# Presentation: 377688

## Updating CAHPS®:Consumer Surveys for Doctors, Groups, and Health PlansPresented by the CAHPS Survey Users Network (SUN)

## CAHPS Surveys Grounded in Four Principles

- Reports and ratings of experiences -- not just satisfaction
- Standardization to enable valid comparisons
- Evidence basis for design, protocols, and language
- All tools, services in public domain

## CAHPS II Consortium: Public-Private Research Team

**CAHPS II Consortium**

- Grantee Teams

- AHRQ

- Westat

- AIR

- Harvard

- RAND

- CMS

- CDC

- NIDRR

- Federal Agencies

## Today’s Panelists

**Charles Darby**, Co-Project Officer for CAHPS at AHRQ
**Julie Brown**, Member of RAND Team
**Dale Shaller**, Member of Harvard Team

## Technical Assistance Tips

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**Problem with ****audio stream****?**Dial 1-888-496-6261; Password “CAHPS”
**Problem on the ****phone****?**Dial “star-zero” for technical assistance.

## Charles Darby

- Co-Project Officer for CAHPS
- Agency for Healthcare Research and Quality

## CAHPS: Not Just a Health Plan Survey Anymore

- Family of surveys: comprehensive and evolving
- Consumers and patients evaluate  interpersonal aspects of health care
- Includes free technical assistance/tools

## A Growing Family of Surveys

- Ambulatory Level
**Health Plans**
**Group Practices**
**Behavioral Health Organizations (ECHO) **
**Individual Clinicians***

- Facility Level
**Hospitals**
**Dialysis Facilities***
**Nursing Homes***

**CAHPS Family**

** In development*

## Why Ambulatory Surveys? Responding to Users’ Needs

- Products for multiple levels of ambulatory care
- Shorter time-to-market for new products
- Results that can drive QI

## Ambulatory Surveys Offer Flexibility: Example

- Core Plan Survey

- After-Hours Care Module

- Provider Communication Module

**+**

**=**

- Your Health Plan Survey

## Prepackaged Surveys Available for Ease of Use

- Core Survey

- Commonly Used Modules

**+**

**=**

- Prepackaged Survey

## Audience Poll Results – Question 1: Which level are you primarily interested in as either a survey sponsor or a user of survey results?

## Audience Poll Results – Question 2: If you anticipate fielding a survey, which levels of the system would you ask about? 

## A-CAHPS Draws Heavily on CAHPS 3.0

- ExistingCAHPS Surveys

- Health Plan

- Group

- Clinician

- Sorted by level

**+**

- New Items for

- Health Plan

- Group

- Clinician

**=**

- CAHPS Ambulatory Surveys

## From Core Survey to Mix & Match Options

- Core Plan Survey

- Commonly Used Modules

**+**

**=**

- Prepackaged Survey

- Your Choice of Modules

**+**

**=**

- Your Customized Survey

- Pre-packaged Survey

- Your Choice of Modules

**+**

**=**

- Your Customized Survey

- Core Plan  Survey

## Key Sources of Input on Existing Instruments

- PBGH
- ICSI
- AMGA
- MGMA

**Health Plan**
- NCQA
- CMS
- URAC

## Consortium Seeks User Feedback and Input

- How are you currently using CAHPS surveys?
- What do you need from the Consortium?
- What can we do to make products meet your needs?

## Julie Brown

- Project Leader for Ambulatory CAHPS
- Member of RAND Team

## Ambulatory Surveys to Assess Care at Three Levels

- Health Plans

- Group Practices

- Clinicians

## Ambulatory Surveys to Cover Seven Domains

- Doctor Communication

- Coordination/Integration

- Access

- Office Staff Courtesy, Helpfulness and Respect

- Shared Decision-Making

- Health Promotion and Education

- Customer Service

## Criteria for Selecting Domains

- Important for reaching, maintaining a high level of quality
- Important to consumers in selecting health care
- Aspects of care for which consumers are best or only judge

