In line with the movement to give consumers more information and choices regarding their healthcare, the federal government's Agency for Healthcare Research & Quality has developed a national clinician and group patient participation survey, CG-CAHPS (Clinician & Group Consumer Assessment of Healthcare Providers Survey).

The survey is currently voluntary, but if it follows in the footsteps of the hospital survey (HCAHPS) as many expect it to, participation in the survey will be tied to Medicare reimbursement.

In fact, at a House hearing in July 2006, the former Centers for Medicare & Medicaid Administrator Mark B. McClellan suggested that payment reductions and flat premiums could be accomplished in part through savings generated by adopting physician care quality measures, "There is growing evidence that these quality reporting programs and steps toward performance-based payments can save money overall."

McClellan stated that 34 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.  Only five specialties lack such measures, he added.

• 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 clnics; 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 - yet.  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).
• The path that the HCAHPS initiative took to national implementation may be the path that CG-CAHPS will also follow for its national roll-out, Medicare reimbursement, administration protocols, and public reporting.  The most up-to-date HCAHPS information is found at www.hcahps.org. 
• While CMS has not yet made overtures to 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.  Other health plans may elect to sponsor the survey as a factor in negotiating contracts with providers.  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.
• Many hospitals got a jump-start on HCAHPS by implementing the PRC HCAHPS Loyalty + Survey prior to its national roll-out.  When comparing these hospitals to a preliminary national database, their scores were much higher than the national average, leading us to believe they will score high when compared to their competitors in public reporting.  We suggest you also take this approach for CG-CAHPS and implement PRC's CG-CAHPS Loyalty + Survey in the next six months.