Update on CAHPS ® Surveys AHRQ ANNUAL MEETING Lunch and Learn Session #46 SEPTEMBER 20, 2011

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

2. 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

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

4. 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.

5. CAHPS Family of Surveys • Integrated system of products and strategies • Ambulatory Care Surveys • Facility Surveys • Supplemental Item Sets • Custom items can be added

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 New New New

10. 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

11. 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

12. 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)

13. 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 email • 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

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

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

16. CG-CAHPS Database Composition(as of December 2010)

17. CG-CAHPS Online Reports(http://www.cahps.ahrq.gov) View Comparative Results Download Reports

18. CAHPS Improvement Guide(updated Spring 2011) New

19. CAHPS User Support Services (FREE!) • Survey Instrumentsand Instructions • https://www.cahps.ahrq.gov • Redesigned CAHPSweb site launched fall 2011 • CAHPS Technical support • E-mail: CAHPS1@ahrq.gov • Phone: 800-492-9261 • CAHPS Database Technical support • E-mail: NCBD1@ahrq.gov • Phone: 888-808-7108 • Sign up for CAHPS listserv for latest updates New

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