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Updated HCAHPS Mode Adjustments

February 6, 2023

CMS has announced that new mode adjustments will be applied to HCAHPS data, starting with patients discharged in January 2023. These mode adjustments were derived using the data gathered during CMS’ 2021 mode experiment.

The mode adjustment allows CMS to account for differences in scores that can be attributed to the patient giving their feedback on a mail survey versus a phone survey, etc. (CMS also uses patient-mix adjustments to account for differences in hospital scores based on demographic variations between the patients seen at each hospital.) This is the third set of mode adjustments used for HCAHPS since its inception in 2006. Compared to the last set, in use from 2017-2022, we still see that all adjustments applied to phone-only data are negative. This reflects that patients who respond by telephone-only tend to respond more positively than patients who completed the survey by mail-only.

The mode adjustments for most items, such as Doctor Communication, Discharge Information, Cleanliness, Quiet, Hospital Rating, and Recommend became less negative, meaning that the difference between how patients answer those items by phone vs. mail is smaller than it used to be. A few questions show the opposite pattern. Nurses Communication, Staff Responsiveness, and Communication about Medicines show that patients responding by phone now respond even more positively compared to those responding by mail.

Mode Adjustment

Mode Adjustment Table
 

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