CMS Mode Adjustments will dial up better adjusted scores for phone surveys

CMS Mode adjustment phone surveys

For the first time in 10 years, CMS (the Centers for Medicare & Medicaid Services) is changing how it calculates Mode Adjustments — the adjustments CMS makes to HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores to account for differences in the survey method used to collect data from patients. That’s good news for hospitals surveying patients by phone.

The Mode Adjustment announcement headlined the annual CMS-sponsored HCAHPS Vendor Update Training that PRC’s HCAHPS Project Team attended March 1. Also announced were minor changes to .xml file specifications, guidelines for hospital studies conducted in conjunction with HCAHPS, and trends in response rates.


Why does CMS make Mode Adjustments?

In a nutshell, CMS wants to level the playing field and make sure that hospitals and health systems are comparing apples to apples and oranges to oranges. The goal is to make sure that differences in HCAHPS scores reflect ONLY differences in the quality of care provided by healthcare providers and systems. That’s why CMS adjusts HCAHPS survey results to account for differences in patient mix and survey mode. Those adjustments also address the impact of non-response bias.

What will this mean for your HCAHPS scores?

In general, HCAHPS responses that patients give over the telephone are more positive than surveys that respondents mail in. From the beginning, CMS has used mail scores as its baseline because the largest percentage of hospitals have surveyed patients by mail. This approach has favored the mail methodology, which means that CMS has assigned negative adjustment values to telephone results. However, when CMS analyzed the results of its 2016 HCAHPS Mode Experiment, the numbers showed that differences between mail and telephone are no longer as great as they were in the 2006 Mode Experiment. That’s why CMS has decided to publish and implement new Mode Adjustments for publicly reported results. On average, the phone adjustments are smaller than they were previously, and PRC clients will see a slight boost in their adjusted scores for most measures.

The HCAHPS Project Team announced that the new Mode Adjustments will be applied beginning with April 2017 discharges for all hospitals. This will affect Hospital Compare for the first time in April 2018, when the published data will include July 2016 through June 2017 patients. The first reporting period with all quarters using the new adjustment will be April 2017 through March 2018, and that data will be published in December 2018.

If you’d like to learn more about the potential impact of the new Mode Adjustments on your HCAHPS scores, just Contact Us.