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The CAHPS Hospital Survey, also known as Hospital CAHPS or HCAHPS, is a standardized survey instrument and data collection methodology for measuring patients' perspectives of hospital care. While many hospitals collect information on patient satisfaction, there is no national standard for collecting or publicly reporting this information that would enable valid comparisons to be made across all hospitals. In order to make "apples to apples" comparisons to support consumer choice, it is necessary to introduce a standard measurement approach. HCAHPS is a core set of questions that can be combined with customized, hospital-specific items to produce information that complements the data hospitals currently collect to support internal customer service and quality-related activities. Three broad goals have shaped the HCAHPS survey. First, the survey is designed to produce comparable data on patients' perspectives of care that allows objective and meaningful comparisons among hospitals on topics that are important to consumers. Second, public reporting of the survey results is designed to create incentives for hospitals to improve quality of care. Third, public reporting will serve to enhance public accountability in health care by increasing the transparency of the quality of hospital care provided in return for the public investment. With these goals in mind, the HCAHPS project has taken substantial steps to assure that the survey is credible, useful, and practical. This methodology and the information it generates will be made available to the public. The HCAHPS survey is composed of 27 items: 18 substantive items that encompass critical aspects of the hospital experience (communication with doctors, communication with nurses, responsiveness of hospital staff, cleanliness and quietness of hospital environment, pain management, communication about medicines, discharge information, overall rating of hospital, and recommendation of hospital); four items to skip patients to appropriate questions; three items to adjust for the mix of patients across hospitals; and two items to support congressionally-mandated reports. Hospitals implement HCAHPS under the auspices of the Hospital Quality Alliance (HQA), a private/public partnership that includes major hospital associations, government agencies, consumer groups, measurement and accrediting bodies, and other stakeholders that share a common interest in improving hospital quality. HCAHPS Development The Centers for Medicare & Medicaid Services (CMS) partnered with the Agency for Healthcare Research and Quality (AHRQ), another agency in the Department of Health and Human Services, to develop HCAHPS. AHRQ carried out a rigorous, scientific process to develop and test the HCAHPS instrument. This process entailed multiple steps, including a public call for measures; literature review; cognitive interviews; consumer focus groups; stakeholder input; a three-state pilot test; consumer testing; small-scale field tests; and responding to public comments generated by several Federal Register notices. In May 2005, the HCAHPS survey was endorsed by the National Quality Forum (NQF), which represents the consensus of many healthcare providers, consumer groups, professional associations, purchasers, federal agencies, and research and quality organizations. In December 2005, the federal Office of Management and Budget gave its final approval for the national implementation of HCAHPS for public reporting purposes. HCAHPS has also been endorsed by the HQA. Acting upon a NQF recommendation, CMS commissioned an independent research firm, Abt Associates Inc., to conduct an analysis of the benefits and costs of HCAHPS. The Abt report, which includes detailed cost estimates for hospitals, can be found at the link below. HCAHPS National Implementation Voluntary collection of HCAHPS data for public reporting began in October 2006. The first public reporting of HCAHPS results, which encompassed eligible discharges from October 2006 through June 2007, occurred in March 2008. HCAHPS results were posted on the Hospital Compare website, found at www.hospitalcompare.hhs.gov, or through a link on www.medicare.gov. A downloadable version of HCAHPS results is available. Prior to public reporting, data were adjusted to account for the effects of mode of survey administration and patient mix characteristics on HCAHPS results. To assure that HCAHPS data are collected correctly, CMS has initiated a series of quality oversight activities, which include inspection and approval of survey administration procedures, analysis of submitted data, and detailed on-site reviews of approved HCAHPS survey vendors and self-administering hospitals. Beginning in July 2007, hospitals subject to IPPS payment provisions ("subsection (d) hospitals") must collect and submit HCAHPS data in order to receive their full IPPS annual payment update (APU) for fiscal year 2008. IPPS hospitals that fail to report the required quality measures, which include the HCAHPS survey, may receive an APU that is reduced by 2.0 percentage points. Non-IPPS hospitals, such as Critical Access Hospitals, can voluntarily participate in HCAHPS. For more information about HCAHPS For more details and information about HCAHPS, check the hcahpsonline website (http://www.hcahpsonline.org), or access the Downloads and links below. Note: CAHPS (Consumer Assessment of Healthcare Providers and Systems) is a registered trademark of the Agency for Healthcare Research and Quality, a U.S. Government agency.
Page Last Modified: 08/28/2008 10:30:49 AM
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