CAHPS- Patient Experience | June 2022 | Clinical Corner

June 1, 2022


CAHPS - Patient Experience

The Centers for Medicare & Medicaid Services (CMS) develop, implement, and administer several different patient experience surveys. One of them is the Consumer Assessment of Healthcare Providers & Systems (CAHPS). These surveys ask patients and care givers about their experiences and opinions of their health care providers, their health plan, hospitals, home health care agency, and drug plan. There are number of surveys that may pertain to your practice and patients – the Fee-for-Service CAHPS, the Medicare Advantage and Prescription Drug Plan, the CAHPS Hospice Survey, the CAHPS Survey for Accountable Care Organizations Participating in Medicare Initiatives, Outpatient and Ambulatory Surgery CAHPS, CAHPS for MIPS and Emergency Department CAHPS. These surveys are not patient satisfaction surveys, but rather the questions focus on the patient experience of care.

Twenty-five years ago, the Agency for Healthcare Research and Quality (AHRQ) launched CAHPS surveys which established a standardized approach for measuring patient experience of care. Since then, CAHPS surveys are used by CMS, state, and private organizations to improve healthcare in the U.S. and in Value-Based Purchasing initiatives. The quality of services is measured clinically and using patient experience surveys. The surveys are administered between March and June using a mixed mode collection protocol (mail and phone).

Sample questions from various CAHPS surveys are as follows:

  • From the CAHPS Clinician & Group Survey, under Provider Communication, the question “In the last six months, how often did this provider listen carefully to you?”
  • From the CAHPS Home Health Care Survey, the question “Would you recommend that agency to someone else?”
  • From the CAHPS Emergency Room Survey, the question “During this emergency room visit, did the doctors and nurses ask about all of the medicines you were taking?”
  • From the CAHPS Hospice Survey, the question “While your family member was in hospice care, when you or your family member asked for help from the hospice team, how often did you get help as soon as you needed it?”

    Why is CAHPS survey results important to you?

  • CAHPS surveys are used in Value-Based Purchasing (Pay for Performance) initiatives. This is one of our ACO thirteen quality metrics as well as a contracted health plan metric. NCQA uses the CAHPS Health Plan Survey as part of the Experience of Care domain of HEDIS.
  • Ratings show better patient engagement for those in value-based practices.
  • HCAHPS (CAHPS Hospital Survey) scores provide higher reimbursements for hospitals that have higher scores.
  • CAHPS scores for you and your practice effect your reputation among consumers.
  • CAHPS survey results can be used to create and implement action steps to improve patient experience and quality care.

How your patient’s perceive you as a provider, the care they receive from you and their experience with your practice can all impact your relationship with them and your personal/practice revenue. There are many websites (example: where these ratings are made visible to patients and a lower score may cause patients to think about seeking care elsewhere.