Major changes are ahead for the CAHPS for PQRS Survey starting next year. By now, you are likely aware that the PQRS program will be retired at the end of this year. The new Quality Payment Program (QPP) will replace PQRS, the Meaningful Use of EHR technology and the Value Modifier programs. Clinicians will have two options for participating in the new QPP:

 

  1. Merit-based Incentive Payment  System (MIPS)
  2. Advanced Alternative Payment Model (APM) (these practices are exempt from MIPS reporting)

 

Under MIPS, a CAHPS survey is one of the available quality measures that clinicians may choose to report via a certified survey vendor, such as HealthStream. What is new is that the survey is no longer required for any size of practice. However, there is a scoring incentive (i.e. bonus points) to encourage primary care practices to report the CAHPS for MIPS Survey. Whether practices will decide that the bonus points are worth the cost of administering the survey remains to be seen. CMS says, “Under the first performance period of MIPS, we assume that 461 groups will elect to report on the CAHPS for MIPS survey, which is equal to the number of groups reporting via CAHPS for the PQRS in 2014.”

 

For 2017, here’s what we know:

  • In 2017, the CAHPS for MIPS Survey will be voluntary. However, practices may earn bonus points if they do conduct the survey.
  • Under MIPS, groups of two or more clinicians may elect to contract with a CMS-approved survey vendor and use the CAHPS for MIPS survey as one of their six required quality measures. The CAHPS survey counts for one measure towards the MIPS quality performance category, as a patient experience measure, and also fulfills the requirement to report at least one high priority measure in the absence of an applicable outcome measure.
  • CMS anticipates retaining the same policies and procedures they currently follow for a CMS-approved survey vendor for PQRS and apply them to a MIPS CMS-approved survey vendor.
  • Practices will need to register if they elect to conduct the survey, and contract with an approved vendor like HealthStream.
  • Only Medicare beneficiaries will be selected to participate in the survey.
  • Survey administration will be from November 2017-February 2018.
  • The survey is not expected to change in 2017.
  • In terms of scoring, each survey summary measure (SSM) will have an individual benchmark. CMS will score each SSM individually and compare it against the benchmark to establish the number of points. The CAHPS score will be the average number of points across SSMs.

 

CMS has hinted at significant changes to the CAHPS survey in future years of the QPP, such as:

  • Expansion to non-Medicare payers
  • Electronic data collection
  • Revisions to the questions
  • Expansion to other specialties (not just primary care)
  • Expansion to clinicians who participate in MIPS as individuals (as opposed to as a group)

 

Read more here: https://www.federalregister.gov/documents/2016/11/04/2016-25240/medicare-program-merit-based-incentive-payment-system-mips-and-alternative-payment-model-apm