Consumer Assessment of Healthcare Providers and Systems Surveys

Consumer Assessment of Healthcare Providers and Systems surveys

CAHPS Clinician & Group Surveys

The Visit Survey, which is one of the Clinician & Group Surveys, asks patients to report on their experiences with providers and office staff at their most recent visit to a doctor's office. This instrument addresses feedback from many users regarding the need for a CAHPS survey that focuses on experiences during a single visit rather than over a period of time. More targeted feedback about a visit can provide medical practices with valuable information for monitoring and improvement. Also, many physicians are accustomed to seeing survey results for a visit, which they sometimes perceive as more valid and credible.

The Visit Survey includes a standardized questionnaire for adults and children.

Adult surveys:

CAHPS® Clinician & Group Surveys - 12-Month Survey 2.0 (Adult) (PDF, 70 KB)
CAHPS® Clinician & Group Surveys - 12-Month Survey with Patient-Centered Medical Home (PCMH) Items (Adult) (PDF, 86 KB)
CAHPS® Clinician & Group Surveys - Supplemental Items for the Adult Surveys 2.0 (PDF, 348 KB)
CAHPS® Clinician & Group Surveys - Visit Survey 2.0 (PDF, 75 KB)

Children surveys:

CAHPS® Clinician & Group Surveys - 12-Month Survey 2.0 (Child) (PDF, 81 KB)
CAHPS® Clinician & Group Surveys - 12-Month Survey with Patient-Centered Medical Home (PCMH) Items (Child) (PDF, 95 KB)
CAHPS® Clinician & Group Surveys - Supplemental Items for the Child Surveys 1.1 (PDF, 107 KB)
CAHPS® Clinician & Group Surveys - Visit Survey 2.0 (Child) (PDF, 86 KB)

CAHPS Health Plan Survey

The CAHPS Health Plan Survey is a tool for collecting standardized information on enrollees' experiences with health plans and their services. Since its launch in 1997, this survey has become the national standard for measuring and reporting on the experiences of consumers with their health plans. A version of this survey is conducted in almost every State in the United States.

The NQF-endorsed Health Plan Survey includes standardized questionnaires and optional supplemental items that can be administered to adults and children in commercial plans and Medicaid plans and programs. To be accredited by the National Committee for Quality Assurance, health plans must submit the results of a modified version of the commercial questionnaire. The Centers for Medicare & Medicaid Services also administers a version of the CAHPS Health Plan Survey designed for Medicare beneficiaries.

In-Center Hemodialysis survey

The CAHPS In-Center Hemodialysis Survey (ICH) is a standardized questionnaire for adult hemodialysis patients who receive care from dialysis facilities. This survey asks adults with end-stage renal disease about their experiences with the facility that provides their hemodialysis. It is intended to serve as a tool that both facilities and End-Stage Renal Disease Network can use to measure and improve the patient-centeredness of their care.

Core ICH Survey with Supplemental Items (PDF, 136 KB)

CG CAHPS – Clinician & Group CAHPS for ACOs

12 domains of 94 questions Field Test Survey of May 29, 2012
The Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CGCAHPS) survey is a standardized tool to measure patient perceptions of care by physicians in an office setting.

HCAHPS - The Hospital Consumer Assessment of Healthcare Providers and Systems formal public reporting initiative asks your patients to rate their experiences with respect to various health care delivery systems. These ratings are shared with the public and can potentially affect your hospital's reputation and standing in the community it serves, and will be used in calculating value-based purchasing payments going forward.

HHCAHPS - The Home Health Care Consumer Assessment of Healthcare Providers and Systems Survey will initially be enforced on a pay-for-reporting basis, but will likely transition to a pay-for-performance structure.

Patient Satisfaction Surveys

Client Satisfaction Questionnaire (CSQ Scales)

In use since 1979, intended to measure and assess consumer satisfaction with health and human services. They are not specific for Behavioral Health

Patient Satisfaction Survey, based upon the review of integration literature and input from demonstration site representatives, is a 9-item general satisfaction survey developed to improve consumer satisfaction with services and the model, as well as comfort levels with treatment and treatment setting;

Patient Satisfaction Questionnaire from RAND Health

Visit-Specific Satisfaction Instrument (VSQ-9)

The VSQ-9 is a visit-specific satisfaction instrument adapted by the American Medical Group Association from the Visit Rating Questionnaire used in the Medical Outcomes Study, a two-year study of patients with chronic conditions.
To score the VSQ-9, the responses from each individual should be transformed linearly to a 0 to 100 scale, with 100 corresponding to "excellent" and 0 corresponding to "poor." Responses to the 9 VSQ-9 items should then be averaged together to create a VSQ-9 score for each person.

Quality of Life Instruments

RAND Medical Outcomes Study (MOS):

Core Survey: Measures of Quality of Life
Short Forms:12-Item (SF-12), 20-Item (SF-20), 36-Item (SF-36)

Daily Living Activities (DLA-20)

To assess level of functioning for persons with severe mental illness

Palliative Care Outcome Scale (POS) is a validated scale developed in the UK which assesses quality of life outcomes for patients with advanced cancer. It addresses physical, psychological and spiritual domains which are relevant to palliative care. It consists of two nearly identical sets of ten measures – one to be completed by the patient, independently, and one by a staff member:

Collecting assessments from both patients and staff allows the identification of differences between patients’ self-assessment and staff assessment of their needs.
Patients have found the POS a useful communication tool in relation to their needs
The POS has been validated for use in both inpatient and outpatient palliative care settings, and has also been studied in the nursing home setting, including patients both with and without dementia.

