Browse All CAHPS® Publications

Development of the Revised CAHPS Hospice Survey

Describes development of the revised CAHPS Hospice Survey, a CMS-required instrument at 4,000+ hospices, using cognitive interviews with 59 caregivers to shorten the survey and add content on care preferences and cultural needs.

Danielle Schlang, Melissa A. Bradley, Rebecca Anhang Price

Using a Quality Improvement Priority Metric to Promote Uniformly High-Quality Care: An Illustrative Example Using Child HCAHPS Survey Data

This study presents a priority metric combining case-mix-adjusted means and partial correlations of patient experience measures, revealing distinct improvement priorities for the overall population and for subgroups by race, ethnicity, and language.

Denise D. Quigley, Marc N. Elliott, Mary Ellen Slaughter, Ron D. Hays

How Closed-ended Survey Questions and Narrative Comments Interact in Characterizing Caregivers’ Overall Assessment of Hospice Care

We examine the usefulness of the CAHPS Hospice Survey comments for informing hospice quality improvement.

Denise D. Quigley, Anagha Alka Tolpadi, Danielle Schlang, Joshua Wolf, Rebecca Anhang Price, Melissa A. Bradley

Stakeholder Input on the CAHPS Ambulatory Surveys

This study aimed to gather systematic stakeholder feedback to inform future revisions of CAHPS ambulatory surveys.

Ron D. Hays, Julie A. Brown, Emma Bianculli, Marc N. Elliott

CMS Hospice Star Ratings

Many hospices lack CAHPS star ratings due to being new or small, but most patients are served by hospices with reliable, publicly reported scores, making the data a useful quality guide.

Rebecca Anhang Price, Melissa A. Bradley, Joan M. Teno, Ann C. Haas, Anagha Alka Tolpadi, Marc N. Elliott, Maria DeYoreo

Supplemental Items Reduce HCAHPS Response Rates, but Response Rates Do Not Affect HCAHPS Scores: A Randomized Experiment

The objective of this paper is to estimate the effect of the 59-item versus 32-item survey on response rates by survey mode and assess whether any reductions in response rates change HCAHPS scores.

Megan K. Beckett, Katrin Hambarsoomian, Julie A. Brown, Paul Cleary, Gary A. Abel, Laura Giordano, Marc N. Elliott

Evaluation of Proposed New Measures for the Hospital CAHPS Survey

The HCAHPS survey has become the most used hospital patient experience survey. Responding to possible gaps in survey content, CMS developed new HCAHPS measures. We describe the development and testing of new HCAHPS measures.

Marc N. Elliott, Megan K. Beckett, Katrin Hambarsoomian, William Lehrman, Laura Giordano, Elizabeth Goldstein, Julie A. Brown

Updated Adjustment of the HCAHPS Survey for New Modes of Survey Administration and Patient Mix

Phone-only and Web-Phone without email produce more positive responses than Mail-only, requiring negative adjustments. All other survey protocol effects and adjustments are mixed in direction and generally small.

Marc N. Elliott, Megan K. Beckett, Katrin Hambarsoomian, Julie A. Brown, Paul Cleary, William Lehrman, Elizabeth Goldstein, Laura Giordano, Layla Parast

Telephone Follow-Up on Medicare Patient Surveys Remains Critical

Telephone follow-up improves response rates in many health care settings. Our objective was to describe response rates to the 2022 MCAHPS surveys and the completion mode (mail or telephone), overall and by person-level characteristics.

Ann C. Haas, Denise D. Quigley, Amelia Haviland, Nathan Orr, Julie A. Brown, Sarah J. Gaillot, Marc N. Elliott

Does an "EZ" Survey Improve the Data Quality of the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Clinician and Group Survey 3.1?

We randomized patients from an urban safety net provider to complete the CAHPS Clinician and Group survey or "EZ" survey created using plain language principles. We compared response rates, missingness, correlations, and reliability of scores.

Ron D. Hays, Julie A. Brown, Charleen Mikail, Denise D. Quigley

Associations of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician and Group Survey Scores with Interventions and Site, Provider, and Patient Factors: A Systematic Review of the Evidence

We conducted a systematic review of factors associated with CG-CAHPS scores including 52 peer-reviewed articles using CG-CAHPS data. We reviewed the evidence and identified interventions supporting patient-centered care.

Denise D. Quigley, Marc N. Elliott, Nabeel Qureshi, Zachary Predmore, Ron D. Hays

Patient Surveys Are Used Most Often to Assess Health Care Innovations, Rigorous Methods Are Less Common

Broad use of patient experience surveys and more rigorous evaluation study designs has increased some over time but is still lacking.

Nabeel Qureshi, Denise D. Quigley

How the CAHPS Clinician and Group Patient Experience Survey Data Have Been Used in Research: A Systematic Review

The widespread use of CG-CAHPS data implies the survey's value in measuring and improving care quality.

Denise D. Quigley, Marc N. Elliott, Nabeel Qureshi, Zachary Predmore, Ron D. Hays

Trends in HCAHPS Survey Scores, 2008–2019: A Quality Improvement Perspective

Characterize pre-COVID-19 (2008-2019) trends in hospital consumer assessment of healthcare providers and systems (HCAHPS) scores.

Megan K. Beckett, Denise D. Quigley, Christopher W. Cohea, William Lehrman, Chelsea Russ, Laura Giordano, Elizabeth Goldstein, Marc N. Elliott

Narrative Comments About Pediatric Inpatient Experiences Yield Substantial Information Beyond Answers to Closed-Ended CAHPS Survey Questions

Child HCAHPS narrative comment data provide significant additional information about what is important to parents and guardians during inpatient pediatric care beyond closed-ended composites.

Denise D. Quigley, Marc N. Elliott, Mary Ellen Slaughter, Carlos F. Lerner, Ron D. Hays

Changes in Hospice Care Experiences During the COVID-19 Pandemic

We examine how the COVID-19 pandemic may have influenced the characteristics of patients receiving hospice care, the settings in which they received care, and their care experiences using national data from the CAHPS Hospice Survey.

Maria DeYoreo, Rebecca Anhang Price, Ann C. Haas, Anagha Alka Tolpadi, Joan M. Teno, Marc N. Elliott

Do Hospital Characteristics Predict Racial-and-Ethnic Disparities in Patient Experience? National Results from the HCAHPS Survey

Large, for-profit hospitals and hospitals serving higher proportions of Black and Hispanic patients tend to be lower performing overall but have smaller disparities in patient experience.

Megan K. Beckett, Marc N. Elliott, Katrin Hambarsoomian, Loida Tamayo, William Lehrman, Denis Agniel, Meagan Khau, Elizabeth Goldstein, Laura Giordano, Judy H. Ng, Steven C. Martino

Association of Hospice Profit Status With Family Caregivers' Reported Care Experiences

In this analysis of national CAHPS Hospice Survey data from 653,208 caregiver respondents, reflecting care received from 3107 hospices, family caregivers reported worse care experiences at for-profit hospices compared with not-for-profit hospices.

