How Your Patient’s Rating of their Medical Care is Affecting your Payment

For several years hospitals have been required to survey patients about their experience while hospitalized with the results used as part of hospital payment calculation.  The survey used is the hospital version of a government survey named the “Consumer Assessment of Healthcare Providers and Systems” (H-CAHPS).  The clinicians and group version of this survey was started in 2005 but has not used as a measure of payment to provider groups less than 100 until version 3 in 2017 when it was introduced as an option in the new Medicare Quality Payment Program (QPP).  Under QPP in the Merit Based Incentive Payment System (MIPS) the CAHPS survey is given high priority as a Quality Measure and as an Improvement Activity (IA) in calculating provider payments.  Not only the government, but private insurers such as Blue Cross and Aetna are tying payments to such patient experience measurement.  Aetna is projecting their current 25% use of such measurements to 75% by 2020 in value-based contracts.

It is anticipated that this CAHPS “gold standard” government survey will be required in the near future for all providers as a measure of payment for medical care.  This CG-CAHPS survey is not a secret and all providers would be well advised to use the actual survey to identify problem areas before it is required for the calculation of reimbursement. 

Duxware has partnered with MER Consulting LLC to offer a voluntary CG-CAHPS survey in 2018 at a reduced cost to providers which will not be sent to a government database.  Reservations for the survey will be taken in early 2018.

COVID-19 Resource Center    Visit our Resource Center to stay up to date.​