CMS officials counter fears about HCAHPS surveys

Common misperceptions persist regarding the role of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys, Medicare officials write in a commentary for the Journal of the American Medical Association.

Used properly, HCAHPS scores can be a valuable tool in the quest to improve patient experience, write Centers for Medicare & Medicaid Services Chief Medical Officer Patrick Conway, M.D.; William G. Lerhman, Ph.D., of CMS' Division of Consumer Assessment and Plan Performance; and Lemeneh Tefera, M.D., of CMS' Quality Measurement and Value-Based Incentives Group. Patient experience accounts for 30 percent of a hospital's Total Performance Score (TPS) under the Hospital Value-Based Purchasing program, they write, and despite concerns that patient satisfaction is given too much weight relative to other measures, a CMS analysis indicates no one HCAHPS measure can throw off a hospital's scores by itself, according to the report.

There have also been concerns raised that HCAHPS provides a financial incentive for hospitals to prescribe more prescription opioids amid increased misgivings about the role of such prescriptions in the nation's opioid abuse epidemic. However, the authors write, no data indicates hospitals that prescribe fewer opioids have lower HCAHPS scores. "Nothing in the survey suggests that opioids are a preferred way to control pain," they write. "On the other hand, good nurse and physician communication are strongly associated with better HCAHPS scores. Five of the eight HCAHPS dimensions directly involve communication with hospital staff, a critical issue from the patient perspective."

Nor should these concerns prompt CMS to remove pain management-related questions from HCAHPS surveys, the authors write, as the category remains vital for assessing care quality. The agency, they add, continues to research the most instructive possible patient experience measures for inclusion on the survey.

To learn more:
- read the commentary abstract

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