Rebecca Anhang Price, Layla Parast, Marc N. Elliott, Anagha Alka Tolpadi, Melissa A. Bradley, Danielle Schlang, Joan M. Teno

Follow-Up Shadow Coaching Improves Primary Care Provider-Patient Interactions and Maintains Improvements When Conducted Regularly: A Spline Model Analysis

Re-coaching improved patient experience more than initial coaching, suggesting the reactivation of knowledge from initial coaching. However, re-coaching gains also eroded. Coaching should occur every 6–12 months to maintain behaviors and scores.

Denise D. Quigley, Marc N. Elliott, Mary Ellen Slaughter, Efrain Talamantes, Ron D. Hays

The Hospital Care Experiences of Older Patients Compared to Younger Patients

Patients ages 75+ reported less-positive experiences than patients ages 55-74, especially for measures of communication. These differences may be specific to inpatient care.

Marc N. Elliott, Megan K. Beckett, Christopher W. Cohea, William Lehrman, Chelsea Russ, Paul Cleary, Laura Giordano, Elizabeth Goldstein, Debra Saliba

Reasons Primary Care Practices Chose Patient Experience Surveys During Patient-Centered Medical Home Transformation

In 2008–2017, 15–18% of U.S. primary care practices sought or maintained patient-centered medical home recognition. We interviewed a sample of 105 of these practices to determine why patient experience surveys were chosen.

Denise D. Quigley, Nabeel Qureshi, Ron D. Hays

Shadow Coaching Improves Patient Experience With Care, But Gains Erode Later

We examined whether shadow coaching improves patient experience across 44 primary care practices in a large urban Federally Qualified Health Center.

Denise D. Quigley, Marc N. Elliott, Mary Ellen Slaughter, Q. Burkhart, Alex Y. Chen, Efrain Talamantes, Ron D. Hays

Summary of the 2020 AHRQ Research Meeting on 'Advancing Methods of Implementing and Evaluating Patient Experience Improvement Using Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Surveys'

The Agency for Healthcare Research and Quality held a research meeting on using Consumer Assessment of Healthcare Providers and Systems (CAHPS®) data for quality improvement (QI) and evaluating such efforts. This article summarizes the meeting.

Denise D. Quigley, Nabeel Qureshi, Lise Rybowski, Dale Shaller, Susan Edgman-Levitan, Paul Cleary, Caren Ginsberg, Ron D. Hays

A Systematic Review of Strategies to Enhance Response Rates and Representativeness of Patient Experience Surveys

The objective of this paper is to review evidence on survey administration strategies to improve response rates and representativeness of patient surveys.

Rebecca Anhang Price, Denise D. Quigley, J. Lee Hargraves, Joann S. Sorra, Alejandro Uriel Becerra-Ornelas, Ron D. Hays, Paul Cleary, Julie A. Brown, Marc N. Elliott

Practices and Changes Associated With Patient-Centered Medical Home Transformation

Evidence shows that leaders who implement the patient-centered medical home care model encounter challenges in driving change. Understanding which changes and quality improvement practices further implementation is essential.

Denise D. Quigley, Mary Ellen Slaughter, Nabeel Qureshi, Marc N. Elliott, Ron D. Hays

Using CAHPS Patient Experience Data for Patient-Centered Medical Home Transformation

We interviewed 105 practice leaders from 294 sampled practices and used content analysis to identify themes about uses of patient experience data for practice improvement during PCMH transformation.

Denise D. Quigley, Luma Issa Al Masarweh, Nabeel Qureshi, Ron D. Hays

What Parents Have to Say: Content and Actionability of Narrative Comments from Child HCAHPS Survey

The purpose of this paper is to examine the content and actionability of written comments from parents and guardians on the Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child HCAHPS) survey.

Denise D. Quigley, Zachary Predmore

Usefulness of Child HCAHPS Survey Data for Improving Inpatient Pediatric Care Experiences

We surveyed children's hospital leaders and staff about their use of Child HCAHPS for QI, including measures from other studies. We compared scale and item means for leaders and staff and compared means to other studies.

Denise D. Quigley, Mary Ellen Slaughter, Courtney A. Gidengil, Alina I. Palimaru, Carlos F. Lerner, Ron D. Hays

Content and Actionability of Recommendations to Providers After Shadow Coaching

This study aimed to examine the content of the recommendations given to providers aimed at improving provider-patient interactions, characterize these recommendations, and examine their actionability.

Denise D. Quigley, Nabeel Qureshi, Alina I. Palimaru, Chau Pham, Ron D. Hays

Examining the Business Case for Patient Experience: A Systematic Review

This article reviews the literature on associations between patient experience and business outcomes, including patient allegiance and retention, complaints, lawsuits, provider job satisfaction, and profitability.

Denise D. Quigley, Kerry Reynolds, Stephanie Dellva, Rebecca Anhang Price

Provider and Coach Perspectives on Implementing Shadow Coaching to Improve Provider-Patient Interactions

We aimed to characterize lessons and barriers to implementing shadow coaching as a mechanism to improve interactions with patients and change organizational culture.

Denise D. Quigley, Nabeel Qureshi, Mary Ellen Slaughter, Scott Kim, Efrain Talamantes, Ron D. Hays

Improving Care Experiences for Patients and Caregivers at End of Life: A Systematic Review

Previous reviews examined palliative care improvements or available measures but none explicitly on improving care experiences. We reviewed literature on improving patient and/or caregiver end-of-life care experiences.

Denise D. Quigley, Sara G. McCleskey

Some Aspects of Patient Experience Assessed by Practices Undergoing Patient-Centered Medical Home Transformation Are Measured by CAHPS, Others Are Not

Overview of survey items used to assess patient experience and whether those items are on the CAHPS survey or not.

Lea Xenakis, Denise D. Quigley, Nabeel Qureshi, Luma Issa Al Masarweh, Chau Pham, Ron D. Hays

Nationwide Qualitative Study of Practice Leader Perspectives on What It Takes to Transform Into a Patient-Centered Medical Home

Primary Care Medical Home efforts necessitated support and assistance to practice leaders. Changes include financial incentives,leadership direction and support, and staff with experience with the PCMH application process, implementation, and QI.

Nabeel Qureshi, Denise D. Quigley, Ron D. Hays

Differences in Caregiver Reports of the Quality of Hospice Care Across Settings

Important opportunities exist to improve quality of hospice care in nursing homes and assisted-living facilities. Quality improvement and regulatory interventions targeting these settings are needed to ensure that all hospice decedents and their family receive high-quality, patient- and family-centered hospice care.

Denise D. Quigley, Layla Parast, Ann C. Haas, Marc N. Elliott, Joan M. Teno, Rebecca Anhang Price

Characteristics of Hospices Providing High-Quality Care

Hospice characteristics associated with strong performance on Hospice Item Set measures differ from those associated with strong performance on CAHPS measures. Providing professional staff visits in the last two days of life is associated with high performance in both quality domains.

Rebecca Anhang Price, Anagha Alka Tolpadi, Danielle Schlang, Melissa A. Bradley, Layla Parast, Joan M. Teno, Marc N. Elliott

Differences in Consumer Assessment of Healthcare Providers and Systems Clinician and Group Survey Scores by Recency of the Last Visit: Implications for Comparability of Periodic and Continuous Sampling

Patient experiences an be collected by sampling patients periodically (visits over a 1-year period)or continuously (any visit in a monthly interval). We explored differences in Consumer Assessment of Healthcare Providers and Systems Clinician and Group scores using both sampling methods.

