Consumer Assessment of Healthcare Providers and Systems:
This is a survey developed by CMS, to gain feedback from patients and their relatives about experiences with and ratings of their healthcare providers and plans. The survey includes hospitals, home health agencies, Doctors (single and groups), and health drug plans. The survey results are publicly shared by CMS, so Providers may have an impact due to ratings, because it is the feedback of the patients. It is not similar to the patient satisfaction survey, which focuses mainly on the facilities provided to them in the hospital during their stay. Whatever the patient is experiencing with the provider is recorded – the ambience, cleanliness, waiting times, the communication with the doctors, understanding the instructions provided by the Providers on their ailment and medications etc.
This survey uses a standardized questionnaire and data collection protocols to ensure that the information can be used for comparison across different healthcare settings. This survey is finalized based on a technical expert’s opinion and through public comments obtained during the public comment period and if there are any mismatches, then those will be addressed. This survey, thus helps CMS to initiate quality health programs to the patients and also used as a tool to initiate many value based payment initiatives.
CMS Patient Experience survey also includes:
- Hospital CAHPS – This records the patients feedback on their hospital experience – the ambience, cleanliness, how they were treated by the staff and nurses at the hospital etc. Basically it records the feedback of the overall performance of the Hospital.
- Home Health CAHPS – This covers the patient receiving Home Health services and other Skilled Nursing care.
- Fee-for-service CAHPS – This targets the enrollees of Medicare plans and their experience with the respective fee for service Providers.
- Medicare Advantage and Prescription Drug CAHPS – This survey targets the enrollees of Medicare Advantage plans and prescription drug plans of Medicare.
- In-center Hemodialysis CAHPS – This survey is the first of its kind, focusing towards a chronic disease. This documents the feedbacks provided by the patients with End Stage Renal Disease (ESRD), regarding the ‘in-center’ Hemodialysis care.
- Nationwide Adult Medicaid CAHPS – As the name suggests, this targets the low-income groups of patients and their experiences from national or state healthcare Providers through the Medicaid programs.
Health Outcomes Surveys:
Another important survey is known as Health Outcome Survey which is also designed and developed by CMS. This survey is the first patient reported outcomes measures used in Medicare Managed Care. This also helps a lot in assessing the quality of health care to the patients from the Providers.
A random sample of Medicare Beneficiaries are drawn from each participating Medicare Advantage Organization and surveyed. After 2 years, the same patients are approached again to compare the results with the initial assessment obtained. These outcomes were analyzed by a team of technical assistants and this survey is used as a part of the effectiveness of Healthcare Effectiveness Data and Information Set (HEDIS).
The survey questionnaire contains questions on Socio-demographics, patients day to day activities, their mental status, records also number of unhealthy days in the past 30 days as well as height and weight categories used in calculating the body mass index etc., The answers to these questions are analyzed in-depth to determine the mental and physical ability of the patient, and for those who need additional attention are directed towards the proper Providers. This in turn, will improve the member’s mental and physical health.
Once these data are collected and analyzed, they are shared publicly and these will be used by the Providers/Hospitals accordingly to improve the quality of care, or billing correctly using the correct techniques, which helps in better returns to the Providers and the Hospitals, thereby increasing their reputation.Tweet