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O que é uma pesquisa CAHPS?

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.

Por fim, o CMS deve desenvolver pesquisas CAHPS e o Consórcio CAHPS deve aprová-las. Estas pesquisas — que seguem princípios específicos de design e desenvolvimento — utilizam perguntas padronizadas e protocolos de coleta de dados para avaliar com precisão grandes amostras de pacientes.

O CMS desenvolve e refina estas pesquisas com ampla participação das partes interessadas e do público, incluindo o recebimento de orientação de um painel de especialistas técnicos e a criação de diversos períodos de comentários públicos através do Escritório do Registro Federal. Ainda mais importante, as pesquisas CAHPS também são ajustadas estatisticamente para realizar correções entre diferentes profissionais e modos de pesquisa.

Quais são os dois tipos de pesquisas CAHPS?

Os dois tipos de pesquisas CAHPS são as pesquisas CAHPS Clinician & Group (CG-CAHPS) e CAHPS Health Plan.

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:

• Estas ajudam o CMS a determinar se e onde hospitais, consultórios particulares ou grupos médicos podem melhorar as experiências de seus pacientes.
• Estas permitem que o CMS meça e monitore o desempenho de clínicas e grupos médicos para garantir que estes forneçam cuidados de alta qualidade de forma consistente a todos os pacientes.
• Estas oferecem aos consumidores a capacidade de encontrar e comparar informações sobre qualidade de atendimento para escolher o médico mais adequado.

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:

• Estas ajudam o CMS a descobrir se e onde os planos e sistemas de saúde podem melhorar as experiências de seus pacientes.
• Estas permitem que o CMS meça e monitore o desempenho dos planos e sistemas de saúde para garantir que estes forneçam cuidados de alta qualidade de forma consistente a todos os seus beneficiários.
• Estas fornecem aos beneficiários a capacidade de encontrar e comparar informações sobre a qualidade do atendimento para ajudá-los a escolher o plano de saúde mais adequado.

Qual é o objetivo das pesquisas CAHPS?

Em resumo, o objetivo de uma pesquisa CAHPS é melhorar o atendimento médico nos Estados Unidos. Medindo efetivamente a experiência do paciente, o CMS pode, idealmente, encontrar maneiras de otimizá-la — tanto clínica quanto administrativamente.

Quantas pesquisas CAHPS existem?

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

As duas pesquisas CAHPS mais conhecidas são as pesquisas Hospital CAHPS (HCAHPS) e Home Health CAHPS (HHCAHPS).

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

• Em uma amostra aleatória de clientes adultos, entre dois e 42 dias após a alta
• De uma de quatro maneiras: via correio, telefone, correio seguido de um acompanhamento por telefone ou resposta de voz interativa
• Em vários idiomas, incluindo Espanhol, Chinês, Russo, Vietnamita, Português e Alemão

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.)

Além destas duas pesquisas CAHPS, confira algumas informações breves sobre outros tipos:

• 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)
• Os beneficiários são entrevistados apenas se estiverem inscritos em um dos planos há pelo menos seis meses.
• Embora todas as três versões da pesquisa sejam comparáveis, cada uma inclui perguntas/categorias adicionais relacionadas ao tipo de plano específico.
• 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)