Claude Messan Setodji, Q. Burkhart, Ron D. Hays, Denise D. Quigley, Samuel A. Skootsky, Marc N. Elliott

Associations of CAHPS Composites With Global Ratings of the Doctor Vary by Medicare Beneficiaries' Health Status

Good care coordination and communication are especially important for less healthy Medicare beneficiaries' overall evaluations of their doctors.

Ron D. Hays, Joshua Mallett, Ann C. Haas, Katherine L. Kahn, Steven C. Martino, Sarah J. Gaillot, Marc N. Elliott

Use of CAHPS Patient Experience Survey Data as Part of a Patient-Centered Medical Home Quality Improvement Initiative

Practice leaders at a large urban Federally Qualified Health Center in California. regularly engaged and used CAHPS scores, trends, and benchmarks alongside other data while making changes related to QI and patient centered medical homes

Denise D. Quigley, Peter Mendel, Zachary Predmore, Alex Y. Chen, Ron D. Hays

What Matters Most to Whom: Racial, Ethnic, and Language Differences in the Health Care Experiences Most Important to Patients

Policies to improve patient experience may be more effective if tailored to the patient population at a given practice or hospital.

Rebecca L. Collins, Ann C. Haas, Amelia Haviland, Marc N. Elliott

Black and Hispanic Patients Receive Hospice Care Similar to That of White Patients When in the Same Hospices

Black and Hispanic patients received care from poorer quality hospices than white patients.

Rebecca Anhang Price, Layla Parast, Ann C. Haas, Joan M. Teno, Marc N. Elliott

Implementation of Practice Transformation: Patient Experience According to Practice Leaders

An evaluation of federally qualified health centers found that transforming primary care to a medical home model can improve patient experience.

Denise D. Quigley, Alina I. Palimaru, Alex Y. Chen, Ron D. Hays

CAHPS and Comments: How Closed-Ended Survey Questions and Narrative Accounts Interact in the Assessment of Patient Experience

Incorporating a protocol for eliciting narratives into a patient experience survey results in minimal distortion of patient feedback, and narratives from sicker patients help explain variation in provider ratings.

Steven C. Martino, Dale Shaller, Mark Schlesinger, Andrew M. Parker, Lise Rybowski, Rachel Grob, Jennifer L. Cerully, Melissa L. Finucane

The SelectMD 2.0 Provider Choice Experiment: Methodological Overview

Provides a detailed methodological overview of the SelectMD 2.0 provider choice experiment.

Jennifer L. Cerully, Andrew M. Parker, Mark Schlesinger, Steven C. Martino, Dale Shaller, Lise Rybowski, Rachel Grob, Melissa L. Finucane

Can a More User-Friendly Medicare Plan Finder Improve Consumers' Selection of Medicare Plans?

Enhancements to the Medicare Plan Finder website not only improved user experience but also helped users make good decisions when choosing plans.

Steven C. Martino, David E. Kanouse, David J. Miranda, Marc N. Elliott

Establishing Limits for Supplemental Items on a Standardized National Survey

Response rates for the Medicare Advantage Consumer Assessment of Healthcare Providers and Systems (MA CAHPS) survey were 2.5 percentage points lower when 12 questions had been added to the survey, compared with no additional questions.

Megan K. Beckett, Marc N. Elliott, Sarah J. Gaillot, Ann C. Haas, Jacob W. Dembosky, Laura Giordano, Julie A. Brown

Satisfaction of Discharged Nursing Home Residents

Most of the psychometric properties of the CAHPS® Nursing Home survey: Discharged Resident Instrument (NHCAHPS-D) have acceptable levels of reliability.

Nicholas G. Castle, John Engberg, Aiju Men

Racial/Ethnic Disparities in Medicare Beneficiaries' Carecoordination Experiences

Hispanic, black, and Asian/Pacific Islander Medicare beneficiaries are more likely to have gaps in their care coordination than their non-Hispanic white peers.

Steven C. Martino, Marc N. Elliott, Katrin Hambarsoomian, Robert Weech-Maldonado, Sarah J. Gaillot, Samuel C. Haffer, Ron D. Hays

Medicare Prescription Drug Plan Enrollees Report Less Positive Experiences Than Their Medicare Advantage Counterparts

Medicare enrollees with standalone prescription coverage reported less positive experiences with their plans than their counterparts in Medicare Advantage plans.

Marc N. Elliott, Bruce E. Landon, Alan M. Zaslavsky, Carol A. Edwards, Nathan Orr, Megan K. Beckett, Joshua Mallett, Paul Cleary

Performance of the Medicare Consumer Assessment of Health Care Providers and Systems (CAHPS) Physical Functioning Items

The aim of this study is to evaluate physical functioning items in Medicare beneficiaries.

Ron D. Hays, Joshua Mallett, Sarah J. Gaillot, Marc N. Elliott

Less Use of Extreme Response Options by Asians to Standardized Care Scenarios May Explain Some Racial/Ethnic Differences in CAHPS Scores

This study explores whether lower ERT is observed for Asians than whites in response to standardized vignettes depicting patient experiences of care and whether ERT might in part explain Asians reporting worse care than whites.

Lauren A. Mayer, Marc N. Elliott, Ann C. Haas, Ron D. Hays, Robin M. Weinick

How Patient Comments Affect Consumers' Use of Physician Performance Measures

This study examines the effects of providing patient comments about doctors along with standardized performance information in a web-based public report.

David E. Kanouse, Mark Schlesinger, Dale Shaller, Steven C. Martino, Lise Rybowski

Possibilities for Shortening the CAHPS Clinician and Group Survey

Several domains in the CAHPS Clinician and Group Survey can be substantially reduced without sacrificing reliability or content; the shorter version could be useful in health care settings when the full-length survey is impractical.

Brian D. Stucky, Ron D. Hays, Maria Orlando Edelen, Jill Gurvey, Julie A. Brown

CAHPS Surveys: Valid and Valuable Measures of Patient Experience

This is a commentary on a recent CAHPS survey titled, "Patient-Satisfaction Surveys on a Scale of 0 to 10: Improving Health Care, or Leading It Astray?"

William Lehrman, Mark W. Friedberg

Comparing the Health Care Experiences of Medicare Beneficiaries with and Without Depressive Symptoms in Medicare Managed Care Versus Fee-for-Service

Disparities in care experienced by older Medicare beneficiaries with depressive symptoms tend to be more negative in managed care. Efforts identify and address barriers these beneficiaries encounter to help them better traverse the managed care environment.

Steven C. Martino, Marc N. Elliott, Amelia Haviland, Debra Saliba, Q. Burkhart, David E. Kanouse

Accelerating Improvement and Narrowing Gaps: Trends in Patients' Experiences with Hospital Care Reflected in HCAHPS Public Reporting

Five years after HCAHPS public reporting began, meaningful improvement of patients' hospital care experiences continues, especially among initially low-scoring hospitals, reducing some gaps among hospitals.

Marc N. Elliott, Christopher W. Cohea, William Lehrman, Elizabeth Goldstein, Paul Cleary, Laura Giordano, Megan K. Beckett, Alan M. Zaslavsky

Do Racial/Ethnic Disparities in Quality and Patient Experience Within Medicare Plans Generalize Across Measures and Racial/Ethnic Groups?

