Hospitals to CMS: No more patient surveys, please

The American Hospital Association is asking the Centers for Medicare and Medicaid Services to drop plans to create two more types of patient surveys in favor of adding supplemental questions to existing surveys.

In a letter sent yesterday, the AHA said adding surveys about patient experiences at hospital outpatient surgery departments and ambulatory surgical centers creates potential confusion "as well as excessive survey administrative burden."

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) program "already includes multiple overlapping survey tools" assessing patient experiences across multiple care settings, the AHA said in the letter.

The association also suggested CMS consider changing its formula for adjusting scores based on the severity of patient illness. Sicker patients, as well as depressed patients, tend to provide lower scores, AHA said, artificially depressing the scores of hospitals that treat more of those patients.

Among other the points in the letter:

  • Patients whose care crosses multiple care settings may be confused about which provider or facility is being accessed when receive surveys days or weeks later.

  • Two existing surveys, one for clinicians and groups and the other for surgical services, already capture similar information. Ambulatory surgical patients could potentially receive three similar surveys for the same "care episode" under the CMS plan.

  • Modifying an existing survey would relieve hospitals of having to pay vendors even more to administer and analyze results. Those costs could be further reduced if hospitals and their vendors could survey some patients online or via email, instead of just by phone or postal mail.

Given the potential financial ramifications of poor patient-satisfaction scores – up to a 1 percent reduction in Medicare reimbursements--hospitals already are "totally preoccupied" with HCAHPS survey scores, John Haupert, chief executive of Grady Memorial Hospital in Atlanta, told the Wall Street Journal in a recent report.

Meanwhile, a study published earlier this year in the New England Journal of Medicine found that factors such as assessing a specific event or visit, evaluating interactions with all providers (rather than just physicians) and sending out surveys shortly after treatment can provide more meaningful patient-survey results.

To learn more:
- read the letter (.pdf)