Numerous HCAHPS changes are set to take effect Jan. 1, aiming to modernize the survey and increase patient response rates.
The survey's main mode of administration — paper — and its question sets have remained largely unchanged since CMS launched HCAHPS in 2008, according to Rick Evans, senior vice president of patient services and chief experience officer of NewYork-Presbyterian Hospital in New York City.
CMS outlined key changes to the survey process in its inpatient prospective payment system final rule released Aug. 1. HCAHPS scores collected under the modernized process will be reflected in hospitals' payment determinations for fiscal 2027.
Eight survey changes that will take effect in 2025:
1. CMS will allow patients to fill out the HCAHPS survey online, as opposed to only over the phone or by mail. In a 2021 pilot run, CMS found adding an option for electronic administration increased survey response rates. The three new web-first survey offering will include:
- Email survey, followed by mail survey to non-respondents
- Email survey, followed by phone survey to non-respondents
- Email survey, followed by mail survey then phone survey to non-respondents
2. CMS will sunset two current survey administration options — the aActive interactive voice response and the hospitals administering HCAHPS for multiple sites survey modes — which have not been used by any hospitals since 2016 and 2019, respectively. Mail-only, phone-only and mail-phone survey options will remain available.
3. The current HCAHPS survey includes 29 questions organized into 10 submeasures. The updated version will add three new submeasures for care coordination, restfulness of hospital environment and information about symptoms, bringing the total number of questions to 32.
4. Four questions, including those about call-button use and care transitions, will be eliminated as they either reflect outdated hospital processes or prove redundant with other survey questions.
5. The data-collection period for the survey will extend from 42 days to 49.
6. CMS will end a regulation that prohibits patients' loved ones from filling out the survey on their behalf, though patients will still be encouraged to fill out the survey themselves.
7. CMS will limit the number of supplemental items to 12 to align with its other patient experience surveys.
8. Hospitals will be required to collect information about what language a patient speaks. Spanish-speaking patients must be presented with the official CMS Spanish translation of the survey.