The survey is currently voluntary for most clinicians and groups, and at this time there are no plans to tie it to reimbursements or make it mandatory.

However, certain clinicians and groups are required or strongly urged to use the survey by their state, insurer, or physician specialty organization.  For instance, the Massachussetts Health Quality Partners, state-wide coalition of Massachusetts physicians, hospitals, health plans, purchasers, consumers and goverment agencies, reports CG-CAHPS data on their website at http://www.mhqp.org/.

Additionally, 34 out of 39 physician specialities have developed measures that doctors could use to report performance data using the current claims they file when they seek reimbursement from Medicare. 

Response Scale Options
Users have their options to choose from two response scales for their survey.  They are:

1. 6-point scale (Never, Almost Never, Sometimes, Usually, Almost Always, or Always)
2. 4-point scale (Never, Sometimes, Usually, or Always); this scale was endorsed by the NQF and is most widely used.

Beta Version Child Primary Care 2.0
The Commonwealth Fund drove the development of this survey version as they believed that the first version didn't accurately reflect the differences with pediatric primary care.  The new survey responds to the following differences in adult vs. pediatric care:

1. Good care should access and promote children's active development.
2. Scheduled & preventative care
3. Pediatric healthcare outcomes are heavily dependent upon doctor to parent education.
4. Only a small percentage of children have chronic problmes yet they account for a large percentage of utilization.
5. Increased morbidities
6. Children are disproportionally affected by social and environmental health issues.

The development of this survey version included many stakeholders, including the American Academy of Pediatrics.  This survey has been translated into Spanish, is for children under 18 years old and has multiple skip patterns so that it can be used by patients in all age groups.  It was field tested by the Massachusetts General Physician Organization.

Visit-Specific Adult Survey
As a response to the many clinicians and organizations seeking more specific data, the CAHPS organization is in the final stages of developing a visit-specific adult survey.  In addition, specific-visit surveys are more in-line with current survey trends and are liked better by clinicians as they work better for improving quality.

This survey was developed from the core Adult Primary Care survey and includes 32 items on the questionnaire.  This new survey also includes questions on test results, likelihood to recommend, as well as an open-ended question on how the office could improve care.  The survey includes verification information with the physician's name and date of visit.

The Minnesota Community Measurement group is piloting the data from September - November 2008, with plans to report the data in early 2009.  The pilot will test the sample size, estimate differences in response rates and scores as well as estimate differences in how sites rank comparing the visit-specific survey to the 12-month survey.

National CAHPS Benchmarking Database
This database is the national repository of all CAHPS data which is funded by AHRQ and administered by Westat.  AHRQ is recruiting more clinician groups to add to the database so that they can build both the visit-specific and 12-month databases.  In addition, AHRQ is working with survey vendors to help them include respondent-level and clinic-level characteristics such as physician specialty, practice size, ownership, etc.  The organization is also developing new online reporting so that users can retrive custom reports from a password-protected area. 

If you would like to learn more about this database or are interested in voluntary participation, please contact AHRQ at NCBD1@ahrq.gov.

• The CAHPS family of surveys are experience surveys - they measure how consistently certain actions were performed by healthcare providers.  The purpose of these surveys is to allow consumers to make objective comparisons between providers and clinics; to create incentives for clinicians and administrators to assess and improve patients' experiences with their care; and to enhance public accountability by increasing the transparency of the quality of care provided in return for the investment.
• CG-CAHPS is not mandatory and it is unknown whether it will eventually be mandatory or tied to financial reimbursement.  To keep updated on the survey initiative, continually monitor AHRQ's CAHPS website at www.cahps.ahrq.gov (click on Ambulatory Care on the left side of the page for the CG-CAHPS information).
• While CMS' current plans do not include adopting the CG-CAHPS survey as a reimbursement criterion, other organizations have started sponsoring the survey.  A few large health plans have been using versions of the survey for years in order to provide plan members with information to aid in their selection of a primary care provider.  The American Board of Medical Specialties has indicated that over half of their certifying Member Boards have expressed interest in adopting the CG-CAHPS survey as a component of their Maintenance of Certification program for physicians.
• CG-CAHPS is not conducive to identifying perceptions of care, the "how well" of a visit.  Rather, it identifies consistencies of behavior, the "how often" during a visit.  To increase patient loyalty and service excellence, clinics must also include loyalty-building questions in their patient survey.  CG-CAHPS administration protocols allow additional questions to be added at the end of the survey.
• The CG-CAHPS survey questions are written to ask patients to reflect on ALL of their clinic visits during the last 12 months, rather than focusing on a specific visit in the recent past.  Attributing survey results to a particular event in the clinic will be very difficult, making the survey much better suited for use as a report card than a process improvement tool.  CG-CAHPS does offer a module of questions that may be added to the survey to measure behaviors during a specific visit.