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| HCAHPS and IPPS Payment Provisions
| Background
| Participation
| About the Survey | Data Collection and
Public Reporting
| For More Information | To Provide Comments
or Questions| Internet Citation
Current News
HCAHPS and IPPS Payment Provisions (revised 08/20/2007)
On August 1, 2007, the Centers for Medicare and Medicare Services (CMS) issued a
final rule to update the hospital inpatient prospective payment system (IPPS) for
fiscal year (FY) 2008. The final rule takes significant steps to improve the accuracy
of Medicare's payment under the acute care hospital inpatient prospective payment
system, while providing additional incentives for hospitals to engage in quality
improvement efforts. In particular, this rule affects the submission of hospital
quality data.
IPPS hospitals participating in the Reporting Hospital Quality Data Annual Payment
Update program (RHQDAPU-eligible "subsection (d) hospitals") that fail to report
the required quality measures (which include the HCAHPS patient perspective survey)
in a form and manner, and at a time, specified by the Secretary could, for FY 2008,
receive an APU that is reduced by 2.0 percentage points. Non-IPPS hospitals can
voluntarily participate in HCAHPS, though doing so will not affect their Medicare
payment. To view the display copy of the Acute Inpatient PPS final rule (CMS-1533-FC)
for FY 2008, go to:
http://www.cms.hhs.gov/AcuteInpatientPPS/IPPS/ on the CMS website.
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Background
The intent of the HCAHPS initiative is to provide a standardized survey instrument
and data collection methodology for measuring patients' perspectives on hospital
care. While many hospitals currently collect information on patients' satisfaction
with care, there is no national standard for collecting or publicly reporting this
information that would enable valid comparisons to be made across all hospitals.
In order to make "apples to apples" comparisons to support consumer choice, it is
necessary to introduce a standard measurement approach. HCAHPS can be viewed as
a core set of questions that can be combined with a broader, customized set of hospital-specific
items. HCAHPS is meant to complement the data hospitals currently collect to support
improvements in internal customer services and quality related activities.
Three broad goals have shaped the HCAHPS survey. First, the survey is designed to
produce comparable data on the patient's perspective on care that allows objective
and meaningful comparisons between hospitals on domains that are important to consumers.
Second, public reporting of the survey results is designed to create incentives
for hospitals to improve their quality of care. Third, public reporting will serve
to enhance public accountability in health care by increasing the transparency of
the quality of hospital care provided in return for the public investment. With
these goals in mind, the HCAHPS project has taken substantial steps to assure that
the survey will be credible, useful, and practical. This methodology and the information
it generates will be made available to the public.
In May 2005, the National Quality Forum (NQF), an organization established to standardize
health care quality measurement and reporting, formally endorsed the CAHPS Hospital
Survey. The NQF endorsement represents the consensus of many health care providers,
consumer groups, professional associations, purchasers, federal agencies, and research
and quality organizations.
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Participation (revised 08/20/2007)
To participate in HCAHPS Data Collection and Public Reporting, all hospitals self-administering
the survey, hospitals administering the survey for multiple sites, and survey vendors
must meet certain Program Requirements and must be in accordance with the requirements
in the HCAHPS Quality Assurance Guidelines, V. 2.0. In addition, hospitals/survey
vendors must submit a Participation Form to the HCAHPS Project Team for approval
prior to the administration of the HCAHPS survey.
Please note: At a minimum, the hospital's/survey vendor's Project Manager is required
to participate in the HCAHPS Training. Hospitals that have contracted with a survey
vendor to collect HCAHPS survey data are not required to attend training. CMS strongly
recommends that hospitals newly joining HCAHPS participate in a dry run, if feasible,
prior to beginning to collect HCAHPS data on an ongoing basis to meet the Reporting
Hospital Quality Data Annual Payment Update program (RHQDAPU) requirements. Please
see the www.hcahpsonline.org website for
a schedule of upcoming dry runs.
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About the Survey
The CAHPS Hospital Survey can be seen as a core set of questions that may be combined
with a broader, customized set of hospital-specific items. The survey is meant to
complement to the extent possible, not replace, the data hospitals currently collect
to support improvements in internal customer services and quality related activities.
The CAHPS Hospital Survey is composed of 18 patient rating and patient perspectives
on care items that encompass seven key topics: communication with doctors, communication
with nurses, responsiveness of hospital staff, cleanliness and quietness of hospital
environment, pain management, communication about medicines, and discharge information.
It also includes four screener questions and five demographic items, some of which
may be used for adjusting the mix of patients across hospitals and for analytical
purposes. The survey is 27 questions in length.
There are four approved modes of administration for the CAHPS Hospital Survey: 1)
Mail Only; 2) Telephone Only; 3) Mixed (mail followed by telephone); and 4) Active
Interactive Voice Response (IVR).
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CAHPS Hospital Survey Data Collection and Public Reporting (revised 1/11/2008)
CAHPS Hospital Survey Data Collection and Public Reporting of the survey results
will quickly follow the Dry Run. Once the CAHPS Hospital Survey is fully implemented,
the results will be publicly reported on the Hospital Compare website, which can
be found at
http://www.hospitalcompare.hhs.gov,
or through a link on
http://www.medicare.gov.
The first public reporting of HCAHPS results will occur in March 2008. Hospital
results for patients discharged between October 2006 and June 2007 will be displayed
on the
Hospital Compare website. Participating hospitals will receive a
"preview report" of their results and will have the option, on this occasion, to
suppress their results. CMS anticipates that hospital results will be presented
in a fashion similar to that currently used for the clinical quality measures.
Extensive consumer testing of HCAHPS reporting formats has been conducted by CMS
in preparation for the initial public reporting of HCAHPS results on the
Hospital
Compare website in March 2008.
As a result of this testing, CMS has decided to report the former 'cleanliness and
quietness' composite as two separate items: "Cleanliness of the Hospital Environment,"
and "Quietness of the Hospital Environment."
Public reporting of participating hospitals' HCAHPS results will therefore consist
of the following ten items:
- Six composite topics
- Two individual topics ('cleanliness' and 'quietness')
- Two overall ratings
In addition, CMS will report the 'number of completed surveys' and the 'survey response
rate' for each participating hospital.
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For More Information
To learn more about the HCAHPS survey, please visit the following websites:
For general information:
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To Provide Comments or Ask Questions
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Internet Citation
Please use the following citation when referencing material on this website.
hcahpsonline.org. Centers for Medicare & Medicaid Services, Baltimore, MD.
Month,
Date, Year the page was accessed.
http://www.hcahpsonline.org
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