Health plan structural changes might reduce disparities across multiple measures.

Robert Weech-Maldonado, Marc N. Elliott, John L. Adams, Amelia Haviland, David J. Klein, Katrin Hambarsoomian, Carol A. Edwards, Jacob W. Dembosky, Sarah J. Gaillot

Do Experiences with Medicare Managed Care Vary According to the Proportion of Same-Race/Ethnicity/Language Individuals Enrolled in One's Contract?

The authors examine whether care experiences and immunization for racial/ethnic/language minority Medicare beneficiaries vary with the proportion of same-group beneficiaries in Medicare Advantage (MA) contracts.

Rebecca Anhang Price, Amelia Haviland, Katrin Hambarsoomian, Jacob W. Dembosky, Sarah J. Gaillot, Robert Weech-Maldonado, Malcolm V. Williams, Marc N. Elliott

Clinician Advice to Quit Smoking Among Seniors

Little smoking research in the past 20 years includes persons 50 and older; herein we describe patterns of clinician cessation advice to US seniors, including variation by Medicare beneficiary characteristics.

William G. Shadel, Marc N. Elliott, Ann C. Haas, Amelia Haviland, Nathan Orr, Melissa M. Farmer, Sai Ma, Robert Weech-Maldonado, Donna O. Farley, Paul Cleary

Should Health Care Providers Be Accountable for Patients' Care Experiences?

Patient experience measures based on rigorously developed and implemented patient surveys can and do overcome concerns regarding the relevance, fairness and unintended consequences of these surveys.

Rebecca Anhang Price, Marc N. Elliott, Paul Cleary, Alan M. Zaslavsky, Ron D. Hays

Emergency Department Patient Experience of Care Survey: Development and Field Test

RAND researchers designed and field tested an Emergency Department Patient Experience of Care Survey for the Centers for Medicare & Medicaid Services for use with adult patients who have visited the emergency department.

Robin M. Weinick, Kirsten Becker, Layla Parast, Brian D. Stucky, Marc N. Elliott, Megan Mathews, Chris Chan, Virginia Kotzias

Use of CAHPS Patient Experience Surveys to Assess the Impact of Health Care Innovations

Although innovations targeting quality improvement are often evaluated using surveys, there is considerable untapped potential for using CAHPS measures or surveys to assess their effectiveness.

Robin M. Weinick, Denise D. Quigley, Lauren A. Mayer, Clarissa Sellers

Hospice Experience of Care Survey: Development and Field Test

This report describes development of the Hospice Experience of Care Survey, field test design, procedures, analytic methods and findings, and the final survey for national implementation by the Centers for Medicare & Medicaid Services.

Rebecca Anhang Price, Denise D. Quigley, Melissa A. Bradley, Joan M. Teno, Layla Parast, Marc N. Elliott, Ann C. Haas, Brian D. Stucky, Brianne Mingura, Karl Lorenz

Examining the Role of Patient Experience Surveys in Measuring Health Care Quality

There is no inherent trade-off between strong performance on patient experience indicators and performance on clinical quality measures.

Rebecca Anhang Price, Marc N. Elliott, Alan M. Zaslavsky, Ron D. Hays, William Lehrman, Lise Rybowski, Susan Edgman-Levitan, Paul Cleary

Development and Evaluation of the CAHPS (Consumer Assessment of Healthcare Providers and Systems) Survey for In-Center Hemodialysis Patients

This study provides support for the reliability and validity of the CAHPS In-Center Hemodialysis Survey for assessing patient experiences of care at dialysis facilities.

Beverly A. Weidmer, Paul Cleary, San Keller, Christian T. Evensen, Margarita Patricia Hurtado, Beth Kosiak, Patricia Gallagher, Roger E. Levine, Ron D. Hays

Modern Psychometric Methods for Estimating Physician Performance on the Clinician and Group CAHPS® Survey

Modern psychometric methods for scoring the Clinician & Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS®) instrument can improve the precision of patient scores.

Shubhabrata Mukherjee, Hector Rodriguez, Marc N. Elliott, Paul K. Crane

Care Experiences of Managed Care Medicare Enrollees Near the End of Life

To compare reports about care experiences of individuals who died within 1 year of survey with reports of those who did not.

Marc N. Elliott, Amelia Haviland, Paul Cleary, Alan M. Zaslavsky, Donna O. Farley, David J. Klein, Carol A. Edwards, Megan K. Beckett, Nathan Orr, Debra Saliba

Racial/ethnic Differences in Medicare Experiences and Immunization: The Role of Disease Burden

Whites have better overall access to care than other beneficiaries with Medicare in the absence of major health conditions.

Nathan Orr, Marc N. Elliott, Q. Burkhart, Amelia Haviland, Robin M. Weinick

Specialties Differ in Which Aspects of Doctor Communication Predict Overall Physician Ratings

Effective doctor communication is critical to positive doctor–patient relationships and predicts better health outcomes.

Denise D. Quigley, Marc N. Elliott, Donna O. Farley, Q. Burkhart, Samuel A. Skootsky, Ron D. Hays

Evaluating the Content of the Communication Items in the CAHPS® Clinician and Group Survey and Supplemental Items with What High-Performing Physicians Say They Do

A doctor's ability to communicate effectively is key to establishing and maintaining positive doctor–patient relationships.

Denise D. Quigley, Steven C. Martino, Julie A. Brown, Ron D. Hays

Does Naming the Focal Plan in a CAHPS Survey of Health Care Quality Affect Response Rates and Beneficiary Evaluations?

The use of a generic survey did not appear to affect either unit or item response rates, and did not appear to affect the ways in which beneficiaries evaluate various aspects of their care experiences.

Jacob W. Dembosky, Amelia Haviland, Marc N. Elliott, Paul Kallaur, Carol A. Edwards, Edward S. Sekscenski, Alan M. Zaslavsky, Julie A. Brown

Evaluation of a Care Coordination Measure for the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Medicare Survey

We evaluated a five-item measure of care coordination included in the 2012 Consumer Assessment of Healthcare Providers and Systems (CAHPS) Medicare survey (n = 326,194 respondents, 46% response rate).

Ron D. Hays, Steven C. Martino, Julie A. Brown, Mike Cui, Paul Cleary, Sarah J. Gaillot, Marc N. Elliott

Consumer Response to Patient Experience Measures in Complex Information Environments

As indicators of clinician quality proliferate, public reports increasingly include multiple metrics. This approach provides more complete performance information than did earlier reports but may challenge consumers' ability to understand and use complicated reports.

Mark Schlesinger, David E. Kanouse, Lise Rybowski, Steven C. Martino, Dale Shaller

Development of and Field Test Results for the CAHPS PCMH Survey

This study provides support for the reliability and validity of new items to supplement the CG-CAHPS 1.0 Survey to assess aspects of primary care that are important attributes of PCMHs.

Sarah Scholle, Oanh Vuong, Lin Ding, Stephanie Fry, Patricia Gallagher, Julie A. Brown, Ron D. Hays, Paul Cleary

Can Hospital Cultural Competency Reduce Disparities in Patient Experiences with Care?

Greater hospital cultural competency may improve overall patient experiences, but may particularly benefit minorities in their interactions with nurses and hospital staff. Such effort may not only serve longstanding goals of reducing racial/ethnic disparities in inpatient experience, but may also contribute to general quality improvement.

