CG CAHPS Is Here!
What it Means for Your Organization
with Michael Smith, Vice President, Physician Practice Management, CarolinaEast Health System and T.R. Lewis, MD, Pediatric Core Medical Director, OU Physicians
Ready or not, CMS' www.medicare.gov/physiciancompare website is live! While public reporting of patient perception of care data is still voluntary1, it won't be long until family and friends of all impacted physicians can log on and see how their patients rate them. Have you checked the website lately?
It's true that the Clinician and Group Consumer Assessment of Healthcare Providers and Systems Survey (CG CAHPS) directly impacts just one to two percent of Medicare physician practice reimbursement, but here's the kicker: These (or similar) scores will provide the foundation to measure the success of many reimbursement models being piloted, from the Patient Centered Medical Home to statewide collaborative and regional networks. When you add these effects in, 70 to 80 percent of practice reimbursement is at risk as early as 2014!
CG CAHPS is a survey—much like HCAHPS—developed by the Agency for Healthcare Research and Quality (AHRQ). Just like the Hospital Compare website, the Physician Compare website provides patients with comparative information based on reported survey results to make informed healthcare decisions.
Physician Compare was launched in 2011, with voluntary data collection and reporting beginning in 2012. In 2013, public reporting on the website began. It's likely that reimbursement ad justments will begin in 2015. There are six different versions of the surveys providers may choose from. (See sidebar for complete details.) All surveys include questions in five domains: Overall willingness to recommend, access to care, follow-up on test results, how well doctors communicate, and courtesy and helpfulness of office staff.
The Good News
If you've already hardwired key Must-Haves in physician offices, you're off to a fast start. "While we have more work to do around wait times and access, we recognize that some of our strong CG CAHPS performance is due to our work with AIDET and post-visit phone calls—tools Studer Group has helped us hardwire over the last 18 months," says Michael Smith, vice president, physician practice management at CarolinaEast Health System in New Bern, North Carolina. "So we are definitely benefiting from our earlier commitment to getting these tools right."
At CarolinaEast, all physicians and clinic staff consistently use AIDET®—Acknowledge-Introduce-Duration-Explanation-Thank You—with patients, which shows up in great performance on the CG CAHPS domain on doctor communication and courtesy and helpfulness of staff...clear evidence that patients agree they are receiving quality care. CarolinaEast also makes post-visit phone calls to 100 percent of targeted patients. This has boosted CG CAHPS results in domains for follow-up, communication, helpfulness, and overall willingness to recommend.
How did CarolinaEast get physicians on board? "Several of us attended Studer Group's two-day Physician Institute where physician speakers explained the value of using objective data—not what we think, but what patients say—in changing physician behavior and culture," adds Smith. "We're just now working with our Medical Executive Advisory Committee to begin rolling out results through a physician champion." (Learn more about Studer Group's Physician Partnership Institute at www.studergroup.com/institutes).
Rounding Improves CG CAHPS Results Too
At OU Physicians, rounding on physicians cascades from the CEO and CMO through three core medical directors for primary care, adult and pediatric clinics to 830 individual providers...and it includes conversations around CG CAHPS. Currently, OU Physicians exceeds its targets in three of five CG CAHPS domains.
"In addition to sharing what's going well and thanking them for their contributions, I share CG CAHPS results for all OU children's physicians, the individual physician's clinic, and then we talk about individual performance," explains T.R. Lewis, MD, pediatric core medical director for OU Physicians. "We've also used rounding to harvest and share best practices at monthly meetings with 15 to 20 medical directors."
"It's important to validate the work physicians do by helping them understand what these scores mean," he adds. "For instance, if a patient's rating of the provider is a raw score of 90 (on the Child and PCMH CG CAHPS survey), he's barely above the 50th percentile according to AHRQ averaged data for the composite. We need to reach higher...but it also means that 9 out of 10 patients gave him top marks."
1 While reporting is still voluntary for most providers, PQRS participants with more than 100 providers under a single tax ID will be required to collect and report data in 2014. (This is also true for Pioneer and Medicare Shared Savings ACOs.)