CMS CAHPS Surveys: Public Reporting

1. Liz Goldstein, Ph.D. Division of Consumer Assessment and Plan Performance CMS CAHPS Surveys: Public Reporting

2. Overview CMS Initiatives to Publicly Report CAHPS Data Consumer Testing of Displays HCAHPS Displays Health and Prescription Drug Plan CAHPS Displays 2

3. CMS Initiatives to Publicly Report CAHPS Data Hospital CAHPS Medicare Advantage (MA) and Prescription Drug Plan CAHPS Data Home Health Care CAHPS � coming soon! 3

4. Consumer Testing Conduct multiple rounds of cognitive and usability testing with consumers (including caregivers) and health care professionals Test Mock websites Print materials that include the narrative content (including measures and footnotes) and alternate display options 4

5. Formats for Public Reporting Graphs Tables Star Ratings 5

6. Public Reporting of HCAHPS Hospital results displayed on http://www.hospitalcompare.hhs.gov Roll-up of four most-recent quarters Results adjusted for patient mix and mode of survey administration See http://www.hcahpsonline.org for details �The Effects of Survey Mode, Patient Mix, and Nonresponse on CAHPS Hospital Survey (HCAHPS) Scores.� M.N. Elliott, A.M. Zaslavsky, E. Goldstein, W. Lehrman, K. Hambarsoomian, M.K. Beckett and L. Giordano. Health Services Research 44: 501-518. 2009. 6

7. HCAHPS Results on Hospital Compare: Summer 2009 Public Reporting Discharges: Oct. 2007 - Sept. 2008 3,746 hospitals National Response Rate: 34% ~2.5 million completed surveys Ten HCAHPS measures reported 7

8. HCAHPS Measures Composite Measures Communication with Nurses Communication with Doctors Responsiveness of Hospital Staff Pain management Communication about Medicines Individual Items Cleanliness of the Hospital Environment Quietness of the Hospital Environment Global Items Overall Hospital Rating Recommend the Hospital 8

9. 9 This slide is a screenshot of the Home Page of www.hospitalcompare.hhs.gov. You would click on Find and Compare Hospitals to find a hospital in your area. The right hand side provides information about the other type of information on the site which include process of care measures, outcome of care measures and Medicare payment and volume.This slide is a screenshot of the Home Page of www.hospitalcompare.hhs.gov. You would click on Find and Compare Hospitals to find a hospital in your area. The right hand side provides information about the other type of information on the site which include process of care measures, outcome of care measures and Medicare payment and volume.

10. 10 This screenshot is an example of what comes up once you have chosen which geographic range you are interested in for finding hospitals. For example, I selected hospitals within 25 miles of my home zipcode. A list of hospitals comes up and you can select up to 3 to see additional information.This screenshot is an example of what comes up once you have chosen which geographic range you are interested in for finding hospitals. For example, I selected hospitals within 25 miles of my home zipcode. A list of hospitals comes up and you can select up to 3 to see additional information.

11. 11 On this screenshot I have chosen three hospitals to review. You can see the type of information available � Hospital Process of care measures, hospital outcome measures which include mortality rates and hospital readmission rates, and the survey of patients� hospital experiences. You can pick which measures you want to view in greater detail and whether you would like to see the data in a graph or table.On this screenshot I have chosen three hospitals to review. You can see the type of information available � Hospital Process of care measures, hospital outcome measures which include mortality rates and hospital readmission rates, and the survey of patients� hospital experiences. You can pick which measures you want to view in greater detail and whether you would like to see the data in a graph or table.

12. 12 This screenshot is an example of the graphical display for How Often did Nurses Communicate Well with Patients. The bar chart shows the percent of patients who reported that their nurses �always� communicated well. Data is shown for the three hospitals selected as well as a national average and a state average.This screenshot is an example of the graphical display for How Often did Nurses Communicate Well with Patients. The bar chart shows the percent of patients who reported that their nurses �always� communicated well. Data is shown for the three hospitals selected as well as a national average and a state average.

