2/9/2016
CAHPS and Patient Experience:
Outlook for 2016
Jeanna Founds, CPHQ
Patient Experience Advisor
February 2016
Today’s Agenda
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ƒ
ƒ
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Overview of CAHPS Landscape
Overview of OAS-CAHPS requirements and timeline
Impacting the Patient Experinence
Q&A
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CAHPS Updates
Regulatory Timeline
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Acute CAHPS Requirements
Key milestones for CMS programs, payment models
2015
2016
2017
Inpatient Hospitals
HCAHPS continues tied to APU and used within VBP
Pediatric Inpatient Hospitals
Child HCAHPS implementation (voluntary)
Hospital Outpatient
Departments, Ambulatory
Surgery Centers
Outpatient Surgery CAHPS
survey development
Emergency Departments
ED CAHPS survey
development
OAS CAHPS implementation
(voluntary)
Anticipated OAS
CAHPS tied to APU
Anticipated ED CAHPS implementation (voluntary)
2%
Voluntary
Required/Penalty
Information and time lines are based solely upon Press Ganey's experience with other CAHPS initiatives and our interpretation
of CMS rulemaking and policy statements. The information presented herein does not reflect the
5 views or policies of CMS or
any other governmental agency. Official CMS policy is distributed as part of their normal rulemaking process.
2%
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Regulatory Initiatives are Driving Improved Performance
& Higher Patient Expectations
“I think patient experience has been
unfortunately branded as things we do to
make patients happy. Nothing could be
further from the truth! Patient experience
is about care delivery, as measured from
the patient perspective.”
Average HCAHPS Performance Increased 6%
Mean: Mean:
63.4% 69.3%
6%
Jim Merlino, MD – Press Ganey CXO
30
40
50
60
70
80
90
100
Percent of Patients that Rate Your Hospital a 9 or 10
2008
2013
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OAS-CAHPS Overview
OutpatientandAmbulatorySurgeryConsumerAssessmentofHealthcare
ProvidersandSystems
OAS-CAHPS Anticipated Timeline
ƒ Standardized national patient experience survey for both
hospital outpatient departments (HOPDs) & ambulatory
surgery centers (ASCs)
ƒ Voluntary participation in OAS CAHPS begins in Jan 2016
ƒ Clients must authorize PG as a vendor to participate
ƒ January – June 2016 Data: Not Publicly Reported
ƒ July 2016 – June 2017: First Data Publicly Reported
ƒ Anticipate mandatory implementation of OAS CAHPS in 2017
ƒ OAS CAHPS data publicly reported beginning in 2018
ƒ Representing data collected July 2016 - June 2017
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OAS CAHPS Eligible Patients
Patient Eligibility Requirements:
ƒ Had at least one outpatient surgery/procedure in the sample
month
ƒ This includes patients admitted for observation
ƒ Is at least 18 years old at time of the surgery/procedure
ƒ Has a U.S. domestic mailing address
ƒ Surgery or procedure performed at an HOPD or ASC that fits
within:
ƒ CPT code range 10021–69990
OR
ƒ A G-code of G0104, G0105, G0121, or G0260
ƒ These codes include surgery, diagnostic procedure, or
other type of procedure such as an injection for pain
management
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OAS CAHPS Ineligible Patients
Ineligible Patients Excluded from OAS CAHPS:
ƒ Procedure performed by the HOPD or ASC but not appropriate for OAS CAHPS:
ƒ Diagnostic imaging procedures, preadmission testing, post-surgery follow-up
testing, physical therapy, respiratory therapy, laboratory, or radiology testing
only
ƒ Admitted as inpatient following procedure/surgery
ƒ Deceased
ƒ Discharged to hospice
ƒ Live in a nursing home
ƒ Incarcerated
ƒ “No publicity”
ƒ Included in OAS CAHPS within the previous 5 months
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OAS-CAHPS Survey
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Preparing for OAS-CAHPS
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Registration Requirement
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Impacting The Patient Experience
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Impacting the Patient Experience
OUR GOAL:
OUR GOAL:
Alleviate by
responding to
Inherent patient
needs
Prevent
suffering by
optimizing
care delivery
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Discussion
The Patient Centered Path to Improvement
Connecting Metrics to the Mission of Healthcare
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Today’s Patients and Landscape
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What Causes Patient Anxiety?
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Compassionate Connected Care™
Clinical Excellence:
Connecting clinical
excellence with outcomes
Operational Excellence:
Connecting efficiency with
quality.
Compassionate
Connected
Care
Caring Behaviors:
Connecting engagement
with action.
Culture:
Connecting mission, vision,
& value with engagement.
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Addressing Patient Suffering
They need to feel…
They need you to
be…
They need to get…
Informed
Knowledgeable &
Communicative
Introductions &
Explanations
Safe
Professional &
Proficient
Teamwork &
Discretion
Seen
Attentive &
Observant
Presence & Focus
in the Moment
Heard
Available &
Responsive
Listening Skills &
Tactful Responses
Connected
Compassionate &
Considerate
Kindness &
Personalization
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Addressing Employee Well-Being
They need to feel…
They need you to
be…
They need to get…
Informed
Knowledgeable &
Communicative
Explanations &
Info Sharing
Safe
Professional &
Proficient
Safe Spaces &
Discretion
Seen
Attentive &
Observant
Recognition &
Encouragement
Heard
Available &
Responsive
Listening Skills &
Outlets to Share
Connected
Compassionate &
Considerate
Kindness &
Personalization
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© 2015 Press Ganey Associates, Inc.
Review: The “Science” of Patient Experience
MANY BENEFITS
ƒ Reduction in malpractice claims. Lower performance = 110% higher
malpractice lawsuit rates
ƒ Decreased patient defections – MDs with scores in lowest 20% are four times
more likely to have patient turnover than MDs in the top 20%
ƒ Decreased negative word of mouth (verbal, internet)
ƒ Increased referrals – patients with good experience will tell 5 people
ƒ Increased productivity and volume; decrease length of visit and wait times;
improved staff retention
ƒ Improved outcomes; better compliance with treatment regimens
ƒ Impacts pay for performance and public reporting (value, not
volume)
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Current Performance and Opportunities to
Impact the Patient Experience
Mean Score Trending
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Key Driver’s for Overall Performance
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Thought Leadership: A view of 2016
Research Notes
Patient Experience In The
Very Elderly Population
Consumerism: Earning Patient
Loyalty and Market share
Reducing Serious Safety
Events: A Critical Dimension
of the Patient Experience
National Client Conference
Orlando World Marriott
NOV 2-4
FL
Regional Education Symposiums – 2016
•
•
•
Chicago:
San Diego:
Houston:
APR 26-27
MAY 3-4
JUN 7-8
IL
CA
TX
Key Executive Summit Dates - 2016
•
•
•
•
•
•
Transparency:
Engagement:
Children’s Hospital:
Nursing Leadership:
Patient Experience:
Safety Summit:
MAR 2-3
MAR 21-22
APR 13-14
JUN 15-16
SEP 7-8
SEP 20-22
UT
FL
FL
CO
MA
IL
Thank you!
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