This blog post was written by our guest blogger Megan O’Donnell, Manager at Research & Marketing Strategies, Inc. (RMS) Healthcare Division.

Improving CAHPS response rates is top of mind for many of our clients.  In our experience, Telephone Only and Mixed modes of survey administration result in higher response rates than Mail Only mode. The following blinded case study addresses the issues an RMS client was facing, the steps taken to overcome the issues, and the resulting success of the changes.

Background: A hospital, operating in a large metropolitan city, serving an inner city population, was experiencing very low response rates to its Mail Only administration of the Hospital CAHPS survey being conducted by a large national survey vendor. In addition, the hospital’s survey results were falling consistently below the averages for their state and national averages. Furthermore, the hospital was concerned that such low response rates would make taking actions based on those responses to be questionable business decision-making. The low response rate (9% from 2nd Quarter 2012 through 1st Quarter 2013) troubled the hospital’s administration enough to seek out a solution to improve these rates. In early 2013, the hospital administration came across a blog post by RMS that seemed to present a solution (HCAHPS® Response Rate | Approved Vendor RMS Far Exceeds National Average).  The hospital team contacted RMS, made the decision to switch survey vendors, and employed the Telephone Only mode in an attempt to improve its overall response rates.

Approach: In order to address the objectives at-hand, while following all procedures and protocols outlined by the Centers for Medicare and Medicaid Services (CMS), the RMS Healthcare team worked with the hospital’s administrative team to roll out the Hospital CAHPS survey telephone administration in July 2013. To encourage participation, RMS developed signage for the hospital to post around its facility regarding the survey, letting patients know that they may receive a call from Research & Marketing Strategies on behalf of the hospital and encouraging patients to provide accurate contact information and to answer the call when it came.

At the onset of survey administration, RMS Healthcare encountered a high volume of inaccurate telephone numbers. The hospital administration corrected this issue by training its admission staff to explain the importance of accurate contact information. In addition, administrative rounding staff reiterated the importance of the survey and accuracy of contact information during the patients’ hospital stays. After these efforts were employed, RMS saw a considerable increase in viable telephone numbers during survey administration.

Results: Here are a few key takeaways that have resulted from the change in survey administration mode for the client:

  • There was a 155% increase in response rate after the first full year of Telephone Only surveying with RMS.  The 9% response rate the hospital was getting using the Mail Only mode was increased to 23% in the first year of RMS survey administration.
  • High statistical reliability in the survey results.  By choosing to include all eligible patients in the survey administration, the hospital’s survey results have a confidence interval of ±3.5% at the 95% confidence level (Industry standard for statistical reliability is ±5% at the 95% confidence level].
  • Improved accuracy of survey results.  Utilization of the Telephone Only mode of survey administration means that the telephone interviewer controls the routing of questions and accuracy of responses. Therefore, no patient has an opportunity to answer a question if it is not relevant to their  hospital stay (screening questions are followed automatically by the computer-assisted-telephone-interviewing system).

The hospital continues to engage with RMS regarding the survey response rates and overall scores, utilizing the RMS CAHPS Portal as a means of getting up-to-date survey results in addition to the monthly and quarterly reports they receive from RMS. Now that the hospital can feel confident in the accuracy of the survey results, they can make smart action plans to address survey results and improve the patient experience for its patients.

Research & Marketing Strategies, Inc. (RMS) is a market research firm that specializes in healthcare market research and the CAHPS family of surveys. Are you interested in finding out more about Research & Marketing Strategies (RMS) and how our CMS approved vendor healthcare division can help increase your CAHPS® response rate? For more information contact our Business Development Director Sandy Baker, at or by calling her at (315) 635-9802. For other RMS blog posts about the CAHPS® process – click here.