This blog post was written by our guest blogger Marc Bovenzi, Business Development Associate at Research & Marketing Strategies (RMS). RMS is an approved HH-CAHPS ® survey vendor.

Home health agencies have the option of choosing one of several modes for the administration of the Home Health Care Consumer Assessment of Healthcare Provider and System (HH-CAHPS®) survey. Below are some factors to consider when choosing which mode is right for your agency and your patients. Each of the following modes offers its own pros and cons:

  • Mail Mode

Mailed surveys cost less than phone surveys but result in the lowest response rates. The national response rate for HH-CAHPS® mail mode is currently 33.5%.

These surveys are completed when it is convenient for patient. This may be a positive in that it allows the patient to do the survey on their own time, but it also means that the survey vendors (and home health agencies) have no control when the survey is returned despite having a finite window to collect responses.

HH-CAHPS survey vendor

There is no interviewing bias when the respondents complete the survey on their own. However, there may be errors in the survey responses if a patient misses a question or does not follow the surveying routing properly.

Respondents have more time to formalize answers to questions before completion.

Multilingual surveys are available via paper modalities. If the home health agency can identify the appropriate language, the survey should be administered. This can help increase response rates among non-English speaking patients.

  • Phone Mode

Phone surveys cost more than mail surveys but result in a slightly higher response rate. National response rate for HH-CAHPS® phone mode is currently 35.5%.

With phone, interviewer can clarify survey questions through the use of neutral probing techniques, resulting in a more well-rounded survey. In addition, interviewers are able to automatically follow appropriate question routing, eliminating skipping errors and ensuring a higher degree of accuracy.

approved hh-cahps vendor

Telephone interviewers can establish a rapport with respondents, leaving a more positive impression of the home health agency.

Interviewers make up to 5 attempts to reach each patient. At the patient’s request, interviews can be scheduled at a convenient time for the patient.

Multilingual interviewers are available via telephone. Bilingual interviewers are able to automatically transition the interview from one language to another if it becomes clear that the patient is more comfortable in an alternate language.

  • Mixed Mode

Mixed Mode is a mixture of mail and telephone modalities combined. After one attempt to reach a patient by mail, there are up to 5 attempts to reach them by phone as stated by CMS regulations.

Usually pricing is a balance between the mail only mode and the phone only mode.

Mixed mode is proven to achieve the highest response rates. National response rate for HH-CAHPS® mixed mode is currently 42.9%, almost 10% higher than the mail mode and 7% higher than the phone only mode.

Although CMS has no penalty for providers with low response rates, every effort should be made to obtain as many completed surveys as possible towards the CMS target of 300 completes over a 12-month period. A larger sample size may increase the number of completed surveys your agency receives and decrease the margins of error.

Which HH-CAHPS® mode is the best? It’s ultimately up to your agency and HH-CAHPS® consultant to determine. Many variables are considered including cost, response rate, the ability to provide a personal touch, the ability to offer multiple languages, just to name a few. If you are interested in discussing which mode is best for your agency, contact our Research & Marketing Strategies (RMS), your approved HH-CAHPS® vendor and consultant. Our Business Development Director, Sandy Baker, can be reached at or by dialing 1-866-567-5422.