blog post 05062016

CAHPS Survey Program Will Grow Further in 2016

In this issue of the PX Advisor we focus squarely on nursing, on human resources and training challenges, in light of the changing healthcare environment. This post excerpts our regular RE-CAHPS article by Karen Sorensen, Associate Vice President, National Initiatives, HealthStream. Subscribe to PX Advisor.

This year may surpass 2015 in terms of new and evolving Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient experience surveys. With four new CAHPS programs in development, the voluntary national implementation of another that began in January, and significant changes looming that impact the Physician Quality Reporting System (PQRS), we can’t afford to ignore the patient experience in 2016. In a world of change, the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) have embraced transformation. By the end of this year, HHS plans to tie 30% of Medicare payments to quality through one of the following payment models:

  • Fee-for-service with a link of payment to quality
  • Alternative payment models built on fee-for-service architecture
  • Population-based payment

    That percentage increases to 50% by the end of 2018. CAHPS patient experience surveys are an integral part of CMS’s strategy to improve healthcare quality. That explains why we have seen multiple quality programs add a CAHPS survey to their reporting measures. The table below provides a snapshot of the major CAHPS surveys that HealthStream supports, as well as current news that may impact your facility in 2016. We’ve also included an update on HealthStream’s new approach to surveying clinic patients, and the Merit-based Incentive Payment System or MIPS.

    HealthStream’s New Approach to CG-CAHPS

    Physicians and providers measured by the CG-CAHPS survey continue to express concerns about that survey and the traditional methodologies for gathering patient feedback. After conducting clinic surveys for over 10 years, we’ve heard providers loud and clear. They want a short survey that is focused solely on the things that matter, immediate feedback about a specific visit, and a convenient way for patients to respond. With this feedback in mind, HealthStream’s CG-Express survey will include only the questions that drive accountability and improvement. We are in the process of validating the survey tool now, as well as testing new administration protocols that will allow patients to respond in a manner that’s most convenient for them–via text, email, or phone.

    Goodbye PQRS… Hello MIPS

    The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is set to make changes to how CMS pays Medicare providers. In addition to ending the Sustainable Growth Rate formula, the MACRA combines existing quality reporting programs into one new system. The MACRA aims to help Medicare achieve its goal of paying for value and better care through two programs:

  • Merit-based Incentive Payment System (MIPS)
  • Alternative Payment Models (APMs)

Under the MACRA, parts of the Physician Quality Reporting System (PQRS), the Value Modifier, and the Medicare Electronic Health Record (EHR) incentive program have been combined into a single new program called MIPS. While the 2018 PQRS payment adjustment is the last adjustment that will be issued under PQRS, certain aspects of that program will be incorporated into MIPS, including the CAHPS for PQRS Survey.

Just like we have seen with the Hospital Value-Based Purchasing Program and other alternative payment models, Medicare is steadily transitioning from traditional fee-for-service payments to paying for value and quality. When fully implemented, MIPS providers will be subject to a +/- 9% adjustment to their Medicare payments. APM providers will be eligible for a 5% incentive payment and are excluded from MIPS reporting. Although MIPS and APMs do not begin until the 2017 performance year at the earliest, the fact that MIPS mandates and includes elements of Meaningful Use, PQRS, and the Value Modifier means that the best thing an organization can do now is to continue to improve performance for those three existing programs.

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