Home Health & Hospice Week

New patient satisfaction survey has four big flaws, reps point out. You may not have to use the new CAHPS patient satisfaction survey for home health agencies now, but chances are you soon will. The National Quality Forum has endorsed the new 34-question Consumer Assessment of Healthcare Providers and Systems HHA survey and the Office of Management and Budget has concluded its comment period on the new form. Now the Centers for Medicare & Medicaid Services plans to incorporate any final changes and roll out implementation of the voluntary patient satisfaction tool this summer, says contractor RTI on the CAHPS Web site. For now, it's up to agencies whether they want to voluntarily collect the survey data through a vendor. But if they do, their scores after four quarters of collection will go onto the Home Health Compare Web site. Pretty soon, the survey may not be optional,industry veterans predict. That's because law- and policymakers may be eager to use CAHPS-collected measures as part of a pay for performance (P4P) payment structure. Having a standardized patient satisfaction tool that allows HHAs to compare themselves is a good idea, says the National Association for Home Care & Hospice in its OMB comment letter. But there are four key problems with the new form that should be ironed out, especially before it becomes mandatory: • Length. "We remain concerned about the practicality of an instrument of this size," notes Bob Wardwell with the Visiting Nurse Associations of America, who is retiring from VNAA this summer.CMS cut the questionnaire length from 36 to 34 questions as part of the NQF endorsement process, but that still leaves a lengthy instrument. "Home health patients, most of whom are elderly and frail, may avoid participating in HH CAHPS surveys due to its length," NAHC worries in its comment letter. Both the number of questions and "wordiness of some individual questions" are problems.NAHC urges CMS to streamline the tool. • Repetitive questions. Part of the length problem comes from questions that are redundant, especially to non-expert patients, NAHC maintains. For example: "From a clinical practice perspective,there are important differences between the [seven] medication questions posed," NAHC notes."However, patients may find them redundant and confusing since the wording of these questions is very similar." Some of the questions may not be "really understandable to all patients," fears Wardwell, a former top CMS official. NAHC urges CMS to cut five of the med questions and consolidate some of the queries into one new question. Similarly, three questions about which disciplines patients saw could be combined into one concise question, the trade group suggests. • Respondents. Findings may be suspect due to "the issue of who actually is responding when [...]