Home Health & Hospice Week

If you're dreading the 2011 implementation date for the new Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey tool, you aren't alone Each agency uses the patient satisfaction tool they want -- and the differences between tools can be vast. This leaves the Centers for Medicare & Medicaid Services without a reliable method to compare how well agencies are performing, points out Elizabeth Hogue, a health care attorney based in Burtonsville, Md. The new CAHPS tool is designed to eliminate that problem by "giving agencies a standardized tool that will allow surveyors to better gauge patient satisfaction," she says.

Good news: While you and your patients will need to incorporate a whole new questionnaire, you can make the process a bit easier, said Elizabeth Goldstein, director of CMS' Division of Consumer Assessment & Plan Performance, in the Sept. 9 Home Health, Hospice, and DME Open Door Forum.

One reason many agencies aren't happy about using the CAHPS survey is agencies want specific information from patients that the standardized tool doesn't ask for.

Best: You can integrate your favorite questions into the standardized tool, Goldstein revealed in the forum. The survey has 25 core questions (1-25) and 9 value questions (26-34). Each of those questions must remain on the survey tool without any modification, but agencies can squeeze in many of their own questions in between those two sets, she explained. Some common supplemental questions that many agencies plan to add include:

• Did this home health care start as soon as you thought you needed?

• Did your care from this agency follow a stay in a hospital, nursing home, or rehabilitation center?

• In the last two months of care, how often did home health providers from this agency behave in a professional manner?

• Is there anything else you'd like to say about the care you received?

Resource: The CAHPS Web site (www.homehealthcahps.org) offers a bevy of supplemental information that you can use to customize the questionnaire so that you get the most bang for your buck.

While you won't have to use the CAHPS questionnaire until 2011, you don't have to wait that long to hammer out your policies and procedures.

CMS is encouraging home health agencies to voluntarily start participating in the survey starting in October, Goldstein said in the forum. However, agencies can begin participating in the last month of any quarter. So, to participate in Q409, they'd do a dry run in December 2009.

Why do it: If you start collecting patient data now, you'll have plenty of time to work out any kinks in the process as well as gain valuable practice in "conducting data collection, pulling samples, and submitting samples to a vendor's data center," Goldstein explained.

How to participate: While participation is voluntary, agencies do need to follow certain steps to make sure their hard work pays off.

Step 1: Notify CMS that you plan to participate by registering at the Home Health CAHPS Web site, www.homehealthcahps.org.

Step 2: Contract with an approved CAHPS survey vendor. CMS offers a list of approved survey vendors at https://homehealthcahps.org/GeneralInformation/ApprovedSurveyVendors.aspx.

Step 3: Apply for access to secure sections of the CAHPS Web site. Goldstein recommends that each agency select two staff members who will have access to the secure site: one who is appointed as the official CAHPS monitor and one to act as a back up when the monitor is unavailable.

Step 4: Authorize an approved survey vendor to submit data on the agency's behalf.

Everyone involved in the collection and reporting process has specific tasks and responsibilities that they must carry out or the survey won't work, Goldstein says. Use this breakdown to help staffers at your agency better understand where they fit -- and what they can expect:

1) The CMS and the CAHPS Survey Coordination Team will provide training and technical assistance to vendors. They will ensure collected data's integrity by conducting oversight and quality assurance for vendors. The team is also tasked with analyzing and publicly reporting collected data on Home Health Compare.

2) Home health agencies must contract with an approved survey vendor and then compile and deliver information on discharged patients to the survey vendor each month. Agencies must also monitor vendors' data submissions and preview the publicly reported results to ensure all data is accurate.

3) Vendors must apply to become approved and participate in all training sessions. They must follow survey protocol and guidelines, work with clients to create monthly patient files, and review and process that data. Vendors must also submit monthly files each quarter, review data submission reports, develop and submit a quality assurance plan to CMS and participate in all oversight activities.