The Purpose Behind CAHPs in Home Health Care
According to the official CAHPs government information site, the survey is a “public-private initiative to develop standardized surveys of patients’ experiences with ambulatory and facility-level care.” The survey is intended to:
- Determine the quality of care to the individual;
- Document performance; and
- Advance the overall quality of care.
This particular survey is a general collection of information dealing with Home Health Care providers and the relationship to their patients. The survey’s intentions are to relay feedback to the service provider. An assessment of the results will be made and an evaluation of each Agency will occur.
Who will be taking part in the survey specifically?
If a patient’s care is paid for by Medicare and Medicaid, then they are eligible to be included in the survey. However, a patient has the right to deny participation. Patients excluded from taking the survey are those under the age of 18, those receiving hospice care, and maternity clients.
The survey has been identified as a voluntary survey process; however, the final rule makes it clear that non-participating agencies will be subject to a two-percentage point reduction in the market basket update in 2012.
The Survey Itself: The Patient’s Opportunity to Voice Their Opinion
The survey contains an arrangement of questions related to safety, medications, pain management as well as communication and interpersonal interactions. The patient will also be rating the agency overall and the likelihood of recommending the agency to others.
-To begin, the survey asks a series of yes or no questions about Your Home Health Care provider. These questions will aide in revealing the general relationship that each Home Health Agency has with their patients.
-The next set of questions will determine the experiences sustained by the patients with their agencies specifically within the last 2 months.
-Following this segment is a series of questions dealing specifically with the Home Health Agency offices and the patient’s evaluation of them.
-The survey concludes with a few personal questions asked of the patient. Some of the categories include education, ethnic background, current health, and living status.
Although the standard survey contains 34 questions, Agencies/Vendors may add additional questions, which do not need to be approved by CMS (Centers for Medicare & Medicaid Services). However, additional questions will not be publically reported by CMS, only the questions originally asked in the survey. When an agency receives the survey, questions may be added, but no questions are approved for removal. All of the original questions must stay in place. The target number of surveys that an agency must administer per year is around 300.
The survey is offered in various languages to suit diverse clients. The languages included are English, Spanish, Chinese, Russian, and Vietnamese. Once the survey is completed, 3 options as to how the data will be collected is available to the client:
- By Mail: The client must send in the completed survey and cover letter within 3 weeks of the month end. If the survey is not mailed in, a second survey will be mailed to the client.
- Telephone: The client can choose to respond to the service by telephone only.
- Both: This option includes a mailed survey and a follow up phone call if there is no response to the mailed survey.
Financially speaking, an agency is looking at a cost of about $3300 to $4500 annually for 300 surveys, with the price of a mail survey being around $11.10 to the telephone survey being $15.25.
Timing and Vendors
The regulations set forth by the department of Health and Human Services for the HHCAHPS become effective January 1, 2010. The survey must be implemented by the third quarter of 2010 (July, August, September). Any data that is submitted to CMS within the third quarter will not be publically reported. The public reports will reflect one year’s worth of data.
As for administering the survey, each Home Health Agency must use an approved vendor to distribute amongst their clients. For a list of a few approved vendors, see the CMS website.
The Ghost of a Good Thing
Although the CAHPs survey may be new to Home Health, it has already been initiated into the world of Health Care. For example, between October 2006 and June 2007, the HCAHPS (Hospital CAHPS) survey was discharged and completed by the patients of hospitals. The survey evaluated patient satisfaction and collected invaluable information that allowed medical providers to gain insight for improvement and notified them of already existing flaws. The findings were posted on the Hospital Compare website where a downloadable file of the data is also available. As for the Home Health CAHPS data, the concluded results will be available to the public in early 2010 on the Home Health Compare website at http://www.medicare.gov.
Latest Update
CMS has announced that of the 10,500 certified home health agencies, only about 20% of the agencies have chosen a CAHPs vendor. Exceptions (having less than 60 patients) have been applied for by 9% of agencies. That means that nearly 70% of Medicare certified agencies have not completed the required steps found at www.homehealthcahps.org. Data reporting requirements of HH CAHPs necessary to receive full market basket update in 2012 can be found in the Federal Register notice entitled HH PPS Update 2011 at http://edocket.access.gpo.gov/2010/pdf/2010-17753.pdf.