The following is a selection of tools designed to measure quality of life for patients with advanced disease.

EORTC QOL Scale A 30-item, cancer specific questionnaire developed by the European Organization for Research and Treatment of Cancer for assessing the quality of life in cancer patients. Contact the EORTC Quality of Life Department for more information:
FACT-G (FACT-L) Used to assess the functional status of patients with specific cancer diagnosis.Complete the FACIT User's Agreement in order to access and use this tool.
McGill Quality of Life IndexA 20-item scale specifically developed to measure quality of life at the end of life. Contact the author at to complete the User's Agreement and obtain a copy of this tool.
Missoula-VITAS Quality of Life Index (MVQOLI)The MVQOLI asks patients about 5 dimensions or domains of quality of life:symptoms; function; interpersonal; well-being; and transcendence. The instrument is specifically designed to assess the patients personal experience in each of these dimensions. Please register with the author to use this tool.
Needs at the End-of-life Screening Tool (NEST) NEST is a comprehensive assessment and outcome measures instrument.
Quality of Life at the End of Life (QUAL-E)A tool to assist in the evaluation of the quality and effectiveness of interventions targeting improved care at the end of life.

Behavioral Health

AHRQ - Consumer Assessment of Behavioral Health Services (CABHS). CABHS is based on CAHPS and was developed to collect ratings from consumers about services received from MBHOs. Consumer ratings of behavioral health care services can help to evaluate and identify ways to improve behavioral health insurance plans.

The 56 questions in the CABHS survey ask consumers about their experience in finding a clinician, getting approval for treatment, getting prompt counseling or treatment, communication with clinicians, and customer service, as well as staff, paperwork burden, written materials, and how much the treatment helped patients. CABHS also collects information from clinicians about medications, treatment options, and patient rights.

Based on the CABHS data collected in this AHRQ-funded study, along with data from a previous study using the Mental Health Statistics Improvement Program (MHSIP), researchers developed the (ECHO™).

ECHO 3.0 - Experience of Care and Health Outcomes has two surveys—one for MBHOs and one for health plans. Both surveys ask the same questions, but the health plan survey includes questions about administrative services, such as filling out paperwork and finding information in written materials. The surveys can be downloaded for free from the Web site: Consumers, clinicians, MBHOs, health care plans, purchasers, States, and Federal agencies can collect consumers' ratings of their behavioral health treatment, including mental health and alcohol, drug, and other substance abuse services. ECHO™ assesses specific aspects of care, including getting care quickly, communication with clinicians, information provided by clinicians on medication side effects, family involvement in care, information about self-help groups and treatment, cultural competence, perceived improvement in functioning, patient rights, and health plan or MBHO administrative services.

ECHO has been adopted as a CAHPS® instrument. In addition, NCQA adopted ECHO 1.1H, which excludes 13 questions from the original MBHO version, and made it a part of the NCQA Quality Assurance Plan HEDIS® (the Health Plan Employer Data and Information Set) 2003 Survey Measures. ECHO™ 1.1H was designed to target quality assessment by MBHOs and assesses aspects of care such as overall satisfaction with counseling and treatment, getting treatment quickly, communication with clinicians, access to treatment and information from the MBHO, office wait times, ability to refuse treatment, and receipt of information about treatment options, medication side effects, managing conditions, and patient rights.

The Duke Health Profile (Duke) is a 17-item standardized self-report instrument containing six health measures (physical, mental, social, general, perceived health, and self-esteem), and four dysfunction measures (anxiety, depression, pain, and disability).

Federal Initiatives

CMS has indicated that they are interested in whether Performing Providers are participating in or are implementing DSRIP projects to expand upon the following federal initiatives.

CMS Innovation Center Grants:

Accountable Care Organizations (ACOs)

Advance Payment Model

Pioneer ACO Model

Bundled Payments for Care Improvement

Comprehensive Primary Care Initiative

Federally Qualified Health Center (FQHC) Advanced Primary Care Practice Demonstration

Graduate Nurse Education Demonstration

Health Care Innovation Awards

Independence at Home Demonstration

Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents

Medicaid Emergency Psychiatric Demonstration

Partnership for Patients

State Innovation Models Initiative

Strong Start for Mothers and Newborns

HITECH payments:

EHR incentive payments

Health Information Exchange Grant

Other HITECH grant or payment

HRSA grants:

FQHC/ RHC/ School-based health center grants, including capital grants

Health professions loans and workforce development grants

Ryan White funding

Maternal and child health grants

SAMSHA Funding (list of SAMSHA grants by state):

Community Mental Health services block grant

Substance Abuse Prevention and Treatment Block Grant

Other mental health and substance abuse grants

CDC grants (list of CDC funding by state):

Immunization grants

CLASBI/ Hospital acquired infection initiatives