CMS to Pilot Test Family Experience of Care Survey - Requests Comment on Data Collection Burden and Other Issues
April 9, 2013 03:43 PM
The Centers for Medicare & Medicaid Services (CMS) has developed a hospice experience of care survey to be field-tested in 2013. The survey will include 730 bereaved family members or close friends of hospice patients who died while in hospice care at home, in nursing homes, or in inpatient settings, including acute care hospitals and freestanding hospice inpatient units.
Field-test findings will be used to refine survey content and implementation procedures in advance of CMS’ planned national implementation of a hospice survey. Responses to this national survey could ultimately be used for public reporting of hospice quality performance.
CMS announced the plans for the pilot test in the April 4, 2013, Federal Registeras part of a request for comment on the estimated time burden associated with the field-test, as well as other aspects related to the collection of information, including:
The necessity and utility of the proposed information collection for the proper performance of CMS’ functions
The accuracy of the estimated burden
Ways to enhance the quality, utility, and clarity of the information to be collected
The use of automated collection techniques or other forms of information technology to minimize the information collection burden.
A rigorous, well-designed hospice survey will allow CMS to better understand the experiences of both hospice patients and their family members or friends, as reported by those individuals. This information will ultimately be used to help improve the quality of care hospice patients and their loved ones receive.
CMS has previously stated that they do not intend to implement the experience of care survey and a hospice-specific data set (as part of the Hospice Quality Reporting Program) simultaneously. The expressed preference by CMS was to implement the data set first. However, since development of the data set could take an extended period of time, CMS could choose to implement the hospice experience of care survey first in an effort to advance hospice public reporting.
As anticipated, the hospice experience of care survey is modeled after the other Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys CMS has implemented for other healthcare providers such as hospitals, nursing homes, and home health agencies that have become part of their public reporting.
The hospice experience of care survey is similar to the Family Evaluation of Hospice Care (FEHC) survey, which is used by many hospice providers to assess family satisfaction. The proposed survey will enhance Medicare’s capacity to evaluate hospice care and assess the value of hospice services to patients and their families.
Survey data will be collected via mailed survey. If no response is received within three weeks, the CMS vendor will telephone the family member/close friend to receive verbal responses to the survey. Several telephone attempts will be made over the course of 6-8 weeks. CMS is expecting, based on current hospice survey experience, that there will be a 40 percent response rate. Separate, but similar, versions of the survey will be administered for each of the following three hospice care settings:
In a home-based setting
In a nursing home
In an inpatient setting such as a freestanding inpatient unit or acute care hospital.
The bereaved family member or close friend for each patient, identified as the patient’s primary informal caregiver in hospice records, will receive one pre-notification letter and one survey mailing, followed by telephone interviews. The mailed survey will be formatted for data scanning, and data from all returned surveys will be scanned into an electronic data file. Computer Assisted Telephone Interviewing (CATI) will be used for the secondary mode of data collection for non-responders to the mailed request to complete the survey.
A representative sample of hospices will be utilized for the study. Hospice-level data from this survey will not be made publicly available to Medicare beneficiaries or the general public because the results are from a field test of the survey instrument
One of the concerns from other experience of care surveys is the length of the survey itself and the length of time to complete it. The home version of the survey contains 71 items and is estimated to require an average administration time of 15.8 minutes in English and 18.9 minutes in Spanish, for an average response time of 15.9 minutes or 0.266 hours.
The nursing home version of the survey contains 65 items and is estimated to require an average administration time of 14.4 minutes in English and 17.3 minutes in Spanish, for an average response time of 14.6 minutes or 0.243 hours.
The inpatient version of the survey contains 67 items and is estimated to require an average administration time of 14.9 minutes in English and 17.9 minutes in Spanish, for an average response time of 15.0 minutes or 0.251 hours.
The three versions of the survey can be found here.