Overview of CAHPS® and the National CAHPS® Database (Text Version)

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On September 19, 2009, Dale Shaller made this presentation at the 2009 Annual Conference. Select to access the PowerPoint® presentation (1.2 MB).

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Slide 1

Overview of CAHPS® and the National CAHPS® Database

Assessing Patients' Experiences with Care: Using CAHPS®  as a Standardized Quality Metric

Dale Shaller, Shaller Consulting
Managing Director, CAHPS Database
Yale CAHPS III Team

 

Slide 2

Overview of CAHPS

• CAHPS = Consumer Assessment of Healthcare Providers and Systems
• Most widely used survey tools for assessing the patient's experience with care
• Endorsed by National Quality Forum
• Initiated and funded by AHRQ since 1995
• Consortium members include: AHRQ, CMS, RAND, Yale/Harvard, and Westat

 

Slide 3

Expanding Suite of CAHPS Surveys

Facility Care
 

• Hospitals
• Dialysis Facilities
• Nursing Homes

Ambulatory Care

• Health Plans
• Group Practices and Individual Clinicians
• Behavioral Health Organizations (ECHO)
• Rural Tribe Health Services
• Home Health

 

Slide 4

Core CAHPS Design Principles

• Focus on topics for which consumers are the best or only source of information
• Include patient reports and ratings of experiences—not "satisfaction"
  • Reports: Never/Sometimes/Usually/Always
  • Ratings: 0-10 rating scale
• Base question items and survey protocols on rigorous scientific development and testing, as well as extensive stakeholder input
• All surveys and services are in the public domain

 

Slide 5

The CAHPS Database

• National repository of data from the CAHPS family of surveys
• Two major applications:
  • Benchmarking to evaluate health system performance and support quality improvement
  • Research on consumer assessments of quality
• Funded by AHRQ and administered by Westat through the CAHPS User Network

 

Slide 6

National Advisory Group

• AHRQ
• CAHPS Grantees
  • RAND
  • Yale/Harvard
• CMS Medicare
• CMS Medicaid
• Department of Defense
• Consumer groups
• Employer groups
• State Medicaid
• Health plans
• Hospital systems
• Medical boards
• Statewide information organizations

 

Slide 7

CAHPS Database Components

• CAHPS Health Plan Survey Database
  • 3.6 million records collected
  • 12 Annual Chartbooks (1998—present)
• CAHPS Hospital Survey Database
  • .8 million records collected
  • 3 Annual Chartbooks (2006—present)
• CAHPS Clinician & Group Survey Database

 

Slide 8

CAHPS Database Products

• Online Reporting System
• Annual Chartbooks
• Customized Sponsor Reports
• Research Files
• Support to AHRQ's National Healthcare Quality and Disparities Reports
• Special Analyses and Reports

 

Slide 9

Benefits of Participation

• Free service open to all survey users on a voluntary basis
• Access to comparative results by survey version through Online Reporting System
• Support to participants provided through
  • Data submission specifications
  • Online data submission system
  • Custom analysis and reports
  • User network
  • E-mail and phone technical support

 

Slide 10

Online Reporting System

• Will support all CAHPS surveys maintained by CAHPS Database
  • CAHPS Health Plan Survey
  • CAHPS Hospital Survey
  • CAHPS C&G Survey
• Public portal available to everyone
  • Ability to view summary-level data only
• Password-protected portal will be accessible only to participants who contribute data
  • Ability to view your own results compared to selected benchmarks

 

Slide 11

The CAHPS Benchmarking Database

Image: This screenshot of the CAHPS Database Online Reporting System shows the selection of data for Health Plans (on the left) which takes you to an overview page for the Health Plan Data.

 

Slide 12

The CAHPS Benchmarking Database

Image: This screenshot of the CAHPS Database Online Reporting System shows the selection of 2008 Adult Medicaid data, which allows various data views. The first view shown here is a selection of a two-way frequency for one of two questions that compose the Getting Needed Care Composite: Q27: (got necessary care, tests, or treatment through the health plan).

 

Slide 13

The CAHPS Benchmarking Database

Image: This screenshot of the CAHPS Database Online Reporting System compares results for Q27 by self-reported health status (Q36). Other possible cuts include other respondent characteristics, or location, or plan type (as examples). The frequency table shows the distribution of results with the number of respondents in each category.

 

Slide 14

The CAHPS Benchmarking Database

Image: This screenshot of the CAHPS® Database Online Reporting System shows the selection of data for Health Plans (on the left) which takes you to an overview page for the Health Plan Data.

 

Slide 15

The CAHPS Benchmarking Database

Image: This screenshot of the CAHPS® Database Online Reporting System shows the selection of data for Health Plans (on the left) which takes you to an overview page for the Health Plan Data.

 

Slide 16

Strategic Priorities

• Clinician & Group Survey
  • Strong demand for benchmarks
  • No other national suppliers
  • Opportunity for leadership
• Health Plan Survey
  • Partnership with NCQA and CMS
  • Continued leadership in Medicaid sector
• Hospital Survey
  • Collaboration with CMS

 

Slide 17

CAHPS C&G Database

• Currently developing in response to user demand
• Working with key organizations to provide guidance on implementation
  • Survey vendors
  • Health plans and medical groups
  • Aligning Forces for Quality and CVE markets
  • National medical boards
• Aim is to support all C&G versions and users through standardized data submission specifications

 

Slide 18

Clinician & Group Survey Core Measures

Access: Getting Appointments and Health Care When Needed

• Getting appointments for urgent care
• Getting appointments for routine care or check-ups
• Getting an answer to a medical question during regular office hours
• Getting an answer to a medical question after regular office hours
• Wait time for appointment to start

How People Rated Doctor

• 0-10 rating of doctor
• How Well Doctors Communicate
• Doctor explanations easy to understand
• Doctor listens carefully
• Doctor gives easy to understand instructions
• Doctor knows important information about medical history
• Doctor shows respect for what you have to say
• Doctor spends enough time with you

Courteous and Helpful Office Staff

• Clerks and receptionists were helpful
• Clerks and receptionists treat you with courtesy and respect

 

Slide 19

Several C&G Survey Versions to Meet User Needs

• Last 12 months
  • Adult primary care
  • Child primary care
  • Adult specialty care
• Visit-based
  • Adult primary care

 

Slide 20

Customizing Clinician & Group Survey with Supplemental Items

• Adult Primary Care
  • 17 topics covered by supplemental items
  • Includes health promotion and education, shared decision making, communication items for QI, most recent visit.
• Child Primary Care
  • 7 topics covered by supplemental items
  • Includes doctor communication with child, health improvement, shared decision making.
• Adult Specialty Care
  • 6 topics covered by supplemental items
  • Includes coordination of care, shared decision making, surgery or procedures performed by this doctor.

 

Slide 21

Clinician & Group Survey: Under Construction

• Current surveys focus on primary and specialty care physicians
• CAHPS Consortium is developing a version to measure experience with a broader range of primary care providers (physicians, nurse practitioners, physician assistants)
  • Potential for a "provider neutral" survey tool to assess any type of primary care provider
• Available as a beta survey instrument by the end of 2009

 

Slide 22

Further Information

• To contribute data and obtain access to new online system, contact us:
  • E-mail: ncbd1@ahrq.gov
  • Toll-free number: 888-808-7108
• For more information: https://cahps.ahrq.gov