Recent developments in the national, standardized, publicly reported survey of patients' perspectives of hospital care (HCAHPS)

In this presentation, we introduce and then explore recent developments in the newly-launched CAHPS® Hospital Survey (HCAHPS): the first national, standardized, publicly reported survey of patients' perspectives of their hospital care. HCAHPS will augment consumer choice, increase hospital accountability, provide incentives for improvement, and increase transparency in healthcare. The development and content of HCAHPS reflect the interaction of national health policy and politics, and the survey's publicly reported results will affect public health by increasing consumer information and creating new incentives for hospitals to improve quality of care. We will provide the most recent information on the content, development and implementation of HCAHPS and update the audience on early survey results.

Currently, over 2800 acute care hospitals and hundreds of thousands of patients are voluntarily participating in HCAHPS. When, in July 2007, HCAHPS becomes an ingredient in “pay-for-reporting,” it will have the potential to affect billions of dollars of CMS payments to hospitals. By mid-2007, nearly all eligible hospitals (~ 3900) are expected to participate. The first public reporting of hospital results, scheduled for early 2008, should attract wide attention from the healthcare industry and general public.

As background, we present information on the survey's content (seven topics of vital importance to patients tapped through 27 items: 18 on the patient's experience of care; five demographic; four screeners), participating hospitals (short-term, acute-care), eligible patients (adult; discharged alive; overnight stay; medical, surgical or maternity care) and process of implementation (by hospitals or approved survey vendors; four different survey modes with standardized protocols; 300 completed surveys per year). We then discuss how HCAHPS results will be adjusted for survey mode and patient-mix effects, describe early survey findings, discuss its impending role in hospital reimbursement, and outline how hospital results will be publicly reported on the Hospital Compare website.

The purpose of the HCAHPS survey has expanded from its early emphasis on public reporting to encompass pay-for-reporting and eventually pay-for-performance. We examine the changing role of HCAHPS and how interests of key stakeholders, particularly hospitals, survey vendors and consumer groups, have been accommodated to the degree possible while maintaining fidelity to original goals. Finally, the impact of HCAHPS on patients, consumers, hospitals, and the healthcare industry will be broached. Because its full effects may not be apparent for some time, we will invite the audience to speculate on possible outcomes, consequences, and avenues for research.