Patient satisfaction has come full circle. Why you need to care.


I get it. It is a little strange. In fact, some people even think I’m crazy. Why? I’m a physician, but in my free time, I love helping my colleagues improve their patient satisfaction. Lately, I’ve spent a lot of time discussing a patient satisfaction survey known as CG-CAHPS (Clinician and Group Consumer Assessment of Healthcare Providers and Systems). I’m sure it doesn’t surprise you to learn that CG-CAHPS is a topic that produces little excitement. In fact, if you ever want to end a party early, start talking about patient satisfaction. I understand, but like I tell my coworkers, patient satisfaction is here to stay. So if you can give me a couple minutes of your time, I’ll give you 3 things you can do today to begin improving your patient satisfaction.

What is CG-CAHPS?

CG-CAHPS is a standardized outpatient survey that various organizations, including Medicare, are using to assess your patients’ experience with the clinic visit. In case you’re wondering, the terms patient satisfaction and patient experience are often used interchangeably. In reality, they are intended to be different. For example, if you diagnose Mr. Thomas with diabetes, he won’t be happy, but he can still be satisfied with the overall clinic experience. The CG-CAHPS survey tries to differentiate the care experience from the patient’s emotions. This is helpful because it’s easier to improve an experience.

There are seven questions on the CG-CAHPS survey that specifically relate to you, the provider. When your patients complete the survey, they are asked to rate you in these seven categories.

  1. Did this provider explain things in a way that was easy to understand?
  2. Did this provider listen carefully to you?
  3. Did this provider give you easy-to-understand information about these health questions or concerns?
  4. Did this provider seem to know the important information about your medical history?
  5. Did this provider show respect for what you had to say?
  6. Did this provider spend enough time with you?
  7. Using any number from 0 to 10, where 0 is the worst provider possible and 10 is the best provider possible, what number would you use to rate this provider?

When the scores are reported, you only get credit for the most favorable response. For example, if the survey gives your patients three choices (yes, definitely; yes, somewhat; no), you only get credit for the number of patients who choose the highest score (yes, definitely).

Why should you care?

As physicians, we all want to improve the care we provide our patients. This is what we do every day, so we don’t need a survey to make us do the right thing. However, the Affordable Care Act has increased the stakes by requiring physicians to use the CG-CAHPS survey to assess the patient experience. The requirement initially only applies to certain physician groups, such as those participating in accountable care organizations.

However, the eventual goal is that all providers who participate in fee-for-service Medicare will measure their patients’ experience with the CG-CAHPS survey. Once the survey is implemented, the next step will be to link the survey responses to reimbursement through the physician value-based payment modifier. The modifier is a way for Medicare to tie pay to performance. Doctors who perform well on certain quality and patient satisfaction metrics will be paid more than those doctors who do not. How will patient satisfaction be measured in this program? You guessed it: through CG-CAHPS.

So we’ve come full circle. Create a standardized patient satisfaction survey (CG-CAHPS), require its use (through legislative reform), link reimbursement to patient satisfaction (via the physician value-based payment modifier), then measure patient satisfaction through a standardized survey (CG-CAHPS).

What can you do to prepare?

Begin working to improve your patient satisfaction now. For starters, follow the 3 tips listed below. The infiltration of CG-CAHPS and its effect on reimbursement is right around the corner. You do not want to be caught unprepared.

1. Learn as much as you can about the CG-CAHPS survey. There are several books, articles, and websites about CG-CAHPS. Pick one and begin learning all you can.

2. Incorporate patient satisfaction improvement tips into your daily practice. Find a book, article, or website that gives suggestions for improving patient satisfaction. Choose a few helpful tips, and immediately incorporate them in your practice.

3. Involve your entire clinic staff in your improvement efforts. Educate your staff on the CG-CAHPS survey and challenge them to find ways to improve your clinic’s scores. Improvement is a joint effort, and involving your staff will ultimately improve your scores, too.

Trina E. Dorrah is an internal medicine physician and the author of Physician’s Guide to Surviving CGCAHPS & HCAHPS.


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