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Improving your CAHPS Scores Is Possible — Here’s How...



The Consumer Assessment of Healthcare Providers & Systems (CAHPS) score is a vital marker for hospital networks to get paid by Medicare and Medicaid patients. If you pride yourself on offering a great service you might assume you’ll automatically get a great score — but sometimes, things that were not even related to the physician's care end up affecting the facilities CAHPS Score. In the wake of a disappointing score, it can be tough to figure out what patients are really basing their survey responses on or whether or not they understand which visit and doctor the survey is referring to. As we all know if given the opportunity when something goes wrong a patient will take any opportunity to express the issue, even if that survey doesn't reference the visit, you want it to.

Facilities and leadership tend to use CAHPS scores as a learning tool to improve upon going forward. In many cases improving your communication about the survey to your patients can help the overall outcome of the survey response rate - it can be challenging to gauge what patients want but we try our best to meet their needs.

It really is possible to boost your CAHPS scores without being a mind reader. You’ll need to refer to some data, understand the patient’s experience, and consider their feedback when thinking about how we can do this better with actionable items. While I realize that is a grossly over simplified statement hang on, I will explain.

Focus on patient experience

Over the last few years, the Centers for Medicare and Medicaid Services has put more emphasis on questions that discern patient satisfaction and experience. While member experience accounted for 37% of the rating in 2021, this rose to 60% in 2022 — and it’s set to reach 57% in 2023. Covid has skewed some of these numbers, but we are really talking about how to improve your scores in general, with current circumstances as a factor but not necessarily the only factor.


At first, it can seem challenging to find the underlying cause of what we might be missing — it is not like you can ask the survey respondents personally when they submit their responses anonymously. However, the survey provides data you can use to piece together information.


Dig into the data

We know that the CAHPS survey asks patients about the following:

  • Chronic conditions

  • Demographics

  • Previous responses in mock surveys

  • Did your provider address your concern

  • Was the healthcare facility accessible

For example, you might notice that people with certain chronic conditions are less satisfied than the average person. This could suggest something is going wrong with the processes involved in the care for that decision. Then, you can then put the magnifying glass on that and figure out where the issues may lie.

Or you might realize those in an older age group are less satisfied than younger people. That is another clue to where you are going wrong that you can link to your processes and try to amend.

For this to work, you will also need to refer to your own data. Get creative about what you use — you can pull from more than you might realize, from call recordings to past appeals to comments or reviews on social media accounts. If you are struggling to make sense of everything yourself, you can also turn to artificial intelligence to carry out the analysis for you.

While data analysis might not be able to give you an explanation for your rating with 100% certainty, it can at least point you in the right direction.


Train your staff

Understanding what’s going wrong is only the first stage to making improvements. Next, you need to take action — and in most cases, that will involve training your workforce.

First, we need to train the team on how the CAHPS survey works, what it asks, and make sure that everyone on the team understands how important it is to the facility if we want to get paid the maximum for services rendered. Knowing what they’re being critiqued on can often make a big difference in making little changes in their behavior, and it may help them to adopt the same language as the survey. This will give respondents a feeling of familiarity when filling in the survey, and it also ensures you avoid negative responses to policies and procedures set by the facility.

While most people in the healthcare space are a special kind of person, it's always a good idea to remind the team to try their best to make each patient feel welcome and cared for — a little can go a long way.

Pay attention to your processes.

It may be worth asking yourself and your team if stress levels, poor planning, or a declining corporate culture have somehow contributed to the outcome. Is there something you can do to create an environment that will set them up for success? Maybe a way to make your processes more streamlined? Some of these can be low hanging fruit you can adjust fairly quickly. The things that will require more resources and time should be escalated.

Shape up your communication

There’s nothing worse for a patient than not knowing what is going on or having to call various departments to get the answer they are looking for like lab results. Offering communication via the portal email, phone calls, in-person, and even telehealth appointments to make access easier for patients to get the answers they need and of course respond to their CAHPS survey.

There’s always room for improvement

We know moving the needle on CAHPS scores can seem like an impossible undertaking, but it is certainly not impossible with some trial and error. What I find is an actionable plan with milestones and results will move the needle in an effective way. The challenge always is no one is dedicated to just improving CAHPS Scores you will always have a growing to do list.

At Cornerstone Paradigm Consulting, as consultants, we can help you to map out where you may be going wrong and figure out how to improve. To find out more, book a free consultation today.

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