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member satisfaction

mbr_sat_scr
quality·Updated Jun 23, 2026

Definition

ISO-11179 Definition

A quantitative measure of health plan member overall contentment with their insurance coverage, care access, provider network, and customer service interactions, collected through structured surveys and used in quality performance reporting and value based payment programs. Member satisfaction encompasses multiple dimensions including satisfaction with the choice of providers in the network, ease of getting referrals and authorizations, quality of customer service from the health plan, clarity of benefit explanations and bills, and overall value received from the coverage. CMS CAHPS member satisfaction data feeds directly into Medicare Advantage Star Ratings, where plan ratings of member experience can determine whether a plan achieves quality bonus payment status.

Healthcare data teams track mbr_sat_scr trends over time, segment satisfaction data by member demographics to identify populations with systematically lower satisfaction, correlate satisfaction drivers with operational metrics, and measure the impact of member experience initiatives on satisfaction scores across subsequent survey administrations.

Standard Abbreviation

mbr_sat_scr

Category

quality

Production DDL — FACT_QUALITY_MEASURE

FACT_QUALITY_MEASURE.sql
CREATE OR REPLACE TABLE FACT_QUALITY_MEASURE (
    qlty_key        INTEGER        NOT NULL  -- surrogate key,
    mbr_key         INTEGER        NOT NULL  -- FK to DIM_MEMBER,
    plan_key        INTEGER        NOT NULL  -- FK to DIM_PLAN,
    meas_yr         SMALLINT                 -- measurement year,
    hedis_meas_cd   VARCHAR(20)              -- HEDIS measure code,
    denom_ind       CHAR(1)                  -- denominator eligible,
    numer_ind       CHAR(1)                  -- numerator met,
    excl_ind        CHAR(1)                  -- exclusion indicator,
    gap_open_ind    CHAR(1)                  -- care gap open,
    star_rtg_nbr    DECIMAL(3,1)             -- star rating,
    qlty_scr        DECIMAL(5,2)             -- quality score,
    perf_thrsh_pct  DECIMAL(5,2)             -- performance threshold,
    raf_scr         DECIMAL(10,3)            -- risk adjustment factor,
    outreach_cnt    SMALLINT                 -- outreach attempts,
    load_dt         TIMESTAMP_NTZ  NOT NULL  -- load timestamp
);

Standard Snowflake DDL for the canonical quality table. Convert to BigQuery or Databricks →

Why This Term Matters

Quality measure data determines how payers and providers are rated and reimbursed under CMS Stars, HEDIS, and value-based care contracts. Data engineers who understand quality terminology build measure calculation pipelines that correctly attribute patients, apply denominator exclusions, and flag documentation gaps before submission deadlines. Incorrect quality data directly affects star ratings, pay-for-performance bonuses, and Medicare Advantage plan bids.

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