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3 best practices for improving HCAHPS survey data and patient care

Insight Article - March 8, 2021

Patient Engagement

Business Intelligence

Value-Based Operations

Sumit Aneja
Understanding the patient experience is critical for healthcare practices and providers looking to improve health outcomes, optimize operational resources and maximize revenue from services rendered. Unfortunately, many providers are trying but failing in their efforts to be highly responsive, insight-oriented organizations. 
 
Most prominently, the Hospital Consumer Assessment of Healthcare Providers and Systems Services (HCAHPS) survey — the industry standard for collecting data on patient experience — represents a missed opportunity for healthcare providers to gather more actionable insights that improve outcomes across the board. 
 
Many healthcare practitioners may need to reimagine their approach to HCAHPS surveys to capitalize on these insights and improve patient care while enhancing long-term sustainability in a rapidly changing, highly competitive healthcare sector.

The problem with survey status quo

The HCAHPS survey is a well-intentioned resource that, if deployed effectively, can provide healthcare providers with meaningful data that drives better results on many fronts. Instead, today’s surveys often miss the mark. 
 
For starters, many providers rely solely on telephone and mail responses to solicit patient data. According to Pew Research, telephone response rates have declined for much of the past 20 years, reaching just 6% at the end of the last decade. There are many reasons for this, including carriers flagging surveys as spam and recipients declining to participate because of privacy or data security concerns. This is a significant reason why hospitals need omnichannel survey delivery methods, especially those that appeal to today’s digital-first patients.
 
Of course, healthcare providers can improve more than just the method of delivery. Design shortfalls discourage many patients from completing HCAHPS surveys. For example, survey length, question layout and language/comprehension barriers are each design elements that impact patient response rates.
 
Finally, by restricting surveys to standard questions that don't drill down on experience-specific metrics, healthcare providers fail to gather meaningful, actionable insights even when they do receive a response. 

The consequences of bad surveys

In today’s healthcare environments, poor survey data can be catastrophic. Gathering the wrong insights can reduce patient care quality or specificity, a reality that can have life-or-death-consequences.
 
For instance, a survey of 50,000 patients in the United States found that those who were most satisfied with their care were also 26%more likely to die in the six months after their hospital visit. The study, “The Cost of Satisfaction,” appeared in JAMA Internal Medicine.
 
These patients incurred higher healthcare costs and earned hospitals bigger payouts but ultimately didn’t produce better health outcomes. While there is a meaningful distinction between correlation and causation, the report reflects that healthcare providers may not be asking the right questions when assessing patient satisfaction. 
 
Similarly, after the Department of Health & Human Services connected survey results to Medicare reimbursements, a subheadline in The Atlantic proclaimed, “A misguided attempt to improve healthcare has led some hospitals to focus on making people happy, rather than making them well.”
 
When many providers face funding reductions and revenue losses, survey data can impact everything from Medicaid reimbursement to private insurance payouts. Taken together, insufficient survey data is also a patient care problem with bottom-line implications.

Improving the product 

Patient satisfaction surveys are ubiquitous in the healthcare industry, and the HCAHPS survey specifically represents a readily available opportunity for healthcare providers to become more data-driven when it comes to patient care. For those looking to improve their HCAHPS surveys, here are three steps leaders can take to attain data to help produce a better patient experience. 

1. Optimize surveys for web and mobile 

In today’s digital-first environment, digital HCAHPS is the best way to achieve more robust and representative survey results. People are highly receptive to digital messaging. It’s estimated that SMS message open rates reach 98%and have a response rate of 45%.
 
The results are already apparent. A 2019 survey of hospital IT decision-makers found that 96%of those embracing digital channels saw an increase in patient experience scores. Notably, 32%saw their scores “drastically” increase. 
 
At the same time, digital delivery reduces costs while providing better response flexibility. For example, an online survey costs $2 on average per returned survey compared to $10 via traditional survey methods. 
 
Healthcare leaders also get more insights for their investment. Digital channels provide opportunities for examination, reducing data entry and analysis expenses while also enabling faster insights that can be acted upon compared to traditional survey channels.  

2. Accessibility matters 

Know your audience and create surveys that are accessible to a broad range of patients. Optimize the layout, readability, and length to empower and encourage as many people as possible to provide valuable patient experience insights. It is also important to make surveys available in multiple languages to engage the widest demographic. 
 
In doing so, healthcare providers increase equity among respondents, creating more representative insights that drive meaningful change. 
 
Digital surveys allow creators to continually adjust color, structure questioning to reduce cognitive overload, and include graphics to aid comprehension. By making digital surveys part of an omnichannel delivery strategy, it’s again possible to reach more people by meeting patients where they are.

3. Reduce survey range 

High-integrity survey data becomes less probable when respondents react too long after receiving care. Patient journeys involve multiple touchpoints these days, which makes it difficult to recall which interactions were with which care providers once time has passed. For example, to maximize patient retention in a hospital setting, send surveys no later than seven to 10 days after patient discharge. 
 
Ultimately, healthcare providers need to be dynamic and agile, ready and able to respond to real-time feedback. Timely survey responses are the bedrock of this priority, giving leaders the insights needed to propel their organizations forward.  

Rethinking the approach to patient satisfaction surveys

From hospitals to healthcare providers, the medical profession is continually being assessed. Government and private insurance companies are evaluating each institution's efficacy, and patients are looking for the best care and treatment. 
 
While healthcare organizations continue to employ mandated healthcare surveys such as HCAHPS for measuring patient experience, there is a growing realization that HCAHPS needs to be modernized.
 
  • It captures only a fraction of the factors influencing patient experience.
  • When delivered via traditional channels, results take a long time to gather, leaving no way for the care team to intervene in real time.
  • Survey length induces fatigue, leading to falling response rates.
  • It assumes patient literacy and competency in English.
 
Top performers provide the best possible patient care while maximizing payment for services rendered. Healthcare isn’t a compromise between patient care and fiscal responsibility. These critical elements are intertwined; the success of one is predicated on the other. In 2021, providers can improve both by reimagining their approach to HCAHPS surveys. 
 

About the Author

Sumit Aneja
Sumit Aneja
Chief Executive Officer Voxco

Sumit Aneja serves as Chief Executive Officer at Voxco, a global leader in omnichannel cloud and on-premise feedback management solutions. Sumit brings strong research and entrepreneurial leadership to Voxco through his experience founding companies and working at IMF and Bank of America. He holds an MBA from Yale University, an MS in Financial Engineering from Claremont Colleges, and a BTech in Electrical Engineering from Punjab Engineering College.

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