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| HCAHPS | |
|---|---|
| Name | HCAHPS |
| Caption | Hospital patient experience survey instrument |
| Established | 2006 |
| Administered by | Centers for Medicare & Medicaid Services |
| Purpose | Standardized assessment of inpatient hospital experience |
HCAHPS HCAHPS is a standardized patient survey for measuring inpatient hospital experience developed and endorsed to allow comparisons across Centers for Medicare & Medicaid Services, Agency for Healthcare Research and Quality, Department of Health and Human Services, National Quality Forum, Hospital Quality Alliance, and Institute of Medicine. The instrument informs public reporting and pay-for-performance initiatives involving Medicare, Medicaid, Affordable Care Act, Center for Medicare and Medicaid Innovation, and major hospital systems such as Mayo Clinic, Cleveland Clinic, Johns Hopkins Hospital, Massachusetts General Hospital.
The initiative arose from collaborations among Centers for Disease Control and Prevention, Robert Wood Johnson Foundation, The Joint Commission, American Hospital Association, American Medical Association, American Nurses Association, and academic centers including Harvard Medical School, Stanford University School of Medicine, University of Pennsylvania Health System, and University of California, San Francisco. HCAHPS provides standardized metrics that enable benchmarking across institutions such as Kaiser Permanente, Mount Sinai Health System, NewYork-Presbyterian Hospital, Cedars-Sinai Medical Center, and UCLA Health while aligning with federal reporting platforms like Hospital Compare and data initiatives linked to CMS.gov.
The survey instrument captures domains such as communication with nurses and physicians, responsiveness of hospital staff, cleanliness and quietness of the hospital environment, pain management, communication about medicines, discharge information, overall hospital rating, and recommendation of the hospital. Development involved experts from RAND Corporation, Harvard School of Public Health, Columbia University Irving Medical Center, Yale School of Medicine, Duke University School of Medicine, and University of Michigan Health System. Measures are operationalized to support comparisons with academic medical centers like Barnes-Jewish Hospital, Vanderbilt University Medical Center, Northwestern Memorial Hospital, University of Washington Medical Center, and specialty hospitals including St. Jude Children's Research Hospital.
Administration approaches include mail, telephone, and mixed-mode methods standardized across sites similar to survey practices used by National Health Interview Survey, Behavioral Risk Factor Surveillance System, National Survey on Drug Use and Health, and other federal instruments. Sampling frames are designed to represent adult discharged patients from acute care hospitals such as Seattle Children's Hospital, Ronanoke Regional Medical Center, Scripps Health, and Texas Children's Hospital, excluding inpatients from long-term acute care or psychiatric facilities. Methodological consultation came from groups like Westat, NORC at the University of Chicago, Abt Associates, and survey methodologists at Cornell University.
Scoring converts raw responses into composite measures and global ratings enabling reporting on platforms akin to Medicare Hospital Compare, Healthgrades, Leapfrog Group, U.S. News & World Report Best Hospitals, and regional reporting efforts by state health departments such as California Department of Public Health and New York State Department of Health. Public reporting practices interact with accreditation bodies like The Joint Commission and certification programs administered by National Committee for Quality Assurance and reimbursement oversight by Centers for Medicare & Medicaid Services.
HCAHPS results factor into value-based purchasing and pay-for-performance models implemented by Centers for Medicare & Medicaid Services and piloted through Center for Medicare and Medicaid Innovation initiatives such as the Hospital Readmissions Reduction Program and Hospital Value-Based Purchasing Program. Hospitals participate alongside quality metrics from programs like Meaningful Use, QualityNet, and reporting to registries such as National Surgical Quality Improvement Program and Get With The Guidelines from American Heart Association. Health systems including Trinity Health, HCA Healthcare, CommonSpirit Health, and academic centers adapt HCAHPS data for internal quality improvement, staff training, and patient experience programs.
Critiques have been raised by scholars and policy analysts at Brookings Institution, Urban Institute, Commonwealth Fund, Health Affairs, and research teams at Johns Hopkins Bloomberg School of Public Health and Harvard T.H. Chan School of Public Health regarding survey response bias, case-mix adjustment adequacy, and potential unintended consequences such as risk-averse behavior and gaming. Concerns reference empirical work on patient-reported measures from National Academies Press and debate intersections with legal and regulatory frameworks including Stark Law and Anti-Kickback Statute as hospitals navigate incentives from payers like Centers for Medicare & Medicaid Services and large private insurers such as UnitedHealth Group and Anthem, Inc..
The program grew out of policy efforts following reports from Institute of Medicine and policy momentum generated by laws and initiatives including the Deficit Reduction Act of 2005 and the Affordable Care Act. Early pilots involved collaborations among federal agencies and foundations including the Robert Wood Johnson Foundation and research centers such as RAND Corporation, with implementation phased through regulations published by Centers for Medicare & Medicaid Services and oversight by Agency for Healthcare Research and Quality. Adoption influenced hospital transparency movements associated with organizations such as Consumers Union, National Partnership for Women & Families, and advocacy by patient groups including American Cancer Society.
Category:Patient experience measures