The Centers for Medicare & Medicaid Services (CMS) requires Medicare-certified home health agencies with 60 or more patients in the last 12 months (April 1, 2014 – March 31, 2015) to conduct the Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) surveys. However, all agencies — regardless of the number of patients they serve — should implement these assessments.
The surveys, which capture patient experiences, help agencies to:
- Improve patient outcomes. The surveys reveal deep insights into the care delivered by nurse and therapy clinicians. The 34 standard questions focus on:
- How well home health agencies cared for their patients
- How often each agency used best practices when caring for their patients
- If patients improved in certain important areas of care
- Patients experience with recent home health care
Agencies that are committed to providing exceptional patient care, will keep a pulse on their feedback through both formal and informal means. They should adopt a standardized patient survey instrument such as HHCAHPS. They should also adopt best practices in care delivery, standardize them across clinicians to ensure consistent results and assess the results through both process and outcome measures.
- Catch potential audit issues. The analytic and benchmarking technological capabilities of HHCAHPS offers agencies a measure of safety against audit risk. The surveys can assist in an agency’s holistic view of risk agency-wide by monitoring potential problem areas. While the surveys are not directly aligned with audits, agencies that use HHCAHPS surveys and apply corrective actions, where needed, will be better prepared with a more comprehensive risk reduction strategy when the auditors arrive. Agency operators can monitor their progress through future survey results.
- Use as marketing tool to grow business. The Home Health Compare site lists all home health agencies – those that are participating in the surveys and those that are not. Survey results are aggregated and published as ratings for those agencies using HHCAHPS surveys. For agencies not using HHCAHPS surveys, “Not Available” is stated.
- Prepare for future Value-Based Purchasing (VBP). The Affordable Care Act requires implementation of VBP programs across all healthcare settings that are Medicare-certified. The programs are based on better value at an affordable cost, accountability for improved patient outcomes and patient-focused care instead of the volume of services provided. The new reimbursement models pay for performance through financial incentives tied to quality measures and cost reduction, and patient satisfaction (measured utilizing CAHPS). Last November, CMS announced in Final Rule CMS-1611-F their intent to implement a Home Health VBP program in calendar year 2016.
Two of the ratings are “Overall Rating of the Home Health Agency” and “Would You Recommend this Agency to Family and Friends.” Those agencies with higher ratings will stand out among competitors and will more likely be selected by consumers.
Additionally, survey results are publicly published on CMS’s Home Health Compare site. Agencies can measure their performance against regional benchmarks and against the competition to identify areas of strengths and weaknesses.
Higher ranking agency operators would be wise to use the data as a marketing tool to grow their businesses. The provider’s overall ranking could be used in various marketing formats and activities to promote their quality of care to prospects as well as reinforce their reputation to existing clients to retain their business. CMS publishes new survey results on a quarterly basis to update the ratings.
The HHCAHPS surveys will help agencies prepare for a shift from volume-based fee-for-service reimbursements to value-based reimbursements. Agencies that are better aligned with initiatives that are focused on the quality of care will transition to a VBP program more easily.
CMS requires that agencies use an Approved HHCAHPS Survey Vendor. Approval is granted to a vendor after successfully undergoing a rigorous approval process. The vendor must demonstrate that it has conducted surveys of individuals as an organization for at least two years, demonstrate a statistical sampling process, currently possess all required facilities and systems to implement the HHCAHPS survey and have the ability to perform quality assurance.
Home health agencies should not implement HHCAHPS surveys solely based on whether they meet the requirements of the CMS mandate to adopt the surveys. Agency operators should also consider implementing the surveys to gain crucial understanding of patient experiences associated with their services, which can be leveraged to improve patient outcomes, better prepare for CMS audits, market their organization to grow their businesses and better prepare for future implementation of a VBP program. A list of approved vendors is available on the Home Health Care CAHPS Survey site.
