ASC-CAHPS is Coming: Is Your ASC Prepared?
In a session at the 20th Annual Ambulatory Surgery Centers Conference in Chicago on Oct. 25, Paul Faraclas, MBA, president and CEO of Voyance, discussed the development of the ASC Consumer Assessment of Healthcare Providers and Systems survey, which is currently being developed by CMS.
The comment period for the ASC-CAHPS has passed, and it is expected for the program to roll out in 2017, Mr. Faraclas explained.
The survey will mirror the HCAHPS survey that currently impacts hospitals’ Medicare payments, as well as the CG-CAHPS for caregivers/providers and the HH-CAHPS for home health providers.
ASCs' scores on the ASC-CAHPS, once it is rolled out, are expected to impact their reimbursement, as well how they are perceived by consumers. “CAHPS are tied to reimbursement, but more importantly, they are tied to your brand.”
While CMS’ move to reimburse based on patient satisfaction may seem promising for centers with patient satisfaction scores in a top percentile, Mr. Faraclas warned that the CAHPS survey is much more difficult to score well on, because of how it is designed.
CAHPS surveys rely on frequency-based questions, and for these type of questions, “it’s very, very difficult to achieve that top box” he said.
Why is the top box so important? Because of how CMS currently reports CAHPS scores on its public websites, such as hospitalcompare.gov.
Consider this example: On the HCAHPS, patients are asked the question “How often did doctors treat you with courtesy and respect?” and they may select, always, usually, sometimes or never.
Now imagine a patient has been in the hospital for five days and one of six doctors who the patient interacted with was once disrespectful. The patient selects “usually.”
Currently, CMS only compares hospitals on how many patients selected “always.” So, it’s possible a hospital could have an overall higher score on a measure than another hospital but look like the lower performer on hospitalcompare.gov because fewer patients selected the highest possible rating.
Mr. Faraclas provided an analogy. A friend asks you for a restaurant recommendation, you give a name and tell him it’s a great place. Now, imagine he instead asks how often staff at the restaurant filled your water glass when it was low. If they missed one time in the last few visits, you wouldn’t say “always.” Instead, “usually” would be more likely.
“That’s one of the flaws,” said Mr. Faraclas. To prepare for these type of ratings, providers must create an “always” organizational culture – what he refered to as “the always shift.”
“There is no credit for second place,” he added.
What will the ASC-CAHPS look like?
Based on existing CAHPS surveys, Mr. Faraclas said he expects the ASC-HACPS will contain five or six composite measures that include:
- 2-3 measures on surgeon communication and perception
- 2-3 measures on nurse communication and perception
- 1 measure on pain control
- 1 measure on cleanliness, safety or privacy
- 2 global measures: a 1-10 overall rating of the center, and 1-10 rating of how likely would the patient would be to definitely recommend the ASC.
“Physician-owned hospitals and surgery centers perform a lot better than hospitals typically do,” Mr. Faraclas said. “If it’s considered to be an equal playing field, ASCs will perform better.”
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