Robert Weech-Maldonado, Marc N. Elliott, Rohit Pradhan, K. Cameron Schiller, Allyson Hall, Ron D. Hays

Giving Voice to the Vulnerable: The Development of a CAHPS Nursing Home Survey Measuring Family Members' Experiences

This survey measures family members' experiences of nursing home care, and the results contribute to the understanding of quality of care in nursing homes.

Elizabeth M. Frentzel, Judith Sangl, Christian T. Evensen, Carol Cosenza, Julie A. Brown, San Keller, Steven A. Garfinkel

Development and Evaluation of CAHPS Questions to Assess the Impact of Health Information Technology on Patient Experiences with Ambulatory Care

New CAHPS HIT items were identified that measure aspects of patient experiences not assessed by the CAHPS C&G 1.0 survey.

K McInnes, Julie A. Brown, Ron D. Hays, Patricia Gallagher, James D. Ralston, Mildred Hugh, Michael Kanter, Carl Serrato, Carol Cosenza, John Halamka, Lin Ding, Paul Cleary

A Field Experiment on the Impact of Physician-Level Performance Data on Consumers' Choice of Physician

An inexpensive letter and a phone call reminder can encourage plan members to access physician-level quality data.

Steven C. Martino, David E. Kanouse, Marc N. Elliott, Stephanie S. Teleki, Ron D. Hays

Introduction

This article is an introduction to a special issue of Medical Care describing recent work conducted by investigators on the Consumer Assessment of Healthcare Providers and Systems (CAHPSs) project.

Paul Cleary, Christine Crofton, Ron D. Hays, Ronnie D. Horner

Psychometric Properties of the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Clinician and Group Adult Visit Survey

The CG-CAHPS Adult Visit Survey has acceptable psychometric properties at the individual level and practice site level.

Naomi Dyer, Joann S. Sorra, Scott Alan Smith, Paul Cleary, Ron D. Hays

Differences in CAHPS Reports and Ratings of Health Care Provided to Adults and Children

Consumer assessment of health care is an important metric for evaluating quality of care.

Alex Y. Chen, Marc N. Elliott, Karen Spritzer, Julie A. Brown, Samuel A. Skootsky, Cliff Rowley, Ron D. Hays

The Relationship Between Perceived Discrimination and Patient Experiences with Health Care

Perceptions of discrimination based on race/ethnicity and Medicaid insurance are prevalent and are associated with substantially lower CAHPS reports and ratings of care. Practices must develop and implement strategies to reduce perceived discrimination among patients.

Robert Weech-Maldonado, Allyson Hall, Thomas Bryant, Kevin A. Jenkins, Marc N. Elliott

The Consumer Assessment of Healthcare Providers and Systems (CAHPS) Cultural Competence (CC) Item Set

The CAHPS CC 26-item set demonstrates adequate measurement properties and can be used as a supplemental item set to the CAHPS Clinician and Group Surveys in assessing culturally competent care from the patient's perspective.

Robert Weech-Maldonado, Adam Carle, Beverly A. Weidmer, Margarita Patricia Hurtado, Quyen Ngo-Metzger, Ron D. Hays

Development and Evaluation of CAHPS® Survey Items Assessing How Well Healthcare Providers Address Health Literacy

This study provides support for reliability and validity of the CAHPS Item Set for Addressing Health Literacy.

Beverly Weidmer-Ocampo, Cindy Brach, Ron D. Hays

Development of Items to Assess Patients' Health Literacy Experiences at Hospitals for the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospital Survey

This study provides support for the measurement properties of the HCAHPS Item Set for Addressing Health Literacy.

Beverly A. Weidmer, Cindy Brach, Mary Ellen Slaughter, Ron D. Hays

Reporting CAHPS and HEDIS Data by Race/Ethnicity for Medicare Beneficiaries

How should ethnic group-specific quality of care data best be reported to Medicare beneficiaries?

Steven C. Martino, Robin M. Weinick, David E. Kanouse, Julie A. Brown, Amelia Haviland, Elizabeth Goldstein, John L. Adams, Katrin Hambarsoomian, David J. Klein, Marc N. Elliott

Experiences of Care Among Medicare Beneficiaries with ESRD: Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey Results

Patients with end-stage renal disease (ESRD) have special health needs; little is known about their care experiences.

Charlotte Paddison, Marc N. Elliott, Amelia Haviland, Donna O. Farley, Georgios Lyratzopoulos, Katrin Hambarsoomian, Jacob W. Dembosky, Martin Roland

Differences by Survey Language and Mode Among Chinese Respondents to a CAHPS Health Plan Survey

As efforts to measure, compare, and report patients' health care experiences expand in scope and importance, corresponding efforts have been underway to expand the reach of the underlying survey instruments to patients who prefer languages other than English.

Marc N. Elliott, W. Sherman Edwards, David J. Klein, Amy Heller

Understanding Nonresponse to the 2007 Medicare CAHPS Survey

We describe overall rates and analyze predictors of unit and item nonresponse for the 695,197 Medicare beneficiaries selected for the 2007 MCAHPS survey (335,249 unit respondents, 49% overall response rate).

David J. Klein, Marc N. Elliott, Amelia Haviland, Debra Saliba, Q. Burkhart, Carol A. Edwards, Alan M. Zaslavsky

Improving Customer Service and Access in a Surgical Practice: A Case Study of a Successful Quality Improvement Intervention

Describes the efforts of one surgical specialty medical practice to improve customer service and access for its patients.

Denise D. Quigley, Shelley H. Wiseman, Donna O. Farley

How Do the Experiences of Medicare Beneficiary Subgroups Differ Between Managed Care and Original Medicare?

Quality improvement in Medicare managed care plans should target care for particular subgroups such as beneficiaries who have low incomes, are less healthy, older, female, and who did not complete high school.

Marc N. Elliott, Amelia Haviland, Nathan Orr, Katrin Hambarsoomian, Paul Cleary

Differential Item Functioning By Survey Language Among Older Hispanics Enrolled in Medicare Managed Care

Failure to account for language differences in CAHPS survey items may result in misleading conclusions about disparities in health care experiences between Spanish and English speakers.

Claude Messan Setodji, Steven Reise, Leo S. Morales, Marie N. Fongwa, Ron D. Hays

Depression and the Health Care Experiences of Medicare Beneficiaries

Depressed patients report poorer health care experiences and have less confidence that they can recognize their need for care.

Steven C. Martino, Marc N. Elliott, David E. Kanouse, Donna O. Farley, Q. Burkhart, Ron D. Hays

Understanding Variations in Medicare Consumer Assessment of Health Care Providers and Systems Scores: California as an Example

The mix of fee-for-service and Medicare Advantage enrollees, demographic characteristics of populations, and plan-specific factors can all play a role in observed regional variations in CAHPS scores between California and the nation.

Donna O. Farley, Marc N. Elliott, Amelia Haviland, Mary Ellen Slaughter, Amy Heller

Development, Implementation, and Public Reporting of the HCAHPS Survey

The authors describe the history and development of the CAHPS Hospital Survey (also known as HCAHPS) and its associated protocols.

