A Tale of Two Letters (Part 1 of 2): AHA Challenges CMS’ Newly Proposed Patient Experience Survey

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Editor’s Note: In the second half of March, the Centers for Medicaid and Medicare Services received two letters from influential voices in healthcare directly challenging recently proposed or enacted measures. The first challenge from the American Hospital Association regarding a new patient-experience survey is detailed below. The second challenge from the American Medical Association on federal HIE standards will be discussed in our next post.


Are you overwhelmed by the numerous patient-experience surveys that are thrust upon your organization? If so, then the American Hospital Association is right there with you, according to John Commins at HealthLeaders Media.

Last week, the AHA sent a letter to CMS Acting Administrator Marilyn Tavenner imploring her to consider the “overkill” that would accompany “plans to add a new survey about patient experiences in hospital outpatient surgical departments and ambulatory surgical centers.” The AHA worries that another survey “would confuse patients and prove burdensome and expensive for hospital administrators,” Commins reports.

The AHA clarified that it is not dismissing or downplaying the value or necessity of these surveys, but in the words of Vice President and Director of Policy Ashley Thompson, is instead “concerned that the CAHPS program already includes multiple overlapping survey tools creating confusion about how to assess the patient experience across multiple care settings, as well as excessive survey administration burden. Instead of a separate survey, CMS should incorporate a small number of supplemental survey questions targeted at facility-level issues for ASCs into an existing CAHPS survey.”

Commins writes that the AHA’s letter was a response to a January 25 CMS request for information to hospitals on the proposed survey. In the request, CMS basically acknowledged AHA’s concerns, noting that “two related CAHPS surveys exist: however, they do not collect information specific to the patient experience in HOSD/ASC facilities.” Thompson, however, believes “that the CG-CAHPS and Surgical CAHPS ‘already include information highly relevant to assessing experience of care in ASCs and HOSDs.’”

Implementing “another survey relevant to ambulatory surgical patients” would give them “three separate but similar surveys for exactly the same care episode,” she continued, adding “that CAHPS already survey physicians, hospitals, nursing homes, dialysis facilities, and home-health agencies, and there are plans to build surveys for emergency departments and hospice care.”

In addition to confusing patients with multiple surveys that would be received days, if not weeks, after the provision of care, Thompson also “raised concerns about the cost and administrative burdens of the surveys and suggested that CMS allow hospitals to choose lower-cost surveys to mitigate the financial burden imposed by the process,” Commins reports.

Do you agree with Thompson and the AHA on this matter? Are there too many patient-experience surveys already? How much of a burden are these surveys for your organization?

-by Pete Fernbaugh

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