to their plan, demonstrating the power of proactive communication in strengthening member relationships. Thoughtful, well-timed communication reminds members of the positive aspects of their relationship with the plan, such as the quality of customer service, access to care, and additional benefits offered. For example, a personalized mailer might highlight a member's successful use of a preventive service or remind them of convenient virtual care options.

By prompting members to recall positive interactions, direct mail helps establish a mental framework through which they evaluate their overall experience. It shifts the focus away from isolated frustrations and toward a broader appreciation of the plan’s efforts to support their health and well-being.

Builds Emotional Connections

Personalized communication through direct mail fosters a sense of care and attentiveness, strengthening the emotional connection between members and their health plans. Hallmark cards, for example, deliver heartfelt messages that feel personal and meaningful. A card expressing gratitude or celebrating milestones like birthdays or anniversaries goes beyond routine communication, leaving a lasting impression of genuine care.

This emotional connection shapes how members perceive their health plan during CAHPS surveys. Members who feel supported are more likely to give favorable feedback, associating their plan with positive feelings. Emotional connections also humanize the health plan, transforming it into a trusted partner rather than a distant corporation. Research supports this: 86% of Hallmark card recipients report feeling their plan truly cares about them, a sentiment that drives improved survey responses and loyalty.

Educates and Empowers Members

CAHPS pre-conditioning also serves as a powerful way to educate members about their health plan. Many MA members are unaware of the full range of benefits and services available to them, which can lead to underutilization and dissatisfaction. Over 99% of MA plans now offer at least one supplemental benefit, such as dental, vision, or wellness programs, yet many members remain unaware of how to access these features. Direct mail can highlight underused offerings, such as telehealth, fitness memberships, or wellness programs, helping members see the value their plan provides.

In addition, direct mail can address common coverage questions or explain how to access care, such as reminders about prescription delivery options or finding in-network providers. Proactive communication ensures members feel informed and supported, improving their overall experience and shaping how they respond to surveys. By empowering members with relevant information, health plans reinforce their commitment to care while positively influencing CAHPS outcomes.

Reduces Negative Bias

Proactively addressing potential concerns before they escalate is a critical aspect of CAHPS pre-conditioning. Direct mail provides a strategic platform to reduce the risk of negative feedback by identifying common pain points and offering reassurance or solutions. For instance, if members have experienced delays in accessing care or confusion around benefits, a direct mail campaign can acknowledge these challenges while emphasizing ongoing efforts to improve.

Reducing negative bias isn’t just about addressing concerns—it’s also about emphasizing the positive. By balancing acknowledgment of issues with reminders of strengths, such as robust wellness programs or round-the-clock support, health plans can shift members’ focus away from dissatisfaction. Additionally, direct mail requires 21% less cognitive effort to process than digital messaging, making it particularly accessible and engaging for seniors. This accessibility ensures that key messages resonate with members and leave a lasting impression. Hallmark’s visually engaging designs and clear messaging make it easier for members to understand and access the benefits their health plan provides. This simplicity reduces confusion and reinforces trust. The physical presence of direct mail, which remains in households far longer than an email, serves as an ongoing reminder of the health plan’s efforts, helping to soften any lingering negativity.

Key Strategies for CAHPS Pre-Conditioning with Direct Mail

Implementing a successful CAHPS pre-conditioning campaign requires a thoughtful approach to timing, messaging, and member engagement. To maximize the impact of your efforts, consider these key strategies:

• Timing Is Everything: Timing is crucial for ensuring your message resonates when it matters most. Direct mail should reach members in late February just before the CAHPS surveys begin in March to allow enough time for the message to make an impression while keeping it fresh in their minds. Health plans typically aim for early February or March, aligning with CMS survey distribution timelines. Craft Personalized Messages: Personalization is a powerful tool for creating messages that speak directly to individual member needs and preferences. Leverage member data to tailor your communication—for example, include reminders about preventive care services they've recently used or highlight new benefits they may not yet know about. Such tailored messages remind members that their health plan is attentive and invested in their personal health journey.

• Educate Members About Access to Care: Many members may not fully understand how to navigate their plan or access available services, which can impact survey responses. Direct mail can highlight essential information, such as how to schedule specialist appointments, access urgent care options, or use telehealth services.

• Focus on Gratitude and Support: Expressing gratitude builds trust and creates a positive association with your health plan. A simple thank-you can leave a lasting impression, especially when tied to an emotionally resonant moment. Gratitude-driven messages show members that their trust and loyalty are genuinely appreciated, fostering goodwill ahead of the survey period. Leverage Hallmark’s expertise in gratitude-driven communication to create impactful messages that show members they’re valued. One client reported, “89% of Hallmark card recipients give the highest possible satisfaction rating on surveys.”

• Encourage Open Communication: Proactively inviting members to share questions or concerns positions your health plan as approachable and responsive. Include contact options like a QR code linking to support resources or a toll-free number for direct assistance. This not only reassures members that their feedback matters but also helps address any lingering doubts or frustrations they may have. A personalized message encouraging communication demonstrates your commitment to being accessible and member-focused, leaving a strong impression of care and reliability.

By integrating these strategies into your direct mail campaigns, health plans can effectively pre-condition members for CAHPS success, improving satisfaction, survey outcomes, and overall Star Ratings.

Five Key Considerations for Effective Pre-Conditioning Campaigns

To ensure your CAHPS pre-conditioning campaigns deliver the desired outcomes, it’s important to focus on the elements that make your efforts stand out. From the quality of your materials to the consistency of your messaging, these considerations can help you create campaigns that resonate with members and drive measurable results.

• Invest in High-Quality Materials: Opt for premium materials, such as Hallmark greeting cards, to convey professionalism and care. It reflects the health plan’s commitment to excellence and leaves a lasting impression.

• Incorporate Data-Driven Personalization: Personalize mailers using member demographics, engagement history, or healthcare needs. It could include reminders about overdue screenings or highlight new benefits tailored to individual preferences. Personalized messages demonstrate attentiveness and build trust.

• Integrate with Digital Follow-Ups: Combine direct mail with digital tools like email or SMS to reinforce your message. A mailer encouraging preventive care can include a QR code linking to online appointment scheduling, creating a seamless experience. This approach amplifies engagement and accessibility.

• Measure Success: Track outcomes like response rates and member feedback to evaluate the campaign’s impact. Insights from these metrics can refine future strategies, ensuring continuous improvement.

• Maintain Year-Round Engagement: Consistent communication builds a strong foundation for pre-conditioning campaigns. Sending birthday cards, seasonal greetings, and wellness reminders throughout the year keeps members connected and fosters positive perceptions.

Elevate Your CAHPS Strategy Today

By investing in strategic direct mail campaigns, health plans can pre-condition members for survey success, driving higher CAHPS scores and unlocking the rewards of improved Star Ratings—bonus payments, competitive positioning, and member loyalty. Personalized messages that express gratitude, reinforce positive experiences, and invite open communication make all the difference.

Download our latest whitepaper, Revitalizing Medicare Advantage Member Engagement with Direct Mail, for proven strategies, actionable insights, and real-world examples.