- Hospital leaders are suggesting the CMS patient experience survey should be overhauled to shorten and reframe the questionnaire while adding a digital mode of delivery.
- Although health system employees that focus on patient experience think the Hospital Consumer Assessment of Healthcare Providers and Systems survey does a reasonable job of accurately capturing patients' experience, the majority feel it's important to change the survey, according to a new report from the American Hospital Association, Federation of American Hospitals and other industry groups.
- Hospital leaders say HCAHPS response rates are falling, and national data show 26% of patients who were asked to complete the survey did so in 2017, down from 33% in 2008. That lower response rate could "erode the validity of the survey," according to the report.
There's good reason for patient experience to be top of mind for hospital executives as they face increasing competition from telehealth providers and retail and urgent care clinics. Consumers seek user-friendliness in addition to quality care and they can be quick to post negative reviews online if they don't find it.
U.S. News & World Report has recognized this as an issue in updates to its methodology for ranking the country's best hospitals. The publication is adding HCAHPS responses to its calculations, replacing PSIs (patient safety indicators). Ben Harder, chief of health analysis for U.S. News, told Healthcare Dive recently hospitals didn't offer much pushback to the change.
FAH President Chip Kahn said on a conference call Thursday that "HCAHPS has a great track record, but it has not been closely looked at in more than a decade." Since then, care at hospitals has changed drastically, he added.
For their research, AHA and FAH joined America's Essential Hospitals, the Association of American Medical Colleges and the Catholic Health Association of the United States in interviewing "patient experience leaders" at hospitals across the country.
These employees came from 27 hospitals and health systems — 70% nonprofit and 30% investor-owned. Respondents were split fairly equally among teaching and non-teaching hospitals.
Most of those asked (61%) gave the HCAHPs survey a ranking of five or six (out of 10) on providing patients with useful information, and just over half gave a ranking of seven or higher on giving hospitals incentives to improve quality of care.
AHA Chief Nursing Officer Robin Begley said on the conference call HCAHPS is a crucial survey for hospitals to understand quality measures, but is due for an update.
"It's time to rethink HCAHPS to ensure it is capturing information on critical aspects of care as it's delivered today and that patients can choose to deliver their responses in ways that are most convenient to them," she said.
Currently, the 32-question survey is given to random sample of patients after they are discharged from a hospital. It is taken by mail or over the phone. The hospital groups said, in addition to streamlining the questions and offering an electronic format, the questions should focus more on aspects critical in the shift to value-based care, such as care coordination and post-discharge experience.
Information from the HCAHPS surveys is also used to compile CMS' beleaguered star ratings program, which AHA and others have frequently criticized. Earlier this month, the department said it would hold off on further updates to the ratings pending review from an expert panel.
CMS updated the star ratings methodology in February, but AHA said then the changes did not address its major concerns.