overview of cahps ® and the national cahps ® database assessing patients’ experiences with care:...
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Overview of CAHPS® and the National CAHPS® Database
Assessing Patients’ Experiences with Care:Using CAHPS® as a Standardized Quality Metric
Dale Shaller, Shaller ConsultingManaging Director, CAHPS Database
Yale CAHPS III Team
AHRQ Annual ConferenceSeptember 15, 2009
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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
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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 CareFacility Care Ambulatory Ambulatory CareCare
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Core CAHPS Design Principles
• Focus on topics for which consumers are the consumers are the best or only sourcebest or only source of information
• Include patient reports and ratingspatient reports and ratings of experiences – not “satisfaction”– Reports: Never/Sometimes/Usually/Always– Ratings: 0-10 rating scale
• Base question items and survey protocols on rigorous scientific development and rigorous scientific development and testingtesting, as well as extensive stakeholder input
• All surveys and services are in the public public domaindomain
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The CAHPS Database
• National repository of data from the CAHPS family of surveys
• Two major applications:– BenchmarkingBenchmarking to evaluate health system
performance and support quality improvement– ResearchResearch on consumer assessments of quality
• Funded by AHRQ and administered by Westat through the CAHPS User Network
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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
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CAHPS Database Components
• CAHPS Health Plan SurveyHealth Plan Survey Database– 3.6 million records collected– 12 Annual Chartbooks (1998 – present)
• CAHPS Hospital SurveyHospital Survey Database– .8 million records collected– 3 Annual Chartbooks (2006 – present)
• CAHPS Clinician & Group SurveyClinician & Group Survey Database
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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
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Benefits of ParticipationBenefits of Participation
• Free serviceFree service open to all survey users on a voluntary basis
• Access to comparative resultsAccess to comparative results by by survey version through Online Reporting SystemOnline Reporting System
• Support to participantsSupport to participants provided through provided through– Data submission specifications– Online data submission system– Custom analysis and reports– User network– Email and phone technical support
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Online Reporting SystemOnline Reporting System
• Will support all CAHPS surveys maintained all CAHPS surveys maintained by CAHPS Databaseby 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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Strategic PrioritiesStrategic 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
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CAHPS C&G DatabaseCAHPS 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
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Clinician & Group Survey Clinician & Group Survey Core Measures Core Measures
Access: Getting Appointments Access: Getting Appointments and Health Care When Neededand 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 DoctorHow People Rated Doctor• 0-10 rating of doctor
How Well Doctors CommunicateHow 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 StaffCourteous and Helpful Office Staff• Clerks and receptionists were
helpful• Clerks and receptionists treat you
with courtesy and respect
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Several C&G Survey Versions to Several C&G Survey Versions to Meet User NeedsMeet User Needs
• Last 12 months– Adult primary care– Child primary care– Adult specialty care
• Visit-based– Adult primary care
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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.
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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
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Further InformationFurther Information
• To contribute data and obtain access to new online system, contact us:
– E-mail: [email protected]
– Toll-free number: 888-808-7108
• For more information: https://www.cahps.ahrq.gov/default.asp