Domain II: Data Collection

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ACO CAHPS: Assessing Coordinated Care

Accountable

care organizations (ACOs) are revolutionizing healthcare through integrated,

coordinated, high-quality care. Hospitals, clinics, and other care settings are

beginning to work together to reduce readmissions, minimize errors, and lower

costs. ACO CAHPS was developed to help achieve these collaborative goals using

a universal set of patient experience measures.

In September 2013, CMS

released the final rule for ACO CAHPS with the intent of assessing the

experience of Medicare patients when visiting providers within ACOs over a

period of six months.

The questions seek to

measure the patient experience in the following areas of care:

·

Getting Timely Care

·

Provider Communication

·

Rating of Provider

·

Access to Specialists

·

Health Promotion and Education

·

Shared Decision-Making

·

Health Status/Functional Status

·

Courteous/Helpful Office Staff

·

Care Coordination

·

Between Visit Communication

·

Education About Medication Adherence

·

Stewardship of Patient Resources

Pioneer ACOs, the early

adopters of the Medicare Shared Savings Program (MSSP), completed an initial

fielding of ACO CAHPS in early 2014. These ACOs, along with all other MSSP

ACOs, will be required to survey in November 2014.

For ACOs, this

81-question survey must be performed by a CMS-approved vendor via mixed-mode

methodology; mail and phone.

- See more

at: http://www.nationalresearch.com/products-and-solutions/cahps/aco-cahps/#sthash.qCMRrDXd.dpuf

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CGCAHPS: Improve Delivery of Patient-Centered Care

Clinician

and Group Consumer Assessment of Healthcare Providers and Systems (CGCAHPS) is

an endorsed measure of the patient experience in a medical practice setting by

the National Quality Forum (NQF). The survey evaluates ease of access to care,

provider communication with patients, and courtesy and helpfulness of office

staff.

Measuring patient experiences at the

practice and provider levels leads to patient satisfaction transparency and

facilitates breakthroughs in preventive care and disease management.

A Wealth of Knowledge Beyond

Clinical Outcomes

Studies have shown that the interpersonal aspects of healthcare are valued most

by the average patient. In fact, clinical outcomes are not even included in the

top 10 reasons why most patients choose providers. Research demonstrates that

patients prioritize communication and other aspects of the provider-patient

relationship as key elements of quality. If you want your medical practice to

excel, patient experience matters. A CGCAHPS program can benefit your practice by:

·

Providing actionable feedback for improvement

·

Increasing patient compliance

·

Decreasing malpractice risk

·

Improving patient experience, loyalty, and referrals to boost

your market share

Patient-Centered Medical Home

CAHPS®

A supplemental item set available to CGCAHPS clients is Patient-Centered

Medical Home (PCMH). This enables you to ask patients about their experiences

with the domains of primary care that define a medical home.

While the PCMH CAHPS

survey instrument has many similarities to the Clinician and Group CAHPS

survey, it also addresses specific processes of care relevant to

patient-centered medical homes with the goal of measuring and improving care

delivery.

Survey versions for

adults and children address components of care such as access, communication,

self-management support, office staff, information and coordination of care.

The adult survey includes questions regarding behavioral health care. The child

survey also covers development and prevention.

- See more

at: http://www.nationalresearch.com/products-and-solutions/cahps/cgcahps#sthash.nvWDyz65.dpuf

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HCAHPS: The Complete Picture

The

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)

formal public reporting initiative mandated by the Centers for Medicare and

Medicaid Services (CMS) asks your patients to rate their experiences with

respect to various healthcare delivery systems. These ratings are shared with

the public, potentially affect your hospital's reputation and standing in the

community it serves, and will be used in calculating your value-based

purchasing payments going forward.

With the results of patient

experience surveys available for public scrutiny and reimbursement tied to

these scores through value-based purchasing, HCAHPS scores are more important

than ever.

HCAHPS serves the public’s interest in improving the quality of care in

America’s hospitals by providing consumers, healthcare professionals, and

hospitals with standardized and comparable information on how patients view

their quality of care experience. HCAHPS furnishes valid and reliable

information on several critical aspects of the hospital experience on a

continuous basis.

In addition to gaining

valuable information about your own care processes, participating hospitals are

able to compare with other hospitals and the industry as a whole on exactly the

same indicators. This information could be fed directly into the hospitals

assessment and improvement program. The ongoing and standardized nature of the

survey also allows hospitals to track changes in patient perspectives on care

over time.

The instrument is

endorsed by major hospital associations and is strongly supported by leading

healthcare and consumer organizations. The HCAHPS survey is part of the

Hospital Quality Alliance. The public reporting of HCAHPS data was tied to the

Annual Performance Update from CMS. Beginning July 2007, acute care hospitals

that choose not to participate in HCAHPS measurement will see a 2 percent

reduction of their market basket update.

What is

HCAHPS protocol?

The HCAHPS Survey is

designed to be completed by adult patients who had a recent medical, surgical

or obstetrical visit to an acute care hospital. There are certain exclusions

for patients who should not receive the survey. For example, patients with

certain illnesses or diseases are excluded, as well as patients who are not

alive at discharge.

·

All payor types are included in HCAHPS. Even though this is a

CMS initiative, it is not focused on Medicare beneficiaries.

·

Patients under age 18 are not included in HCAHPS.

·

Specialty hospitals are not included in HCAHPS. Only general

acute care hospitals are covered by the protocol.

·

Some patient exclusions are required. These include expired

patients, most psychiatric cases, and patients who are discharged to hospice,

etc. Exclusions are based on DRG and admit or discharge status.

How is

the survey administered?

The HCAHPS protocol

supports several modes of data collection. There are advantages and

disadvantages for each mode. National Research Corporation will help

you determine which mode is right for you.

·

Mail Only: An initial survey mailing to the sample followed by a

second survey to non-respondents about three weeks later.

·

Mixed Mode: Using this approach, an initial survey mailing is

distributed and then a phone call is made to non-respondents of the mail

survey.

·

Phone Only: This protocol uses exclusively telephone to collect

the results. Five survey attempts must be made to each selected patient.

·

IVR: IVR stands for Interactive Voice Response. Using this mode,

patients will be contacted by telephone and then transitioned to an electronic

survey they can completed with their touch-tone telephone.

- See more

at: http://www.nationalresearch.com/products-and-solutions/cahps/hcahps/#sthash.8OJRks8e.dpuf