Laura Giordano, Marc N. Elliott, Elizabeth Goldstein, William Lehrman, Patrice A. Spencer

Using Standardized Encounters to Understand Reported Racial/Ethnic Disparities in Patient Experiences with Care

A nationally representative sample of white, African American, and Latino respondents reported generally similar expectations about physicians' behaviors and provided similar average responses to questionnaires about interactions with physicians.

Robin M. Weinick, Marc N. Elliott, Angelo E. Volandes, Lenny Lopez, Q. Burkhart, Mark Schlesinger

Racial/Ethnic Differences in Patients' Perceptions of Inpatient Care Using the HCAHPS Survey

Using HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems, also known as the CAHPS Hospital Survey) data from 2,684 hospitals, the authors compare the experiences of Hispanic, African American, Asian/Pacific Islander, American Indian/Alaska Native, and multiracial inpatients with those of non-Hispanic White inpatients to understand the roles of between- and within-hospital differences in patients' perspectives of hospital care.

Elizabeth Goldstein, Marc N. Elliott, William Lehrman, Katrin Hambarsoomian, Laura Giordano

The Effect of Performance-Based Financial Incentives on Improving Patient Care Experiences: A Statewide Evaluation

Pay-for-performance incentives improve physician-patient communication, care coordination, and interaction with office staff.

Hector Rodriguez, Ted von Glahn, Marc N. Elliott, William H. Rogers, Dana Gelb Safran

Managed Care Quality of Care and Plan Choice in New York SCHIP

Examines whether low-income parents of children enrolled in the New York State Children's Health Insurance Program (SCHIP) choose managed care plans with better quality of care.

Harry H. Liu, Charles E. Phelps, Peter J. Veazie, Andrew W. Dick, Jonathan D. Klein, Laura P. Shone, Katia Noyes, Peter G. Szilagyi

Managed Care Quality and Disenrollment in New York SCHIP

Examines whether higher-quality measures in managed care plans are associated with lower disenrollment from the State Children's Health Insurance Program (SCHIP) in New York State.

Harry H. Liu, Charles E. Phelps, Peter J. Veazie, Andrew W. Dick, Jonathan D. Klein, Laura P. Shone, Peter G. Szilagyi

Effects of Survey Mode, Patient Mix, and Nonresponse on CAHPS Hospital Survey Scores

Valid comparisons of hospital performance require that reported hospital scores be adjusted for survey mode and patient mix.

Marc N. Elliott, Alan M. Zaslavsky, Elizabeth Goldstein, William Lehrman, Katrin Hambarsoomian, Megan K. Beckett, Laura Giordano

Adjusting for Subgroup Differences in Extreme Response Tendency in Ratings of Health Care: Impact on Disparity Estimates

Failure to adjust for subgroup differences in extreme response tendency ratings may misdirect resources for reducing disparities and provide inaccurate assessments of some providers.

Marc N. Elliott, Amelia Haviland, David E. Kanouse, Katrin Hambarsoomian, Ron D. Hays

Adapting CAHPS for an American Indian Population

Develop a culturally appropriate, reliable, and valid survey that can be used by the Choctaw Nation Health Services (CNHS) to compare patients' health care experiences across CNHS clinics, and to support quality improvement efforts.

Beverly A. Weidmer, Patrick Johansson, Debbie Dalpoas, David Wharton, Charles Darby, Ron D. Hays

Quality Assessments By Sick and Healthy Beneficiaries in Traditional Medicare and Medicare Managed Care

The Centers for Medicare and Medicaid Services pays for services provided through traditional fee-for-service (FFS) Medicare and managed care plans (Medicare Advantage [MA]). It is important to understand how financing and organizational arrangements relate to quality of care. Compares care experiences and preventive services receipt in traditional Medicare and MA for healthy and sick beneficiaries.

Patricia Seliger Keenan, Marc N. Elliott, Paul Cleary, Alan M. Zaslavsky, Bruce E. Landon

Components of Care Vary in Importance for Overall Patient-Reported Experience By Type of Hospitalization

Because the importance of patient experience dimensions varies by type of hospitalization, quality improvement efforts should target those aspects of patient experience that matter most for each hospitalization type.

Marc N. Elliott, David E. Kanouse, Carol A. Edwards, Lee H. Hilborne

Language and Regional Differences in Evaluations of Medicare Managed Care by Hispanics

Uses the Consumer Assessments of Healthcare Providers and Systems survey to examine the experiences of Hispanics enrolled in Medicare managed care. Hispanics face barriers to care; however, their experiences with care vary by language and region.

Robert Weech-Maldonado, Marie N. Fongwa, Peter R. Gutierrez, Ron D. Hays

Bridging from the Picker Hospital Survey to the CAHPS Hospital Survey

Illustrate an accessible and sufficiently precise method of bridging data from earlier surveys to the CAHPS Hospital Survey to support hospital internal quality improvement efforts. Where correspondence is high, old items can and should be replaced.

Denise D. Quigley, Marc N. Elliott, Ron D. Hays, David J. Klein, Donna O. Farley

Reports and Ratings of Care: Black and White Medicare Enrollees

Compares African American/black and white Medicare enrollees' perceptions of care. Blacks reported significantly worse experiences with speed of care, staff helpfulness, and getting needed care. They rated their doctors and nurses more positively.

Marie N. Fongwa, William Cunningham, Robert Weech-Maldonado, Peter R. Gutierrez, Ron D. Hays

Can Additional Patient Experience Items Improve the Reliability of and Add New Domains to the CAHPS Hospital Survey?

In the Consumer Assessment of Health Care Providers and Systems Hospital Survey, internal consistency reliability is low, and some care domains are not represented. Additional questions significantly improve the psychometric properties of the survey.

Arlyss Anderson Rothman, Hayoung Park, Ron D. Hays, C. A. Edwards, R. Adams Dudley

Survey Response Style and Differential Use of CAHPS Rating Scales by Hispanics

Hispanics report health care that is similar to or less positive than for non-Hispanic whites, yet have more positive ratings of care. Higher Hispanic ratings may be partially attributed to differences in response style rather than superior care.

Robert Weech-Maldonado, Marc N. Elliott, Adetokunbo Oluwole, K. Cameron Schiller, Ron D. Hays

How Do Proxy Responses and Proxy-Assisted Responses Differ from What Medicare Beneficiaries Might Have Reported About Their Health Care?

One should treat proxy responses to subjective ratings cautiously. Even seemingly innocuous reading, writing, and translation by proxies may influence answers. Spouses may be accurate proxies for the elderly in evaluations of health care.

Marc N. Elliott, Megan K. Beckett, Kelly Chong, Katrin Hambarsoomian, Ron D. Hays

Power of Tests for a Dichotomous Independent Variable Measured with Error

Examines implications for statistical power of using predicted probabilities for a dichotomous variable rather than the actual variable. Information loss from not observing actual values can be large. Direct substitution is easy and efficient.

Daniel F. McCaffrey, Marc N. Elliott

Using Pooled Kappa to Summarize Interrater Agreement Across Many Items

Proposes a pooled kappa estimator that efficiently summarizes interrater agreement by domain, as evaluated over 2,176 rated items. It is more widely applicable and makes better use of scarce subjects than simply averaging item-level kappas.