## From Domains to Topics to Items: An Example

**Domain:  Access**

**Topics**
- Getting needed care
- After-hours care
- Utilization
- Getting care quickly
- Wait time
- Special services
- Prescriptions

**Items**
- Problems seeing a specialist
- Problems getting care, tests, or treatment
- Etc.

## Why Use Core Items?

- To construct valid composites
- To ensure comparability of results across users
- To facilitate benchmarking

## Why Use Supplemental Items?

- To provide detailed information within a domain or level
- To provide data for quality improvement

## Dale Shaller

- Principal, Shaller Consulting; Managing Director, NCBD
- Member of Harvard Team

## Many Inputs Into CAHPS Development Process

- Cognitive interviews

- Literature and existing instruments

- Call for measures

- Public and stakeholder input

- Focus groups

- Field testing

- CAHPS Surveys

## Some Ways to Provide Input

- Contact CAHPS SUN:
- Email: cahps1@westat.com
- Phone:  1-800-492-9261
- Respond to formal call for measures (Federal Register, June 10, 2004)
- Respond to invitation to test instruments (Federal Register, Summer 2004)
- Create/update user profile on SUN site

## Attend CAHPS User Group Meeting (UGM)

- When: 	December 2-3, 2004
- Where:	Marriott Waterfront, Baltimore, Maryland

- For more information, visit www.cahps-sun.org.

## How to Contact CAHPS SUN

- Email: cahps1@westat.com
- Phone: 1-800-492-9261
- Website: www.cahps-sun.org

## Timeline for Health Plan Survey

- Summer

- Fall

- Winter

- Summer

- Spring

**More input from users;**

**Finalize draft**

**Cognitive testing of “beta” version**

**Release health plan survey**

**Present to NCQA, CMS, URAC**

- 2004

- 2005

**Field testing**

## What’s Included in the  Development Process?

- What’s Included in the  Development Process?

**Survey****Administration**

**Data Analysis**

**Public Reporting**

**Use for QI**

**Evaluation**

**Survey Content**

## ICSI & Partners Testing Instrument for Groups

**Stage 1:  Survey Design**
- Adapt G-CAHPS for quality improvement
**Stage 2:  Action Group**
- Implement survey
- Identify priorities
- Implement process  improvements
- Assess impact

- Harvard CAHPS Team

- ICSI

- Eight Medical Groups

## Key Sponsors of Surveys for Groups, Clinicians

- Institute for Clinical Systems Improvement
- Pacific Business Group on Health
- Centers for Medicare & Medicaid Services
- Massachusetts Health Quality Partners
- TRICARE
- Central Florida Health Care Coalition

## PBGH Testing Short Survey at Clinician Level

- Pacific Business Group on Health collaborating with 11 medical groups
- Fielded 15-item instrument to 30,000 patients
- Testing item validity, administrative protocols, sampling methods

## Audience Poll Results – Question 3: If your organization sees the results of a CAHPS survey, have you ever used those results to identify specific strengths and weaknesses with respect to patients’ perceptions of care?

- n=91

**Yes**

**No**

## Audience Poll Results – Question 4: If you answered “yes” to the previous question, did you use this information as part of a quality improvement project?

- n=77

**Yes**

**No**

## To Ask a Question

- By Phone
- If on phone, press “*-one”
- If on computer, dial 1-888-496-6261; use password: CAHPS

- Via the Internet
- Click “Q and A” button
- Type in question
- Click send

## To Ask a Question

- By Phone
- If on phone, press “*-one”
- If on computer, dial 1-888-496-6261; use password: CAHPS

- Via the Internet
- Click “Q and A” button
- Type in question
- Click send

## Unanswered Questions?	

- Send email to cahps1@westat.com
- Log onto SUN Web site:  www.cahps-sun.org
- Presenters’ slides
- Archived webcast with streamed audio
- Written transcript

## Upcoming Events	

**Reporting Workshop**
- Topic: Reporting CAHPS Results to Medicaid and SCHIP Consumer Audiences
- When: Early Fall
**User Group Meeting**
- When:  December 2-3, 2004
- Where: Marriott Waterfront, Baltimore, MD