It’s time to think about CAHPS for ACOs and PQRS

Smiling physician from an ACO

When it comes to ACOs meeting CMS reporting requirements for CAHPS and individual EPs and group practices tracking PQRS quality metrics, healthcare organizations can find themselves navigating a veritable alphabet soup of government acronyms. Charting the course that’s right for your organization can be a lot easier if you rely on the most helpful acronym of all — PRC.

Professional Research Consultants, Inc., (PRC) is an experienced, approved vendor for both the CAHPS for ACOs and the CAHPS for PQRS surveys.

What’s CMS looking for?

CMS — The Centers for Medicare & Medicaid Services — is driven by a commitment to improve the quality of healthcare in the United States.

With Accountable Care Organizations (ACOs), the goal is to provide coordinated, high-quality care to Medicare patients to ensure that they get the right care at the right time while avoiding unnecessary duplication of services and preventing medical errors. When an ACO delivers high-quality care and spends healthcare dollars wisely, it will share in the savings it achieves for the Medicare program.

Similarly, the group practices and individual eligible professionals (EPs) reporting on Physician Quality Reporting System (PQRS) quality measures contribute to the CMS’s overall objective of providing the right care at the right time. Starting in 2015, CMS began applying differential payments, either incentives or negative payment adjustments, to group practices and EPs based on the quality of care data they reported.

This carrot-and-stick approach aims at motivating participating healthcare providers and organizations to deliver the best possible care to Medicare patients.

What do the CAHPS for ACOs and CAHPS for PQRS surveys measure?

Both the Consumer Assessment of Healthcare Providers and Systems (CAHPS) for ACOs and CAHPS for PQRS ask Medicare beneficiaries to evaluate the interpersonal aspects of their healthcare experience. These are the factors that patients have identified as having the strongest influence on their perceptions of the care they receive, and patients are in the best possible position to report on these measures.

Both surveys include a combination of core questions from the CG-CAHPS survey (Clinician & Group CAHPS), required questions for the ACO and PQRS measurements, and demographic questions.

Which types of organizations are required to survey patients?

The CAHPS for ACOs survey enables three types of Accountable Care Organizations to satisfy their CMS reporting requirements: those following the Pioneer ACO Model, those participating in the Medicare Shared Savings Program, and those who have adopted the Next Generation ACO Model.

Participation in the CAHPS for PQRS survey depends on the number of eligible professionals in a medical group. CMS requires groups with 100 or more EPs to survey patients but makes data collection and reporting optional for groups of two to 99 EPs.

How are these surveys conducted?

For both the CAHPS for ACOs and the CAHPS for PQRS surveys, CMS requires vendors to blend two different methodologies in a “mixed-mode” approach that includes a pre-notification letter, two survey mailings, and as many as six follow-up telephone calls to non-responders. The survey targets a random sample of 860 Medicare beneficiaries selected by CMS.

What’s the timeline for the upcoming survey period?

For ACOs, the process begins when they authorize a vendor to conduct their survey and ends when that vendor submits the survey data it has collected to CMS. For the group practices and EPs reporting on PQRS quality measures, the first deadline, for registering for a Group Practice Reporting Option (GRPO), has passed already. Otherwise, these groups are on the same schedule as ACOs. Here’s the calendar:

  • July 25, 2016. Vendor authorization forms available.
  • September 20, 2016. Vendor authorization forms due to CMS via online submission.
  • October 25, 2016. File of sampled Medicare beneficiaries delivered to PRC from CMS.
  • November 10, 2016. Pre-notification letter mailed.
  • November 18, 2016. First questionnaire mailed.
  • December 13, 2016. Second questionnaire mailed.
  • January 4, 2017. Follow-up telephone calls begin.
  • February 1, 2017. Data collection ends.
  • February 9, 2017. Data submitted to CMS.

What about reporting? When and how can you see your survey results?

Following the conclusion of the study, CMS will generate results and scores at the ACO and group (for PQRS measures) level and provide reports through its confidential website, portal.cms.gov. All of the data collected will be publicly reported on the federal government’s Physician Compare website.

PRC clients can also view their data and create reports on PRCEasyView.com® using the website’s CAHPS Composites tool when the data are finalized and submitted. The application will display the top-box percent or linear mean score for questions and their rolled-up composite measures. The tool can also incorporate region and practice site information for finer levels of reporting. And if your organization is interested in drilling down to the individual provider level, PRC can work with you to conduct an ongoing CG-CAHPS survey.

Determining your organization’s options can be as easy as A-B-C. Just contact PRC. 

Choose excellence. Choose PRC.