Han de Vries, Marc N. Elliott, David E. Kanouse, Stephanie S. Teleki

Problem-Oriented Reporting of CAHPS Consumer Evaluations of Health Care

CAHPS is an organized effort to provide consumers with standardized, comprehensible, and usable data regarding consumers' experiences with health care

Marc N. Elliott, Megan K. Beckett, David E. Kanouse, Katrin Hambarsoomian, Shulamit Bernard

Improving Performance for Health Plan Customer Service: A Case Study of a Successful CAHPS Quality Improvement Intervention

Describes the successful efforts of one full-service health plan to improve customer service for its members.

Denise D. Quigley, Shelley H. Wiseman, Donna O. Farley

Developing a Spanish-language Consumer Report for CAHPS Health Plan Surveys

Concepts and terms about health care quality translated well from English to Spanish.

Kathryn P. Derose, David E. Kanouse, Beverly Weidmer-Ocampo, Robert Weech-Maldonado, Rosa I. Garcia, Ron D. Hays

The Role of the Bifactor Model in Resolving Dimensionality Issues in Health Outcomes Measures

Application of a bifactor model for exploring the dimensional structure of an item response matrix, and for handling multidimensionality.

Steven Reise, Julien Morizot, Ron D. Hays

Understanding the Reporting Practices of CAHPS Sponsors

This article examines the reporting of CAHPS consumer experience data by sponsors.

Stephanie S. Teleki, David E. Kanouse, Marc N. Elliott, Liisa Hiatt, Han de Vries, Denise D. Quigley

Development of Supplemental Quality Improvement Items for the Consumer Assessment of Healthcare Providers and Systems (CAHPS)

Describes the process whereby RAND worked with health plans to identify the specific issues of concern to them about the usability of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) results for quality-improvement actions.

Denise D. Quigley, Donna O. Farley, Julie A. Brown, Marc N. Elliott, Han de Vries, Ron D. Hays

Comparison of Data Quality for Reports and Ratings of Ambulatory Care by African American and White Medicare Managed Care Enrollees

Compare missing data and reliability of health care evaluations between African Americans and Whites in Medicare managed care health plans.

Marie N. Fongwa, William Cunningham, Robert Weech-Maldonado, Peter R. Gutierrez, Ron D. Hays

Application of Group-Level Item Response Models in the Evaluation of Consumer Reports About Health Plan Quality

These results illustrate why it is important to study evaluations of health care, such as CAHPS, at multiple levels of analyses.

Steven Reise, Rob R. Meijer, Andrew T. Ainsworth, Leo S. Morales, Ron D. Hays

Classical Test Theory and Item Response Theory Analyses of Multi-Item Scales Assessing Parents' Perceptions of Their Children's Dental Care

The beta CAHPS(R) dental survey performed well and the revised instrument is recommended for future studies.

Ron D. Hays, Julie A. Brown, Lorraine U. Brown, Karen Spritzer, Jim Crall

Analysis of Case-Mix Strategies and Recommendations for Medicare Fee-for-Service CAHPS: Case-Mix Adjustment Report: 2004

For readers familiar with the 2000-2002 (Years 1-3) Case-Mix Reports, the authors briefly describe how this report differs from the previous year's report.

Marc N. Elliott, Katrin Hambarsoomian, Carol A. Edwards

Analysis of Case-Mix Strategies and Recommendations for Medicare Fee-for-Service CAHPS: Case-mix Adjustment Report: 2003

For readers familiar with the 2000-2002 (Years 1-3) Case-Mix Reports, the authors briefly describe how this report differs from the previous year's report.

Marc N. Elliott, Katrin Hambarsoomian, Carol A. Edwards

Comparison of Mail and Telephone in Assessing Patient Experiences in Receiving Care from Medical Group Practices

The medical group survey from the CAHPS(R) project, G-CAHPS, focuses on patient experiences in receiving care from their medical group practice.

Kimberly A. Hepner, Julie A. Brown, Ron D. Hays

Do Medicaid and Commercial CAHPS Scores Correlate Within Plans? A New Jersey Case Study

Within-plan variability in evaluations of care by Medicaid and commercial health plan member evaluations is too great to permit meaningful inference about plan performance for one population from the other for many important outcomes.

Marc N. Elliott, Donna O. Farley, Katrin Hambarsoomian, Ron D. Hays

Psychometric Properties of a Group-Level Consumer Assessment of Health Plans Study (CAHPS) Instrument

The G-CAHPS instrument provides an assessment of selected aspects of care that could be a useful complement to the plan-level CAHPS instrument.

Loel S. Solomon, Ron D. Hays, Alan M. Zaslavsky, Lin Ding, Paul Cleary

Field Testing: What It Is and How We Do It

Field testing involves administering an early version of a survey to a sample of the target audience.

Ron D. Hays, Julie A. Brown

Exploratory Factor Analyses of the CAHPS Hospital Pilot Survey Responses Across and Within Medical, Surgical, and Obstetric Services

Variability of CAHPS scores across hospitals can be reported parsimoniously using a limited number of composites.

A. James O'Malley, Alan M. Zaslavsky, Ron D. Hays, Kimberly A. Hepner, San Keller, Paul Cleary

Case-mix Adjustment of the CAHPS Hospital Survey

Case-mix adjustment has a small impact on hospital ratings, but can lead to important reductions in the bias in comparisons between hospitals.

A. James O'Malley, Alan M. Zaslavsky, Marc N. Elliott, Lawrence Zaborski, Paul Cleary

Equivalence of Mail and Telephone Responses to CAHPS Hospital Survey

Estimate the effect of survey mode (mail versus telephone) on reports and ratings of hospital care.

Han de Vries, Marc N. Elliott, Kimberly A. Hepner, San Keller, Ron D. Hays

Methods Used to Streamline the CAHPS Hospital Survey

Identify a parsimonious subset of reliable, valid, and consumer-salient items from 33 questions asking for patient reports about hospital care quality

San Keller, A. James O'Malley, Ron D. Hays, Rebecca A. Matthew, Alan M. Zaslavsky, Kimberly A. Hepner, Paul Cleary

Assessment of the Equivalence of the Spanish and English Versions of the CAHPS Hospital Survey on the Quality of Inpatient Care

The results provide preliminary evidence of the equivalence between the Spanish and English versions of H-CAHPS.

Margarita Patricia Hurtado, January Angeles, Steven A. Blahut, Ron D. Hays

Development and Evaluation of the CAHPS Hospital Survey

Provide the reader with technical documentation of the development and testing of the CAHPS Hospital Survey.

Charles Darby, Ron D. Hays, Phillip R. Kletke

Patterns of Unit and Item Nonresponse in the CAHPS Hospital Survey

Nonresponse weights should not be used for between-hospital comparisons of the CAHPS Hospital Survey.

Marc N. Elliott, Carol A. Edwards, January Angeles, Katrin Hambarsoomian, Ron D. Hays

Role of Cognitive Testing in the Development of the CAHPS Hospital Survey

Cognitive testing only evaluates the way in which respondents understand and answer questions.

Roger E. Levine, Floyd Fowler, Julie A. Brown

The Utility of CAHPS for Health Plans

This report presents findings from these interviews and is intended primarily for the Consumer Assessment of Health Plans Study (CAHPS) consortium, survey sponsors, health plans, and other stakeholders.

