Frequently Asked Questions on HH-CAHPS

Q: What is CAHPS?
A: CAHPS originally stood for Consumer Assessment of Health Plan Survey. The original CAHPS tool was developed by AHRQ (Agency for Healthcare Research and Quality) and is used by health plans to understand their members' perception of their quality of health care. The CAHPS team has expanded the number of survey tools within the suite of surveys developed by AHRQ. The CAHPS acronym has been changed to denote Consumer Assessment of Healthcare Providers and Systems. The family of surveys now includes tools for different types of facility care (e.g., HCAHPS or Hospital CAHPS, NH CAHPS or Nursing Home CAHPS) and ambulatory settings (e.g., CG-CAHPS or Clinician and Group CAHPS).

The Home Health Care CAHPS (HH-CAHPS), a standardized tool to measure home health patient perceptions of their care, is currently under development.

AHRQ's CAHPS resource page: https://www.cahps.ahrq.gov/default.asp

Q: What is HH-CAHPS?
A: HH-CAHPS refers to Home Health Care CAHPS, a tool being designed to assess patient perceptions of care provided by Medicare and Medicaid certified Home Health Care Agencies. The tool is designed for adult patients who currently receive home health care or who have been recently discharged from home health care. The patient population includes those who received skilled care (not related to pregnancy), regardless of payor type.

AHRQ's CAHPS resource page for HH-CAHPS: https://www.cahps.ahrq.gov/content/products/HH/PROD_HH_Intro.asp?p=1021

Q: Who Initiated the Development of HH-CAHPS?
A: CMS initiated the development of the tool and requested that AHRQ develop the survey as a measure of quality for the Home Health Care arena.

Q: Who is Developing HH-CAHPS?
A: The CAHPS team within AHRQ is developing the CAHPS tool.

On December 6, 2007, AHRQ placed a call for comments in the Federal Register regarding the draft instrument and methodology. It is anticipated that the draft survey will be tested at 36 home health care agencies.

Q: What is the Status of the HH-CAHPS Instrument?
A: Currently the HH-CAHPS draft survey is undergoing initial testing which is expected to be completed by the end of April 2008.  Data analyses and the final question set are expected to be completed in in June.

Q: Will HH-CAHPS be Linked to Payment?
A: UPDATE: Press Ganey Associates has received informal indications that the time line to implement the HH-CAHPS tool could be delayed.  As soon as a formal announcement has been made by CMS we will provide an update.  This pilot testing of HH-CAHPS is being done in conjunction with the Centers for Medicare and Medicaid Services (CMS), which has mentioned in the most recent home health payment proposed rule the possibility of including this survey as part of the pay for reporting requirements for home health agencies in CY 2010. CMS plans national implementation of Home Health CAHPS in calendar year 2009. CMS plans to seek National Quality Forum endorsement of the Home Health CAHPS survey instrument in Summer 2008.

Q: What Concept Areas are Included in the Draft of HH-CAHPS?
A: There are several broad areas of patient care represented on the survey including: patient experience with home health staff, patient experience with agency office, patient ratings of service quality and demographics.

Q: What is Press Ganey's Involvement in the Development of HH-CAHPS?
A: Press Ganey responded to AHRQ's initial call for measures for the HH-CAHPS tool in the fall of 2006 and has provided additional research-based information regarding measuring patient perceptions of home health care. Press Ganey has also provided comments on the draft version of the survey through the Federal Register comment submission process.

Q: What is the Time line for the Development of HH-CAHPS?
A: UPDATE: Press Ganey Associates has received informal indications that the time line to implement the HH-CAHPS tool could be delayed. As soon as a formal announcement has been made by CMS we will provide an update.

• September 2006 Call for Measures
• February 2007 Technical Advisory Panel review
• Spring 2008 Pilot Testing (anticipated)
• Summer 2008 Submission to the National Quality Forum (anticipated)
• 2009 CMS National Implementation (anticipated)
• 2010 CMS link of HH-CAHPS to Pay for Reporting (anticipated)

Q: What are Some of the Expected Requirements for HH-CAHPS based on HCAHPS Experience:
A: Based upon our experience in fielding the HCAHPS survey, we expect that HH-CAHPS will require vendors or self-administering organizations to:

• Determine eligible patient populations
• Conduct a random sample of eligible patients, removing patients who have received a previous survey within a calendar month
• Document the process used to meet the CMS requirements by detailing total number of eligible patients, total number sampled, and method of sampling used.
• Track the patient survey through the administration process to link the resulting patient responses back to required administrative data for submission
• Document the final disposition status of the survey (e.g., complete with at least half of the questions completed, incomplete, ineligible due to patient death, ineligible due to language barrier or physical or mental incapacity)