CAHPS® Health Plan Survey Version Child Medicaid Survey 5.0

What is a CAHPS survey?

A Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey requests feedback from a patient regarding their experiences with their healthcare providers and plans, including hospitals, home healthcare agencies, and specific doctors. CAHPS surveys are conducted in the United States.

These patient experience surveys — which the Centers for Medicare and Medicaid Services (CMS) publicly report — can impact payments to CMS providers. (In addition to paying for the number of services provided, CMS also offers value-based programs, rewarding healthcare providers for providing high-quality care. Therefore, if a CAHPS survey reveals a poor patient experience, the healthcare provider may receive a smaller payout.)

To be clear, CAHPS surveys are about patient experience, not patient satisfaction or amenities. They’re a means of understanding how patients (and sometimes their families) experienced or perceived their care, specifically homing in on doctor communication — whether or not the patients understood their medication or aftercare instructions — and how the healthcare providers met their overall needs.

Lastly, CMS must develop CAHPS surveys, and the CAHPS Consortium must approve them. These surveys — which follow specific principles in survey design and development — use standardized questions and data-collection protocols to accurately assess large samples of patients.

CMS develops and refines these surveys with extensive stakeholder and public input, including receiving guidance from a technical expert panel and setting up multiple public comment periods through the Office of the Federal Register. Most importantly, CAHPS surveys are also statistically adjusted to correct for different patient providers and survey modes.

What are the two types of CAHPS surveys?

The two types of CAHPS surveys are the CAHPS Clinician & Group (CG-CAHPS) Survey and the CAHPS Health Plan Survey.

CG-CAHPS Survey

The CG-CAHPS Survey asks patients about their most recent experience with healthcare providers and staff in primary or specialty care settings. These surveys cover a wide range of patient experience topics, including accessibility of care and communication as well as interaction with providers and staff, and they deliver these benefits:

• They help CMS determine if and where hospitals, private practices, or medical groups can improve patient experiences.
• They allow CMS to measure and monitor the performance of healthcare practices and groups to ensure they’re consistently providing high-quality care to all patients.
• They give consumers the ability to find and compare quality-of-care information to choose their best-fit physician.

CAHPS Health Plan Survey

The CAHPS Health Plan Survey asks health plan enrollees about their experience with their specific healthcare plans, both public and private. Similar to CG-CAHPS surveys, these surveys are useful in a number of ways:

• They help CMS discover if and where health plans and systems can improve patient experiences.
• They allow CMS to measure and monitor the performance of healthcare plans and systems to ensure they’re consistently providing high-quality care to all beneficiaries.
• They give beneficiaries the ability to find and compare quality-of-care information to choose their best-fit healthcare plan.

What is the purpose of CAHPS?

Put simply, the purpose of a CAHPS survey is to improve healthcare in the United States. By effectively measuring the patient experience, CMS can, ideally, find ways to optimize it — both clinically and administratively.

How many CAHPS surveys are there?

According to the CMS website, there are 11 types of CAHPS surveys.

The two most well-known CAHPS surveys are the Hospital CAHPS (HCAHPS) and Home Health CAHPS (HHCAHPS) surveys.

HCAHPS Survey

The HCAHPS Survey assesses the patient experience in hospitals — including how doctors, nurses, and general hospital staff treated them; how clean the hospital was; what type of information they received about medication; and what kind of attention they received upon discharge. This survey, which 3 million patients in more than 4,000 hospitals complete annually, is administered

• To a random sample of adult clients, between two and 42 days after discharge
• In one of four ways: via mail, phone, mail first followed by a phone follow-up, or interactive voice response
• In a variety of languages, including Spanish, Chinese, Russian, Vietnamese, Portuguese, and German

Best of all, HCAHPS survey results are updated quarterly on Medicare’s website. (Click Hospitals on the website to find and compare quality-of-care information of 4,000-plus Medicare-certified hospitals across the country.)

Home Health CAHPS Survey

The Home Health CAHPS Survey assesses the experience of home healthcare patients. Either the patient or the patient’s proxy can fill out this 34-item survey. If the proxy answers the survey, they must do so by mail, telephone, or a mix of both: first mail and then a phone follow-up.

Like HCAHPS surveys, Medicare’s website has publicly reported Home Health CAHPS survey results since 2012. They’re grouped into three informative categories: Care of Patients, Communications Between Providers and Patients, and Specific Care Issues. (Once you’re on the website, click Home health services to find and compare Medicare-certified home health agencies in your geographic location.)

In addition to these two CAHPS surveys, here’s some brief information about a few more:

• Consumer Assessment of Healthcare Providers and Systems Home and Community-Based (HCBS CAHPS) Survey: surveys different cross-disability adults (i.e., having multiple qualifying physical, developmental, and/or mental disabilities) receiving support from various state Medicaid HCBS programs across the country
• Fee-for-Service CAHPS: surveys approximately 275,000 Medicare beneficiaries enrolled in the Fee-for-Service (FFS) program
• Medicare Advantage and Prescription Drug Plan CAHPS: assesses beneficiaries enrolled in Medicare Advantage (MA-only) plans, Medicare Advantage Prescription Drug (MA-PD) plans, and Medicare Prescription Drug Plans (PDP)
• Beneficiaries are surveyed only if they’ve been enrolled in one of the plans for at least six months.
• While all three survey versions are comparable, each includes additional questions/categories related to the specific plan type.
• In-Center Hemodialysis CAHPS: assesses the patient experience of those receiving dialysis
• CAHPS Hospice: surveys the patient experience in hospice (over 1 million Americans receive hospice care annually)
• Outpatient and Ambulatory Surgery CAHPS: collects information about the patient experience in both ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs)