Marketplace Members Rate Satisfaction with Providers 

July 8, 2026

Our members in marketplace health plans provide feedback on their experiences with their health plan and contracted providers through the annual Qualified Health Plan Enrollee Experience Survey. 

The survey is a useful tool to assess service gaps and develop specific improvement strategies. With the introduction of our Point of Service health plan, 2025 was the first year our POS members were surveyed. 

Summary of 2025 results: The overall HMO health plan rating improved by two percentage points in 2025 over 2024. The POS health plan rating was statistically higher than the survey vendor’s book of business and the 2024 Centers for Medicare & Medicaid Services National Data average. The HMO response rate decreased from 15% in 2024 to 11% in 2025. The POS response rate was 13%. Key findings on the 2025 surveys were:

Performing well 

  • Rating of health care
  • Rating of specialist
  • Enrollee experience with cost – delayed or did not visit doctor due to cost
  • Getting needed care − getting care, tests or treatment

Measures that showed improvement

  • Advising smokers and tobacco users to quit
  • Discussing cessation medications
  • Discussing cessation strategies

Measures showing opportunity for improvement

  • Getting needed care − getting specialist appointment
  • Rating of personal doctor
  • How well doctors communicate
    • Doctor spent enough time
    • Doctor listened carefully
    • Doctor showed respect
    • Doctor explained things

How you may impact results: A sample of our members are currently completing the 2026 QHP survey. Learn about the survey topics and how you may impact results. Focusing on a positive member experience may have benefits for your practice, including:

  • Member loyalty and growth
  • Adherence to provider recommendations
  • Improving overall member wellness and health outcomes
  • Preventive care addressed more timely
  • Strengthened member-provider relationships and rapport

QHP survey method: The QHP survey asks a random sample of members enrolled in their health plan for at least six months about their experiences. Conducted through mail, phone and online, the survey takes approximately 12 minutes to complete. It emphasizes domains where providers have the most impact, such as access to care and care coordination. Learn more from CMS.