The CAHPS family of surveys
The Consumer Assessment of Healthcare Providers and Systems, or CAHPS, is a set of standardized surveys developed by the Agency for Healthcare Research and Quality (AHRQ) and administered by CMS-approved vendors. Different versions exist for different settings: HCAHPS for hospitals, Hospice CAHPS for hospice agencies, HHCAHPS for home health, and a Nursing Home CAHPS instrument piloted and refined over the past decade. Each survey captures the patient's or family's perspective on access, communication, responsiveness, and overall rating.
What the surveys measure
Common domains across the surveys include communication with nurses and doctors, responsiveness of staff, pain management, discharge information, and an overall numeric rating of the provider. Hospice CAHPS, administered to a family member of a deceased patient typically two to three months after death, has eight composite measures including communication, training family to care for the patient, emotional and spiritual support, and getting timely help.
How the data is used
CMS publishes results on Care Compare for hospitals, hospice, home health, and nursing homes. The data feeds star ratings in some settings and, for hospitals, is built into the Hospital Value-Based Purchasing program where it influences a portion of Medicare reimbursement. Home health and hospice agencies use the results both for public reporting and for internal quality improvement.
Why response rate matters
Survey response rates have declined across healthcare over the past decade, mirroring broader declines in survey participation. Low response rates raise concerns about non-response bias, where the patients who answer differ systematically from those who do not. Agencies invested in CAHPS performance typically focus on operational changes (responsiveness, communication) rather than on coaching patients toward a specific answer, which CMS prohibits.
What an operator can do
Operators improve CAHPS scores by improving the underlying experience. Faster response to call lights, better discharge instruction in plain language, better pain management protocols, and proactive family communication all move scores. Phone handling matters as well. Agencies that miss inbound calls during an episode of care, or that fail to call families back within published timelines, tend to score lower on responsiveness and timely-help measures.