Home Health CAHPS as a Driver of Quality Improvement

Home health agencies are the latest health care setting required by CMS to survey their patients with a Consumer Assessment of Healthcare Provider and Systems (CAHPS) tool. Optimizing the patient experience in home care is essential to promoting better self-management of chronic conditions and preventing hospitalizations. The experience of implementation for a large agency in New York City illuminates some of the challenges and opportunities presented by this new set of publicly reported measures.

This agency implemented the home health CAHPS survey nine months before CMS required it, offering adequate time for staff education and for understanding initial results. The introductory period fostered recognition of the importance of patient centered care and an acknowledgement of shared responsibility for patient satisfaction across roles and disciplines. Subsequently, the agency developed multi-pronged quality improvement plans to address key drivers of satisfaction, such as improving communication skills and enhancing continuity of care.

While home care agencies have benefitted from the hospital CAHPS experience, a challenge for this setting is to observe and provide feedback to clinicians who are providing care dispersed in the community rather than in a controlled environment. Other considerations for this agency included meeting the needs of a highly diverse patient population and focusing on patient satisfaction in a difficult economic climate with many competing priorities.