Update on CAHPS ® Surveys AHRQ ANNUAL MEETING Lunch and Learn Session #46 SEPTEMBER 20, 2011 Judith Sangl, ScD AHRQ CAHPS Project Officer

CAHPS ® Program CAHPS = Consumer Assessment of Healthcare Providers and Systems Most widely used survey tools for assessing the patient’s experience with care Initiated and funded by AHRQ since 1995 Endorsed by National Quality Forum (NQF) Consortium members include: AHRQ, CMS, RAND, Yale/Harvard, and Westat 2

3 CAHPS Obtain assessments from consumers of the quality of care that they receive in different settings which –Inform selection decisions –Identify areas where providers and organizations can improve their services –Provide quality information to care providers and other audiences

CAHPS Design Principles  Emphasis on patients –What patients value with respect to the setting of care –Aspects of care for which patients are the best or only source of information –Extensive testing with patients and families  Reports and ratings about experiences  Standardization –Questionnaires, data collection protocols, analysis, reporting  Multiple versions for diverse populations –Adult; Child; English & Spanish versions  All CAHPS surveys and products are in the public domain. 4

CAHPS Family of Surveys Integrated system of products and strategies –Ambulatory Care Surveys –Facility Surveys –Supplemental Item Sets –Custom items can be added 5 CAHPS Core Questionnaire Items Supplemental Items CAHPS Survey

6 CAHPS Ambulatory Care Surveys Health Plan Surveys –Adult and child –Medicare, Medicaid & commercial –Managed care, FFS, PPO –NCQA version –Disenrollee Clinician & Group Surveys –Adult and child –Visit-based and past 12 months versions –Survey updates (version 2.0) released soon New

7 CAHPS Ambulatory Surveys, cont’d Clinician & Group Surveys (cont.) American Indian Survey Surgical Care Survey Other Ambulatory Surveys Home Health Care Survey ECHO Survey (Behavioral Health Care) Dental Plan Survey

8 CAHPS Facility Surveys Hospital Survey In-Center Hemodialysis Survey Nursing Home Surveys (endorsed by NQF in March 2011) –In-person interview for long-term residents –Recently discharged short-stay residents Time limited endorsement – being finalized –Residents’ family members New

9 CAHPS Supplemental Item Sets Clinician & Group Survey Item Sets Patient-Centered Medical Home Health Literacy Cultural Competence Health Information Technology Health Plan Item Sets Children with Chronic Conditions People with Mobility Impairments Additional supplemental items available for: Health Plan Survey Clinician & Group Survey New

Patient-Centered Medical Home (PCMH) Set Designed as a supplemental item set for the CAHPS Clinician and Group Survey PCMH-specific topic areas covered: -Coordination of Care -Comprehensiveness -Shared decision-making -Whole person orientation -Self-management support 10

Health Literacy Set Designed as a supplemental set of 29 items for the CAHPS Clinician & Group Survey Six main topic areas covered: –Communication with doctors and nurses –Communication about health problems/concerns –Communication about medicines –Communication about tests –Communication about forms –Disease self-management 11

Cultural Competence Domains Designed as a supplemental item set for the CAHPS Clinician & Group Survey 3 reporting composites –Doctors are polite and considerate –Doctors give advice on staying healthy –Doctors are caring and inspire trust Examples of other topics include –Equitable treatment –Language access –Overall ratings (trust, interpreter services) 12

Health Information Technology Set Designed as a supplemental item set for the CAHPS Clinician & Group Survey 3 reporting composites –Getting timely answers to medical questions by –Helpfulness of provider’s use of computers during a visit –Helpfulness of provider’s web site in giving you information about your care and tests 13

The CAHPS Database National repository of data for selected CAHPS surveys Two major applications : o Benchmarking o Benchmarking to evaluate health system performance and support quality improvement o Research o Research on consumer assessments of quality Funded by AHRQ and administered by Westat through the CAHPS User Network 14

CAHPS Database Components 15 Health Plan Survey CAHPS Health Plan Survey Database –4.3 million records collected –12 Annual Chartbooks (1998 – present) Clinician & Group Survey CAHPS Clinician & Group Survey Database –Just launched in May 2011 Hospital Survey CAHPS Hospital Survey Database –.8 million records collected –3 Annual Chartbooks (2006 – 2008) New

CG-CAHPS Database Composition (as of December 2010) 16 CG-CAHPS VersionN of Practice SitesN of Respondents Adult 12-month 4-pt23541,834 Adult 12-month 6-pt339180,588 Child 12-month 6-pt524,883 Adult Visit469103,442 TOTALS1,095330,747

CG-CAHPS Online Reports ( 17 View Comparative Results Download Reports

CAHPS Improvement Guide (updated Spring 2011) 18 New

CAHPS User Support Services (FREE!) Survey Instruments and Instructions – – Redesigned CAHPS web site launched fall 2011 CAHPS Technical support – –Phone: CAHPS Database Technical support – –Phone: Sign up for CAHPS listserv for latest updates 19 New

Additional QI Resources CAHPS Improving Quality site: –Case studies of QI initiatives –Supplemental survey questions –Archived Webcasts and presentations –Links to related resources –- podcast series on quality improvement – released soon 20 New