Get Ready for CG-CAHPS

by Trina E. Dorrah, MD, MPH

I get it. It is a little strange. In fact, some people even think I’m crazy. Why? I’m a physician, but in my free time, I love helping my colleagues improve their patient experience. Lately, I’ve spent a lot of time discussing a patient experience survey known as CGCAHPS (Clinician & Group Consumer Assessment of Healthcare Providers and Systems). I’m sure it doesn’t surprise you to learn that CGCAHPS is a topic that produces little excitement. In fact, if you ever want to end a party early, start talking about the patient experience. I understand, but like I tell my coworkers, focusing on the patient experience is here to stay. So if you can give me a couple minutes of your time, I’ll explain why this is so important, and give you 3 things you can do today to begin improving your patients' experience.

  

What is CGCAHPS?

CGCAHPS is a standardized outpatient survey that various organizations, including Medicare, are using to assess your patients’ experience with the clinic visit. In case you’re wondering, the terms patient satisfaction and patient experience are often used interchangeably. In reality, they are actually  different. For example, if you diagnose Mr. Thomas with diabetes, he won’t be happy, but he can still be satisfied with the overall clinic experience. The CGCAHPS survey tries to differentiate the care experience from the patient’s emotions. This is helpful because it’s easier to improve an experience. 

There are seven questions on the CGCAHPS survey that specifically relate to you, the provider. When your patients complete the survey, they are asked to rate you in these seven categories.

1.     Did this provider explain things in a way that was easy to understand?

2.     Did this provider listen carefully to you?

3.     Did this provider give you easy-to-understand information about these health questions or concerns?

4.     Did this provider seem to know the important information about your medical history?

5.     Did this provider show respect for what you had to say?

6.     Did this provider spend enough time with you?

7.     Using any number from 0 to 10, where 0 is the worst provider possible and 10 is the best provider possible, what number would you use to rate this provider?

When the scores are reported, you only get credit for the most favorable response. For example, if the survey gives your patients three choices (yes, definitely; yes, somewhat; no), you only get credit for the number of patients who choose the highest score (yes, definitely).

Why should you care?

As physicians, we all want to improve the care we provide our patients. This is what we do every day, so we don’t need a survey to make us do the right thing. However, the Affordable Care Act has increased the stakes by requiring physicians to use the CGCAHPS survey to assess the patient experience. The eventual goal is that all providers who participate in fee-for-service Medicare will measure their patients’ experience with the CGCAHPS survey. This information will be publicly available on the Physician Compare website. Once the survey is implemented, the next step will be to link the survey responses to reimbursement through the Physician Value-Based Payment Modifier. The Physician Value-Based Payment Modifier is a way for Medicare to tie pay to performance. Doctors who perform well on certain quality and cost metrics, including the patient experience, will be paid more than those doctors who do not. How will the patient experience be measured in this program? You guessed it…through CGCAHPS.

So we’ve come full circle. Create a standardized patient experience survey (CGCAHPS), require its use (through legislative reform), link reimbursement to the patient experience (via the Physician Value-Based Payment Modifier), then differentiate between providers based on the patient experience through a standardized survey (CGCAHPS).

What can you do to prepare?

Begin working to improve your patients' experience now. For starters, follow the 3 tips listed below. The first phase of the Physician Value-Based Payment Modifier begins in 2015. You do not want to be caught unprepared.  

1.    Learn as much as you can about the CGCAHPS survey.

·     There are several books, articles, and websites about CGCAHPS. Pick one and begin learning all you can.

2.    Incorporate patient experience improvement tips into your daily practice.

·     Find a book, article, or website that gives suggestions for improving the patient experience. Choose a few helpful tips, and immediately incorporate them in your practice.

3.    Involve your entire clinic staff in your improvement efforts.

·     Educate your staff on the CGCAHPS survey and challenge them to find ways to improve your clinic’s scores. Improvement is a joint effort, and involving your staff will ultimately improve your scores, too.

Trina E. Dorrah is an internal medicine physician/hospitalist and author of Physician's Guide to Surviving CGCAHPS & HCAHPS.