1. Overview of CAHPS ® and the National CAHPS ® Database Assessing Patients’ Experiences with Care: Using CAHPS ® as a Standardized Quality Metric Dale Shaller, Shaller Consulting Managing Director, CAHPS Database Yale CAHPS III Team AHRQ Annual Conference September 15, 2009

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

3. 3 Expanding Suite of CAHPS Surveys Hospitals Dialysis Facilities Nursing Homes Health Plans Group Practices and Individual Clinicians Behavioral Health Organizations (ECHO) Rural Tribe Health Services Home Health Facility Care Ambulatory Care

4. 4 Core CAHPS Design Principles consumers are the best or only sourceFocus on topics for which consumers are the best or only source of information patient reports and ratingsInclude patient reports and ratings of experiences – not “satisfaction” –Reports: Never/Sometimes/Usually/Always –Ratings: 0-10 rating scale rigorous scientific development and testingBase question items and survey protocols on rigorous scientific development and testing, as well as extensive stakeholder input public domainAll surveys and services are in the public domain

5. 5 The CAHPS Database National repository of data from the CAHPS family of surveys Two major applications: –Benchmarking –Benchmarking to evaluate health system performance and support quality improvement –Research –Research on consumer assessments of quality Funded by AHRQ and administered by Westat through the CAHPS User Network

6. 6 National Advisory Group AHRQ CAHPS Grantees –RAND –Yale/Harvard CMS Medicare CMS Medicaid Department of Defense Consumer groups Employer groups State Medicaid Health plans Hospital systems Medical boards Statewide information organizations

7. 7 CAHPS Database Components Health Plan SurveyCAHPS Health Plan Survey Database –3.6 million records collected –12 Annual Chartbooks (1998 – present) Hospital SurveyCAHPS Hospital Survey Database –.8 million records collected –3 Annual Chartbooks (2006 – present) Clinician & Group SurveyCAHPS Clinician & Group Survey Database

8. 8 CAHPS Database Products Online Reporting System Annual Chartbooks Customized Sponsor Reports Research Files Support to AHRQ’s National Healthcare Quality and Disparities Reports Special Analyses and Reports

9. 9 Benefits of Participation Free serviceFree service open to all survey users on a voluntary basis Access to comparative results by Online Reporting SystemAccess to comparative results by survey version through Online Reporting System Support to participants provided throughSupport to participants provided through –Data submission specifications –Online data submission system –Custom analysis and reports –User network –Email and phone technical support

10. 10 Online Reporting System all CAHPS surveys maintained by CAHPS DatabaseWill support all CAHPS surveys maintained by CAHPS Database –CAHPS Health Plan Survey –CAHPS Hospital Survey –CAHPS C&G Survey Public portalPublic portal available to everyone –Ability to view summary-level data only Password-protected portalPassword-protected portal will be accessible only to participants who contribute data –Ability to view your own results compared to selected benchmarks

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16. 16 Strategic Priorities Clinician & Group Survey –Strong demand for benchmarks –No other national suppliers –Opportunity for leadership Health Plan Survey –Partnership with NCQA and CMS –Continued leadership in Medicaid sector Hospital Survey –Collaboration with CMS

17. 17 CAHPS C&G Database Currently developingCurrently developing in response to user demand Working with key organizationsWorking with key organizations to provide guidance on implementation –Survey vendors –Health plans and medical groups –Aligning Forces for Quality and CVE markets –National medical boards Aim is to support all C&G versions and usersAim is to support all C&G versions and users through standardized data submission specifications

18. 18 Clinician & Group Survey Core Measures Access: Getting Appointments and Health Care When Needed Getting appointments for urgent care Getting appointments for routine care or check-ups Getting an answer to a medical question during regular office hours Getting an answer to a medical question after regular office hours Wait time for appointment to start How People Rated Doctor 0-10 rating of doctor How Well Doctors Communicate Doctor explanations easy to understand Doctor listens carefully Doctor gives easy to understand instructions Doctor knows important information about medical history Doctor shows respect for what you have to say Doctor spends enough time with you Courteous and Helpful Office Staff Clerks and receptionists were helpful Clerks and receptionists treat you with courtesy and respect

19. 19 Several C&G Survey Versions to Meet User Needs Last 12 months –Adult primary care –Child primary care –Adult specialty care Visit-based –Adult primary care

20. 20 Customizing Clinician & Group Survey with Supplemental Items Adult Primary Care –17 topics covered by supplemental items –Includes health promotion and education, shared decision making, communication items for QI, most recent visit. Child Primary Care –7 topics covered by supplemental items –Includes doctor communication with child, health improvement, shared decision making. Adult Specialty Care –6 topics covered by supplemental items –Includes coordination of care, shared decision making, surgery or procedures performed by this doctor.

21. 21 Clinician & Group Survey: Under Construction Current surveys focus on primary and specialty care physicians CAHPS Consortium is developing a version to measure experience with a broader range of primary care providers (physicians, nurse practitioners, physician assistants) –Potential for a “provider neutral” survey tool to assess any type of primary care provider Available as a beta survey instrument by the end of 2009

22. 22 Further Information To contribute data and obtain access to new online system, contact us: –E-mail: ncbd1@ahrq.govncbd1@ahrq.gov –Toll-free number: 888-808-7108 For more information: https://www.cahps.ahrq.gov/default.asp https://www.cahps.ahrq.gov/default.asp