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Learn The Lingo

Learn the Lingo: Key Terms for Navigating the Value Based Care World

With the shift toward value-based payment models, pharmacists are seizing new opportunities to improve patient care in medical homes, accountable care organizations, and other innovative care models. This resource includes acronyms and terminology commonly used when practicing in or discussing innovative practice models. Each term includes a short description and references so you can further your practice in a value based care world. This is the first of multiple volumes that will be published by the Medical Home/ACO SIG.

Shruthi Gowda
/ Categories: Learn the Lingo

Consumer Assessment of Healthcare Providers and Systems (CAHPS)

Consumer Assessment of Healthcare Providers and Systems (CAHPS)

Definition: Consumer Assessment of Healthcare Providers and Systems (CAHPS) is an Agency for Healthcare Research and Quality (AHRQ) program that has conducted research and developed standardized surveys to gather information about patients’ experiences with health plans, providers, and facilities.1,2 CAHPS surveys are designed with standardized questions to ensure valid comparison of data across health care settings.3 These surveys collect patients’ perceptions of various aspects of health care including, but not limited to, communication with doctors, ability to schedule appointments in a timely manner, level of coordinated care and ease of access to information, etc.1

Patients are asked to complete the surveys either through mail or online, with additional follow-up by telephone for individuals who do not initially respond. On average, surveys take 15 minutes to complete.

How it relates to ACO/PCMH: These patient surveys enable health systems to track and improve care based on a large scale of patient perspectives.3,4 They provide a better understanding of patient experiences and interactions, allowing health systems to utilize this information to provide higher quality of care.

Pharmacists can also have a positive impact on CAHPS scores. For example, pharmacists working in medical home environments have the opportunity to provide medication education, which can create a positive experience for patients that impacts CAHPS surveys.

Many health care organizations have adopted the incorporation of CAHPS surveys as a quality improvement tool. Health care organizations can identify strengths and weaknesses based on patient responses to determine in which areas they can improve. Although CAHPS surveys are not mandated by AHRQ, CMS connects CAHPS surveys with value-based purchasing and other federal reimbursement programs. CMS calculates CAHPS scores based on the data collected from surveys as a reflection of the quality of care provided to patients. CAHPS scores are publicly reported and are used by CMS to calculate reimbursement rates for health care entities.3 Higher scores reflect higher levels of patient care, resulting in higher reimbursement rates.

Involved organizations/oversight: AHRQ created the CAHPS program in alignment with their mission to “produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable.”5

All CAHPS surveys are approved by the CAHPS Consortium, which composed of AHRQ, Yale School of Public Health, and RAND Corporation.2

Resources

  1. Agency for Healthcare Research and Quality. About CAHPS. Rockville, MD: Agency for Healthcare Research and Quality. Available at: https://www.ahrq.gov/cahps/about-cahps/index.html. Accessed February 7, 2023.
  2. Agency for Healthcare Research and Quality. The CAHPS Program. Rockville, MD: Agency for Healthcare Research and Quality. Available at: https://www.ahrq.gov/cahps/about-cahps/cahps-program/index.html. Accessed February 7, 2023.
  3. CMS. Consumer Assessment of Healthcare Providers & Systems (CAHPS). N.p.: CMS. Available at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/CAHPS. Accessed February 7, 2023.
  4. Agency for Healthcare Research and Quality. Improving patient experience. Rockville, MD: Agency for Healthcare Research and Quality. Available at: https://www.ahrq.gov/cahps/quality-improvement/index.html. Accessed February 7, 2023.
  5. Agency for Healthcare Research and Quality. AHRQ: Agency for Healthcare Research and Quality. Rockville, MD: Agency for Healthcare Research and Quality. Available at: https://www.ahrq.gov/. Accessed February 7, 2023.

Contributing authors

Katherine Lyon, PharmD candidate
Chapman University School of Pharmacy
Irvine, CA

Hindu Rao, PharmD, APh, BCACP
Clinical Assistant Professor of Pharmacy Practice
Chapman University School of Pharmacy
Irvine, CA

Last Updated 3/13/2023

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