Southern California Health Center Uses AHRQ Surveys for Patient Feedback and Improvements

AltaMed Health Services, a Federally Qualified Community Health Center providing care to 300,000 Southern California residents, uses AHRQ's Consumer Assessment of Healthcare Providers and Systems (CAHPS®) to learn about patient experiences in receiving health care. The results not only help AltaMed improve patient care, but also influence the financial incentives its medical providers can earn.

Originally established as a free clinic in East Los Angeles in 1969, AltaMed offers services to patients of all ages in Los Angeles and Orange counties in more than 40 locations. Services include medical, dental, senior care, urgent care, pharmacy, and HIV care.

According to Alex Y. Chen, M.D., M.S., Interim Chief Medical Officer for AltaMed, the CAHPS survey data are used to hold providers accountable for providing patient-centered care. Chen oversees quality performance improvements and process improvements to ensure that AltaMed health providers deliver quality care to patients.

In part, AltaMed uses the CAHPS Clinician & Group Survey tool to gather information from patients about their experiences of care. All patients visiting an AltaMed clinic who have shared their email addresses receive email invitations to complete the form. In addition, a random sample of patients (about 300 patients per provider per year) also receives surveys by postal mail via a survey vendor.

AltaMed puts a high priority on knowing how its patients view the experience of their care. Not only does the company use the results to make improvements where gaps are revealed, it also recognizes high-performing providers and clinics each quarter.

CAHPS survey data are summarized for individual physicians and made available for all physicians to see. Chen said that physicians like getting CAHPS reports because they provide information that can balance any patient complaints reported to member services. If a patient makes a complaint about a physician, but that physician has good CAHPS scores, the complaint can be reviewed and resolved in that context.

Chen noted, "CAHPS is the gold standard for measuring both the hospital and outpatient patient experience. We use it to track patient feedback on an ongoing basis. We review CAHPS results monthly at the enterprise level, regional level, site level, and provider level."

"CAHPS data enable us to hold providers to the same universal high standard of patient-centric care. Two-thirds of the allocation of the yearly physician bonus payment is based on Healthcare Effectiveness Data and Information Set (HEDIS) clinical measures and CAHPS survey results. The remainder is used as productivity incentives," he continued.

To help physicians improve their patient experience scores, AltaMed uses provider "shadow coaching." Physicians who score highest on CAHPS are trained as shadow coaches, who observe care during appointments and provide feedback to other physicians about interactions with patients.

"For providers who are low- to mid-level performers, we manage and help support them to improve their performance," Chen said. Shadow coaching has led to noteworthy improvements in CAHPS scores over time, he noted.