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Using a structured consensus process, RAND worked with health plans to identify the specific issues of concern to them regarding the usability of CAHPS results for quality-improvement actions. Results of interviews with health plans confirmed their desire to have supplemental items available that they could use to collect more action-oriented data for quality improvement. In response to this issue, priority domains-coordination of care, access to care, information and materials, and customer service-and topic areas for item development were identified, and items for those areas were developed and field-tested.