1. CAHPS®: Information from the Consumer Perspective Liz Goldstein, Ph.D. Centers for Medicare & Medicaid Services

2. Melding Measurement and Improvement CMS’s Quality Strategy: –Define quality through standardized performance measures –Plans and providers measure care –Create data standards and infrastructure for measurement, quality improvement, and public reporting

3. Patient-centered Measures Priority for CMS is to give consumers information to make choices From our previous experiences we have found consumers value information from the perspective of other consumers CMS is working with AHRQ to develop a survey tools to capture patient experiences across provider types

4. CMS CAHPS Efforts Health Plan CAHPS® –Medicare Advantage plans (enrollees and disenrollees) –Fee-for-service beneficiaries –Preferred Provider Organization (PPO) survey being developed Hospital CAHPS® -- developmental Nursing Home CAHPS® -- developmental –Resident survey –Family survey ESRD CAHPS -- developmental Prescription Drug Plan CAHPS® -- to be developed

5. Goals of CAHPS® Surveys Create a public domain tool for public reporting and quality improvement so comparable information will be available across provider types.

6. CAHPS® Development CMS partners with the Agency for Healthcare Research and Quality (AHRQ) –Current CAHPS® surveys are being developed through CAHPS® II

7. Key Features of CAHPS® Approach Collaborative approach –Within CAHPS team –With other organizations Emphasis on testing and evaluation Reliance on user input Free and open access to standardized instruments CAHPS® owned by AHRQ Technical assistance to users

8. CAHPS® ll Consortium Three grantee teams (PIs): –AIR: Steve Garfinkel, Jim Lubalin –Harvard: Paul Cleary, Susan Edgman- Levitan –RAND: Ron Hays, Donna Farley Survey Users Network (SUN) National CAHPS Benchmarking Database

9. New Focuses for CAHPS® ll More emphasis on reporting Use of CAHPS® for Quality Improvement Continued movement beyond health plan CAHPS®

10. CAHPS® Surveys Collect information that consumers want to know Collect information for which consumers are the best source Draw on existing research and surveys Conduct thorough cognitive and field tests Coordinate with reports development

11. Standard CAHPS® Development Process Rigorous process of scientific research that includes: –a call for measures –review of existing literature –cognitive interviews –testing of the draft instrument –psychometric analysis –consumer focus groups –public input in response to Federal Register notices –stakeholder input