The Consumer Assessment of Healthcare Providers and Systems (CAHPS®) program offers a host of  surveys to accommodate various healthcare settings. Recently, CMS requested information to aid in the design and development of a new survey tool for hospital outpatient surgery departments (HOSDs) and ambulatory surgery centers (ASCs), which ultimately would add another survey tool to compliment the CAHPS® lineup.

Ashley Thompson, Vice President and Deputy Director of Policy with the American Hospital Association (AHA), recently sent a letter urging the Center of Medicare and Medicaid Services (CMS) to “reconsider the necessity of a new, separate survey tool for ASCs and HOSDs, sharing concern that the CAHPS® program already includes multiple overlapping survey tools creating confusion about how to assess the patient experience across multiple case settings, as well as excessive survey administration burden.” As an alternative, the AHA recommends that CMS should incorporate additional supplemental questions into the existing CAHPS® survey, which are targeted to toward facility specific issues.

With the growth of the CAHPS® program, there is increased concern that the multiple patient surveys make it difficult to accurately assess care experiences. Patient care often crosses multiple care settings, which can possibly lead to a patient receiving multiple surveys. This can confuse the patient especially because surveys are usually sent weeks after the patient receives care. It also can be detrimental especially if the patient becomes confused and inadvertently attributes a positive or negative experience to the wrong organization.  It is also a possibility to receive multiple surveys that capture similar information i.e. HCAHPS® and the Surgical CAHPS®.

If CMS adds HOSDs/ASCs to the list, the patient could receive up to three surveys for the same care episode. The AHA recommends that CMS add the supplemental, optional survey questions in regards to the care they received at the HOSDs/ASCs instead of creating a whole new survey to the existing tool.

hospital budgets

It seems that the AHA is concerned that the patient experiences may not be accurately reflected in survey responses due to complex integrated care crossing multiple levels of clinical services. Another concern that the AHA stated in the letter was that the cost of administering multiple surveys further strains finite resources. They suggested that CMS offer additional protocols for surveying such as emailed or web-based surveys, which could make administration less expensive and allow hospitals to increase their sample size without increasing the cost substantially. When looking at costs of outsourcing the surveys to a vendor, often times it may be more expensive to conduct survey administration in-house due to the resources that need to be available whether that be people, equipment or time. With the CAHPS® scores tied to reimbursement, it is important to get the most accurate results from patients and survey vendors can provide.

This is the first of a two-part series in measuring the patient experience. The second part of this series will address steps for how to glean the most out of your patient satisfaction survey findings and additional steps you can take to improve the overall patient experience across all lines of patient care. This will be featured as the April 2013 Healthcare Trend next month.

cahps survey vendor

RMS Healthcare is a premier healthcare consulting firm, assisting healthcare organizations to improve patient care and quality outcomes, as well as being a certified CAHPS® vendor. Whether you are looking for a CAHPS® survey vendor to administer or manage your patient satisfaction survey process and reports or are seeking further information about improving patient care, RMS Healthcare provides a full complement of healthcare consulting and management services. For more information, contact Sandy Baker, Director of Business Development, at (315) 635-9802 or by emailing him at For other RMS Healthcare blog posts, click here.