After adult inpatients leave the hospital, a random sample receives a survey from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). The patient satisfaction survey questions, also referred to as the CAHPS Hospital Survey, ask about caregiver communication and responsiveness, hospital cleanliness, and preparations for the patient’s return home.
The Centers for Medicare and Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ) developed the survey to reflect the patients’ assessment of the care they receive at the hospital. Survey results can reflect the patient experience, perspective, and quality of care, as well as provide insight to hospitals and healthcare systems on how to improve their HCAHPS scores.
The Definitive Healthcare HospitalView product tracks HCAHPS data for nearly 3,300 U.S. hospitals. This Healthcare Insight reviews average HCAHPS scores for each U.S. state.
Fig 1. Data is from our HospitalView product and sourced from the January 2024 HCAHPS results published by CMS. Accessed April 2024.
South Dakota (4.22), Minnesota (4.04), and Wisconsin (4.03) have the highest average HCAHPS scores. These states are also the only three in the U.S. with an average score above a 4-star rating.
Washington D.C. (2.17), Florida (2.61), and New Jersey (2.61) have the lowest average HCAPHS scores.
The average HCAHPS score across nearly 3,300 U.S. hospitals tracked in HospitalView is 3.33.
Hospital ratings are based on individual patient survey responses. The health of the patient population, the level of specialized care a hospital can provide, patient-to-provider ratios, busy patient-care settings, and staffing shortages can all affect how a patient rates their hospital experience, among many other factors.
The HCAHPS survey has a total of 29 questions that break down as follows:
The overall HCAHPS summary score is on a 5-star rating scale, with 1-star being the lowest and 5-star the highest. Summary star ratings average the hospital’s ratings over the 19 main survey questions. Hospitals with 4- and 5-star ratings have the best scores from a patient perspective.
Hospitals that treat Medicare patients and receive funding through the Inpatient Prospective Payment System (IPPS) must participate in HCAHPS. If they don't collect and submit data or fail to report their scores publicly, they risk reduced Medicare payments.
Hospitals not covered by IPPS, such as critical access hospitals, can choose to participate in HCAHPS voluntarily.
VA hospitals also use surveys to assess patient satisfaction and experience, called the Survey of Healthcare Experiences of Patients (SHEP). While the name is different, the VA SHEP asks the same questions and has the same reporting model as the traditional HCAHPS survey.
HCAHPS is quite important for hospitals, healthcare providers, and businesses in the healthcare industry, though its significance can vary depending on the specific entity.
For most hospitals, particularly those treating Medicare patients, HCAHPS is crucial. High scores can lead to financial benefits and attract patients.
While providers themselves aren't directly mandated to participate, HCAHPS scores reflect on their performance within the hospital. Understanding patient experiences through HCAHPS can help them improve communication and bedside manner.
Finally, businesses that partner with hospitals, like patient transport services or medical equipment suppliers, might be indirectly impacted by a facility’s HCAHPS scores. A hospital with a high score could attract more patients, which could, in turn, increase demand for the business’s products or services. In some cases, a hospital might factor HCAHPS scores when making decisions about partnering with new vendors. Companies with solutions that demonstrably improve patient experience could have an edge.
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