Properties of HCAHPS (Patient Experience) Scores in the Centers for Medicare and Medicaid Services' Hospital Value-Based Purchasing Program

• Activity Number: 654
• Type: Contributed
• Date/Time: Thursday, August 8, 2013 : 8:30 AM to 10:20 AM
• Sponsor: Health Policy Statistics Section
• Author(s): Marc Elliott*+ and William G. Lehrman and Christopher Cohea and Elizabeth Goldstein and Laura A. Giordano
• Companies: RAND Corporation and CMS and HSAG and CMS and HSAG

Abstract

Using patient survey data from 3,173 national hospitals, we examine the HCAHPS HVBP score & its 3 components ("achievement sum"/AS, "improvement supplement"/IS, and consistency points/CP), which will affect hospital payments of ~$300M in FY13. Hospitals earn 0-20 CP according to their lowest dimension and 0-10 points for achievement or improvement on each of 8 dimensions. We decompose achievement/improvement into a 0-80 AS and a 0-72 IS -improvement points beyond those earned for achievement. The mean (SD) total score/AS/IS/CP was 43.5 (20.0)/23.2 (19.3)/3.3 (4.7)/17.0 (3.1). AS correlated 0.97 with total points (TP, p<0.001), accounting for 94% of TP variance. IS explained most of the remaining variance and tended to be higher when AS was lower (with more opportunity for improvement), correlating -0.42 with AS (p<0.001). Mean IS was greatest for hospitals with average or just below TP. Mean CP increased with TP (correlating 0.68 with AS), but approached a maximum value at average levels of TP. CP was the primary source of TP for below-average hospitals. While CP accounts for 39% of TP and IS 8%, IS is more variable and accounts for more variance in TP.