Improving Home Health CAHPS Results, One Question at a Time


This is the first in a series of blogs on the importance of HHCAHPS surveys and their value to helping improve patient outcomes and growing business. 

The Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) patient engagement survey impacts the bottom line of home health agencies, primarily through attracting referral sources and value based reimbursement.  The HHCAHPS survey is also important for engaging patients through the survey process and gaining insight from how patients rate the services received from your home health organization.

Patient Opinions Quantified

Patient opinion is the source of truth when rating organizations on the quality of care delivered.   Gathering perceptions of the patient's care experience is tremendously valuable, and focuses on more than just their level of satisfaction.

The HHCAHPS survey was developed to standardize the collection of patient feedback. This makes it possible to measure the quality of care provided by home health agencies (HHAs) as rated by patients receiving care.

Surveying Mandatory to Improve Patient Choice

Since April 2012, the HHCAHPS survey has become mandatory and the results are publicly reported on Home Health Compare, allowing the general public to better understand the quality of care provided by HHAs and select services.

The Centers for Medicare and Medicaid Services (CMS) has introduced a number of programs to shift the healthcare system from fee-for-service (paying for volume) to value-based reimbursement (paying for value) through the introduction of various quality measures, which include the HHCAHPS survey.  Numerous payors and referral sources have also identified potential home health partners through the Home Health Compare data, which may potentially negatively impact home health agencies with lower HHCAHPS values.

Elements of the HHCAHPS Survey

The HHCAHPS survey consists of 34 questions. The first 25 questions serve as the core questions, and the remaining nine questions in the "About You" section are used for analysis.  It takes respondents an average of 12 minutes to complete the HHCAHPS Survey, and the core questions are summarized into the following five categories or domains:

  • Care of Patients
  • Communication Between Providers and Patients
  • Specific Care Issues
  • Rating of The Home Health Care (10 Point Rating Scale)
  • Would You Recommend This Home Health Agency

These domains are publicly reported through the Home Health Compare, the Home Health Star Ratings program and the Home Health Value-Based Purchasing demonstration program.  Therefore, it is imperative for organizations to understand the HHCAHPS survey, how to improve each measure and how to use the domains for maximizing their organization's long-term growth and sustainability.

Improving HHCAHPS Measures

A starting point for improving HHCAHPS measures is to ensure you are familiar with the survey, and the questions.  Next, educate your staff and clinical staff on the survey, and encourage them to mention the survey to patients.  Staff may highlight that a survey will be administered during the Start-of-Care and Resumption-of-Care, and patients may be surveyed by Axxess or your current HHCAHPS survey vendor.

CMS does not allow you to share a copy of the HHCAHPS survey with patients, tell the patient how to answer, or demand the patient provides a positive review. A great way to educate staff on elements of the HHCAHPS survey is to review a question at each staff meeting and discuss ways to improve processes to continually better patient care.

In our upcoming blogs, we will review each of the five HHCAHPS domains and questions asked to patients to provide more insight for improvement and better patient engagement.