Denise D. Quigley, Dennis P. Scanlon, Donna O. Farley, Han de Vries

Satisfaction with Provider Communication Among Spanish-speaking Medicaid Enrollees

Differences in ratings of whether providers spent enough time with children during medical encounters explained by need for interpretive services.

David M. Mosen, Matthew J. Carlson, Leo S. Morales, Pamela P. Hanes

The Applicability of the Consumer Assessments of Health Plans Survey (CAHPS) to Preferred Provider Organizations in the United States: A Discussion of Industry Concerns

This paper examines the applicability of a leading patient survey, the CAHPS, to Preferred Provider Organizations (PPOs) in the United States.

Leo S. Morales, Marc N. Elliott, Julie A. Brown, Christina Rahn, Ron D. Hays

Health Plan Effects on Patient Assessments of Medicaid Managed Care Among Racial/Ethnic Minorities

Health care organizations should engage in quality improvement activities to address the observed racial/ethnic disparities in assessments of care.

Robert Weech-Maldonado, Marc N. Elliott, Leo S. Morales, Karen Spritzer, Grant N. Marshall, Ron D. Hays

Differential Use of the CAHPS 0-10 Global Rating Scale by Medicaid and Commercial Populations

This study is a secondary analysis of CAHPS 2.0 health plan survey data collected in 1999 and 2000.

Peter Damiano, Marc N. Elliott, Margaret C. Tyler, Ron D. Hays

Variation in Racial and Ethnic Differences in Consumer Assessments of Health Care

Examine racial/ethnic differences in consumer assessments and explore variation in such differences across health plans.

Nicole Lurie, Chunliu Zhan, Judith Sangl, Arlene S. Bierman, Edward S. Sekscenski

Analysis of Case-Mix Strategies and Recommendations for 2000 Medicare Fee-for-Service CAHPS

In support of Medicare's Fee-for-Service Consumer Assessment of Health Plans (CAHPS) project, the authors examine the impact of different case-mix strategies on attempts to strip ratings and reports of response bias.

Marc N. Elliott, Katrin Hambarsoomian, Carol A. Edwards, Matthew D. Solomon

Final Task 9 Report: 2001 Analysis of Case-Mix Strategies and Recommendations for Medicare-Fee-for-Service CAHPS

In support of Medicare's Fee-for-Service Consumer Assessment of Health Plans (CAHPS) project, the authors examine the impact of different case-mix strategies on attempts to strip ratings and reports of response bias.

Marc N. Elliott, Katrin Hambarsoomian, Carol A. Edwards

Psychometric Properties of the Spanish Consumer Assessment of Health Plans Survey (CAHPS)

This study suggests that the Spanish CAHPS 2.0 core survey has acceptable psychometric properties.

Leo S. Morales, Robert Weech-Maldonado, Marc N. Elliott, Beverly A. Weidmer, Ron D. Hays

Psychometric Properties of the Consumer Assessment of Health Plans Study (CAHPS) 2.0 Adult Core Survey

To estimate the reliability and validity of survey measures used to evaluate health plans and providers from the consumer's perspective.

J. Lee Hargraves, Ron D. Hays, Paul Cleary

Consumer Choice and Health Care Quality

Consumer choice is a key approach to improving the quality of health care for Americans.

Using Survey Measures to Assess Risk Selection Among Medicare Managed Care Plans

Quantifies risk selection among competing Medicare managed care plans, using beneficiary survey data from the CAHPS.

Alan M. Zaslavsky, Melinda Beeuwkes Buntin

Similarities and Differences in Choosing Health Plans

Increasingly, consumers have multiple health insurance options. New information is being developed to help consumers with these choices.

Pamela Farley Short, Lauren McCormack, Judith Hibbard, James Shaul, Lauren Harris-Kojetin, Michael H. Fox, Peter Damiano, Jennifer Uhrig, Paul Cleary

Effects of CAHPS Performance Information on Health Plan Choices by Iowa Medicaid Beneficiaries

The authors found that CAHPS information did not affect health plan choices by Iowa Medicaid beneficiaries.

Donna O. Farley, Marc N. Elliott, Pamela Farley Short, Peter Damiano, David E. Kanouse, Ron D. Hays

Effects of CAHPS Health Plan Performance Information on Plan Choices by New Jersey Medicaid Beneficiaries

To assess the effects of CAHPS health plan performance information on plan choices and decision processes by New Jersey Medicaid beneficiaries.

Donna O. Farley, Pamela Farley Short, Marc N. Elliott, David E. Kanouse, Julie A. Brown, Ron D. Hays

Summary of Focus Groups for CAHPS Dental Care Project

This report documents the key findings from focus groups conducted as part of the Dental CAHPS effort. The purpose of the focus groups was to affirm the current set of domains and determine whether key aspects of care were missing.

Julie A. Brown

Cross-cultural Adaptation of Survey Instruments: The CAHPS® Experience

Recommendations for the cross-cultural adaptation of survey instruments and illustrates with examples of what is being done in the CAHPS® Study.

Robert Weech-Maldonado, Beverly Weidmer-Ocampo, Leo S. Morales, Ron D. Hays

Readability of CAHPS 2.0 Child and Adult Core Surveys

Balance between collecting important information and maintaining a reasonable level of survey readability will be an important consideration.

Leo S. Morales, Beverly Weidmer-Ocampo, Ron D. Hays

Confirmatory Factor Analysis of the Consumer Assessment of Health Plans Study (CAHPS) 1.0 Core Survey

Analyzes the national Consumer Assessment of Health Plans Study (CAHPS(R)) 1.0 Core Survey with both Latino and Caucasian consumers and finds that ratings and reports of care show marked convergence.

Grant N. Marshall, Leo S. Morales, Marc N. Elliott, Karen Spritzer, Ron D. Hays

Case-mix Adjustment of the National CAHPS Benchmarking Data 1.0: A Violation of Model Assumptions?

To compare models for the case-mix adjustment of consumer reports and ratings of health care.

Marc N. Elliott, Richard Swartz, John L. Adams, Karen Spritzer, Ron D. Hays

The Role of Performance Measures for Improving Quality in Managed Care Organizations

Performance measures are used for quality improvement in addition to informing external constituents.

Dennis P. Scanlon, Charles Darby, Elizabeth S. Rolph, Hilary E. Doty

Differences in CAHPS Adult Survey Reports and Ratings by Race and Ethnicity: An Analysis of the National CAHPS Benchmarking Data 1.0

Comparisons of care in racially and ethnically diverse populations based on global ratings of care should be interpreted cautiously.

Leo S. Morales, Marc N. Elliott, Robert Weech-Maldonado, Karen Spritzer, Ron D. Hays

Racial and Ethnic Differences in Parents' Assessments of Pediatric Care in Medicaid Managed Care

This study examines whether parents' reports and ratings of pediatric health care vary by race/ethnicity and language in Medicaid managed care.

Robert Weech-Maldonado, Leo S. Morales, Karen Spritzer, Marc N. Elliott, Ron D. Hays

Assessing the Usability and Usefulness of the CAHPS Decision Helper, Version 2.0

In cooperation with other organizations, RAND developed a computer-based program, Decision Helper, to provide potential enrollees with information about health plans. This report summarizes the results of initial usability testing of version 2.0.

Mina Kimmerling, Mark Spranca, David E. Kanouse, Susan C. Phillips