OpenPlacement Blog

Understanding The HCAHPS

Health care is a hot topic, and hospitals must pay increasing attention to something called the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS).  Pronounced H-Caps, this assessment is given to random eligible patients after they are discharged, and the patients’ responses are used to establish ratings for the hospitals.  These ratings are released to the public four times a year.

The HCAHPS Requirement

In 2002, the Centers for Medicare & Medicaid Services (CMS) began working with the Agency for Healthcare Research and Quality (AHRQ) to create and test the survey before it went into public use.  Both agencies are in the federal Department of Health and Human Services.

The HCAHPS has been in use since 2006, and is used to meet three main goals:

  • The first goal is to produce data that consumers can use to compare hospitals.

  • The second goal is to encourage hospitals to make improvements to the care they provide, because they know their consumer ratings will be published.

  • This in turn assists the third goal, which is to increase accountability among hospitals.

The survey has 27 questions.  To be eligible for the survey, patients must have been 18 years or older at the time of admission, have stayed in the hospital at least one night as an inpatient, have a non-psychiatric MS-DRG/principal diagnosis when they are discharged, and be alive when they are discharged.  Patients are given the survey at random between 48 hours and six weeks after they are discharged.

Measuring Hospital Performance

Questions on the survey deal with various facets of patients' experiences in hospitals, including:

  • Communication with doctors and nurses

  • How responsive the staff is

  • How clean and quiet the hospital is

  • Management of pain

  • How well information about medicines was communicated

  • Discharge information.

Patients give an overall rating of the hospital and state whether or not they would recommend the hospital.

Patients can take the survey via mail, phone, mail with a follow-up by telephone, or active interactive voice recognition (IVR).  Each hospital can be approved to conduct the survey independently, or can use an approved vendor to conduct the survey.  The written survey is available in English, Spanish, Russian, Chinese, and Vietnamese, and the spoken version in English and Spanish.  Surveys are administered every month of the year.

Improving Your Hospital’s Performance

Apart from the basic desire to provide exceptional service, hospitals also must administer and report the HCAHPS correctly because their funding is tied to it.  Since July 2007, hospitals that are required to comply with the Inpatient Prospective Payment System (IPPS) annual payment update provisions must submit their survey results as a condition of receiving their full reimbursement.

Hospitals can take several initiatives to improve their survey scores. For example:

  • They can be sure to communicate frequently and clearly with patients, educating them well during their stays.

  • Hospitals should listen to patient responses and act on patient feedback, especially when problem areas become obvious.

  • Hospitals must work with their staff as whole to make sure that providing a positive patient experience is part of the culture and atmosphere.

  • Hospitals can improve their discharge process by better communicating with patients and caregivers and, when necessary, finding an appropriate skilled nursing care facility for patients to be discharged to.

Improving the performance of your hospital is a goal that you should always have in order to provide better care to patients. The new survey requirements simply provide added incentive to go the extra mile to increase patient satisfaction and to achieve positive outcomes for patients

About the Author

Christy Rakoczy has a JD from UCLA School of Law and an undergraduate degree in English Media and Communications from University of Rochester. Her career background includes teaching at the college level as well as working in the insurance and legal industries. She is currently a full-time writer who specializes in the legal, financial and healthcare sectors. Ms. Rakoczy writes online content as well as textbooks for adult learners.