13. 13 This screenshot includes an example of the table display for the measure �How often did nurses communicate well with patients?� It includes information for the 3 selected hospitals and the state and national average. It includes the percents for: Nurses �always� communicated well; Nurses �usually� communicated well; and Nurses �sometimes� or �never� communicated well. The table also includes additional information about the number of completed surveys and survey response rate.This screenshot includes an example of the table display for the measure �How often did nurses communicate well with patients?� It includes information for the 3 selected hospitals and the state and national average. It includes the percents for: Nurses �always� communicated well; Nurses �usually� communicated well; and Nurses �sometimes� or �never� communicated well. The table also includes additional information about the number of completed surveys and survey response rate.

14. Medicare CAHPS Surveys for Health and Prescription Drug Plans: Objectives Report comparative performance information for consumer choice Help Plans identify problems & improve quality of care & services Enhance CMS� ability to monitor quality of care & relative performance within & across delivery systems 14

15. Medicare CAHPS Surveys for Health and Prescription Drug Plans: Sample Frame 42+M beneficiaries in 50 States, PR, DC, VI Continually enrolled for 6+ months Institutionalized Excluded 15

16. 2009 Data Collection 690,000 overall national sample Protocol: Two Questionnaire mailings/ Postcard reminder / Telephone follow-up National Response Rate 65+% Measures Reported by October 2009 16

17. Health Plan CAHPS Measures Composites Getting Needed Care Doctors who Communicate Well Getting Appointments and Care Quickly Customer Service Global Ratings Overall Rating of the Plan Overall Rating of Health Care 17

18. Prescription Drug Plan Measures Composites Drug Plan Provides Information or Help When Members Need It Members Ability to Get Prescriptions Filled Easily When Used the Drug Plan Global Rating Overall Rating of Drug Plan 18

19. 19 This screenshot is the home page of www.medicare.gov. You would click on �Compare Health Plans and Medigap Policies in Your Area to get the CAHPS and other quality information about health plans.This screenshot is the home page of www.medicare.gov. You would click on �Compare Health Plans and Medigap Policies in Your Area to get the CAHPS and other quality information about health plans.

20. 20 When you click on �Compare Health Plans in Your Area� you get the screen on this slide. This screen lets you begin either a personalized or general plan search.When you click on �Compare Health Plans in Your Area� you get the screen on this slide. This screen lets you begin either a personalized or general plan search.

21. 21 This screen comes up once you have entered you search parameters. On this screen you just see the information for one plan. If you were on the Internet you would see information about 37 plans that met by geographic search criteria. The user needs to choose up to 3 plans to compare. There is a summary rating of health plan quality on this page for each plan. This summary rating includes information about all of the quality and performance measures displayed on this website.This screen comes up once you have entered you search parameters. On this screen you just see the information for one plan. If you were on the Internet you would see information about 37 plans that met by geographic search criteria. The user needs to choose up to 3 plans to compare. There is a summary rating of health plan quality on this page for each plan. This summary rating includes information about all of the quality and performance measures displayed on this website.

22. 22 This screenshot shows the type of quality and performance information you would see on the site once you have chosen three plans to compare. There are 5 domains related to Part C and 4 domains related to Part D. Most of the CAHPS information is in the Ratings of Health Plan Responsiveness and Care domain on the Part C side and in Members Experience with Drug Plan on the Part D side. Each domain gets a 5 star rating.This screenshot shows the type of quality and performance information you would see on the site once you have chosen three plans to compare. There are 5 domains related to Part C and 4 domains related to Part D. Most of the CAHPS information is in the Ratings of Health Plan Responsiveness and Care domain on the Part C side and in Members Experience with Drug Plan on the Part D side. Each domain gets a 5 star rating.

23. 23 This screenshot shows the detail behind the Ratings of Health Plan Responsiveness and Care domain. It includes 6 measures and 5 out of the 6 are CAHPS measures. Each measure gets a 5 star rating.This screenshot shows the detail behind the Ratings of Health Plan Responsiveness and Care domain. It includes 6 measures and 5 out of the 6 are CAHPS measures. Each measure gets a 5 star rating.

24. 24 This screenshot shows alternative information you can get on the site if you are interested in numeric values instead of stars. Each individual measure on the site also receives a numeric value.This screenshot shows alternative information you can get on the site if you are interested in numeric values instead of stars. Each individual measure on the site also receives a numeric value.

25. Changes for the Upcoming Year Adding Fee-for-Service comparison for CAHPS Summary Plan Rating provided for previous year 25

26. Contact InformationLiz Goldstein 410-786-6665elizabeth.goldstein@cms.hhs.gov 26