Navigating HCAHPS: From Patient Experience to Financial Success in Home Health Care

In the constantly changing home health landscape, understanding the nuances of the Home Health Care Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores is crucial for home health agencies. At the heart of this journey lies the differentiation between ‘patient experience’ and ‘patient satisfaction’, two factors that significantly influence the value-based purchasing (VBP) model.

Distinguishing Patient Experience from Patient Satisfaction

As explained by the Agency for Healthcare Quality and Research:

“The terms patient satisfaction and patient experience are often used interchangeably, but they are not the same thing. To assess patient experience, one must find out from patients whether something that should happen in a healthcare setting (such as clear communication with a provider) actually happened or how often it happened.

Satisfaction, on the other hand, is about whether a patient’s expectations about a health encounter were met. Two people who receive the exact same care, but who have different expectations for how that care is supposed to be delivered, can give different satisfaction ratings because of their different expectations.”

Below, we’ve selected a few HCAHPS survey questions to provide perspective on these two distinctions.

Q3: “Were you advised on how to safely organize your home when you began your home health care journey with this agency?”

Q4: “At the onset of your home health care, were you consulted about all the medications you were taking, both prescription and over-the-counter?”

Such questions focus on tangible interactions, spotlighting the patient’s experience. Conversely:

Q20: “On a scale from 0 to 10, where 10 represents the best possible care, how would you rate this agency’s home health providers?”

Q25: “Would you recommend this agency to family or friends seeking home health care?”

These questions aim to gauge the overall emotional response and the satisfaction levels patients have towards their care.

Here is a link to the HHCAHPS survey. Take a look and determine if you agree with our viewpoint that 16 out of the 19 questions, or 84% of the survey questions influencing an agency’s HHVBP scores, prompt patients to recall specific aspects of their home health care experience rather than measure their level of satisfaction.

The Financial Implications with Home Health Value Based-Purchasing (HHVBP)

In 2025, HCAHPS scores may influence up to 30% of the the home health value-based purchasing financial outcome. In the intensely competitive industry, these changes could have profound impacts on agencies Medicare reimbursement adjustments by up to 5%, either positively or negatively.

Implementation Change to Drive Success

Comprehensive Understanding of HCAHPS:  Surveys indicate that while many home health executives understand the importance of HCAHPS, they believe only a few point-of-care clinicians genuinely grasp the HCAHPS survey. It’s vital to ensure your team fully comprehends each question and adjusts care strategies accordingly.

Revised Engagement Paradigms: Aim for patient engagements that are both meaningful and memorable. When patients recall experiences, the likelihood of them answering favorablely significantly increases.

Education & Skill Enhancement:  Emphasizing the significance of HCAHPS scores to your staff is crucial to ensure they understand the substantial impact that patient experience has on the HCAHPS survey questions.

Integrating Proactive Feedback Mechanisms (Weekly calls as an example):  Implementing a continuous feedback system that fosters ongoing patient engagement between in-home visits is essential. This system can involve activities like conducting weekly calls to gather updates, delivering standardized education regarding medication routines, emphasizing the significance of home safety, discussing upcoming schedules, and more. Such proactive measures are instrumental in averting the escalation of minor issues into significant challenges.

Upcoming ACHC Masterclass Webinar: Elevate Your Agency – Mastering HHVBP: Best Practices for Enhancing Quality of Care

For those eager to stay ahead and grasp impending changes, J’non Griffin, RN, SVP of Coding at SimiTree, will present a three-part ACHC masterclass webinar on HHVBP in September.

OASIS, Patient Engagement, and Expanded HHVBP Model – September 14, 2024

Reducing Hospitalizations with Care Management Protocols – September 21, 2024

Improving Patient Case Management to Increase HHCAHPS Scores – September 28, 2023

During the final session on September 28, 2023, Matthew Mulski, Co-founder of Telos Health, will join her to delve into the intricacies of HCAHPS questions and unpack the playbook Telos has used to assist its home health partners in outperforming the national average across all 5 HCAHPS measures, while also achieving a 4.61% hospitalization rate among patients actively engaged in their partners’ home health care navigation program (approximately 70% of patients receiving care from their home health partners as of mid-year 2023).