Chapter 5. Measure Maps and Profiles (continued, 3)

Care Coordination Measures Atlas

Measure #4a. Consumer Assessment of Healthcare Providers and Systems (CAHPS) — Adult Primary Care 1.0

Care Coordination Measure Mapping Table

 Measurement Perspective:
Patient/FamilyHealth Care
Professional(s)		System
Representative(s)
Care Coordination Activities
Establish accountability or negotiate responsibility

□

  
Communicate

■

  
   Interpersonal communication

■

  
   Information transfer

■

  
Facilitate transitions

 

  
   Across settings

 

  
   As coordination needs change

 

  
Assess needs and goals

■

  
Create a proactive plan of care

 

  
Monitor, follow up, and respond to change

□

  
Support self-management goals

■

  
Link to community resources   
Align resources with patient and population needs   
Broad Approaches Potentially Related to Care Coordination
Teamwork focused on coordination   
Health care home□  
Care management   
Medication management□  
Health IT-enabled coordination□  

Legend:
■ = ≥ 3 corresponding measure items
□ = 1-2 corresponding measure items

Consumer Assessment of Healthcare Providers and Systems (CAHPS) – Adult Primary Care 1.0

Purpose: To measure adult consumers' experiences with a specific primary care physician and practice.

Format/Data Source: Survey comprised of 31 core items with an additional 64 supplemental items specific to adult primary care. Supplemental items focus on additional aspects of care, including: (1) after hours care, (2) costs of care, (3) doctor role, (4) doctor thoroughness, (5) health improvement, (6) health promotion and education, (7) help with problems or concerns, (8) other doctors, (9) provider communication, (10) provider knowledge of specialist care, (11) doctor recommendation, (12) shared decisionmaking, (13) wait time, (14) care received from specialists, and (15) most recent visit. All questions were answered on a 4-point frequency scale. Responses covered experiences in the last 12 months and were compiled into a nationally available database.1

Date: Measure released in 2008.1

Perspective: Patient/Family

Measure Item Mapping:

  • Establish accountability or negotiate responsibility: 2
  • Communicate:
    • Between health care professional(s) and patient/family: 14, 15, AE1, AE2, OD2, C2, SD2
  • Interpersonal communication:
    • Between health care professional(s) and patient/family: COC3, COC5, OD3-OD5, C1, C5, C7, C8, SD3, SC3, RV3-RV5
    • Participants not specified: 18
  • Information transfer:
    • Between health care professional(s) and patient/family: 10, 12, 22, OD8, C9
    • Across health care teams or settings: PK2, SC6
    • Participants not specified: RV6
  • Assess needs and goals: DT2, HPC1, SD1, SD2, RV7
  • Monitor, follow up, and respond to change: 22
  • Support self-management goals: 17, HI1, HP1-HP6, HPC1
  • Health care home: 1, 2
  • Medication management: COC1, COC3
  • Health IT-enabled coordination: AE1, AE2

Development and Testing: Several rounds of revision of the draft instrument (all versions) were based on literature review and feedback from extensive field tests with various health care organizations, cognitive interviews, and stakeholders.1 The final instrument is endorsed by the National Quality Forum as well as the Ambulatory Care Quality Alliance (AQA).

Link to Outcomes or Health System Characteristics: The CAHPS survey questions and data have been used for evaluating patient experiences with care delivery.2 Measure scores related to communication and care coordination were shown to be higher (more favorable) for patients seen by physicians in large, integrated medical groups compared with other practice settings.3 Study populations enrolled in care management programs also showed trends toward higher ratings of patient experience with provider communication via the CAHPS.4

Logic Model/Conceptual Framework: None described in the sources identified.

Past or Validated Applications:

  • Setting: Primary care (outpatient)
  • Population: Adult primary care patients
  • Level of evaluation: Health Care Professional(s)

Notes:

  • The final survey includes 3 variations of a multi-item instrument: (1) Adult Primary Care 1.0, (2) Adult Specialty Care 1.0, and (3) Child Primary Care 1.0, which has a beta adaptation (Child Primary Care 2.0). Core question items are the same across the non-beta versions, but wording (patient vs. child; primary care physician vs. specialist) changes according to the instrument. All questions are answered on a 4-point frequency scale. Supplemental items focus on additional aspects of care (shared decisionmaking, costs, prescription medications, etc.). The survey also includes questions to obtain health status and demographic data.
  • All instrument items are available online.1
  • The core instrument contains 31 questions; 9 were mapped.
  • The supplement contains 64 items; 35 were mapped.
  • Validated versions are available online for adult and child, in both English and Spanish.1

Sources:

1. CAHPS Surveys and Tools. Agency for Health Research and Quality. Available at: https://cahps.ahrq.gov. Accessed: 20 September 2010.
2. Agency for Health Research and Quality CAHPS Web site, CAHPS Bibliography. Available at: https://cahps.ahrq.gov. Accessed: 16 September 2010.
3. Rodriguez HP, von Glanh T, Rogers WH, et al. Organizational and market influences on physician performance and patient experience measures. Health Serv Res 2009;44(3):880-901.
4. Isetts BJ, Schondelmeyer SW, Heaton AH, et al. Effects of collaborative drug therapy management on patients' perceptions of care and health related quality of life. Res Soc Adm Pharm 2006;2:129-42.

Return to Contents

Measure #4b. Consumer Assessment of Healthcare Providers and Systems (CAHPS) — Adult Specialty Care 1.0

Care Coordination Measure Mapping Table

 Measurement Perspective:
Patient/FamilyHealth Care
Professional(s)		System
Representative(s)
Care Coordination Activities
Establish accountability or negotiate responsibility

□

  
Communicate

■

  
   Interpersonal communication

■

  
   Information transfer

■

  
Facilitate transitions

 

  
   Across settings

 

  
   As coordination needs change

 

  
Assess needs and goals

□

  
Create a proactive plan of care

 

  
Monitor, follow up, and respond to change

□

  
Support self-management goals

■

  
Link to community resources   
Align resources with patient and population needs   
Broad Approaches Potentially Related to Care Coordination
Teamwork focused on coordination   
Health care home□  
Care management   
Medication management□  
Health IT-enabled coordination   

Legend:
■ = ≥ 3 corresponding measure items
□ = 1-2 corresponding measure items

Consumer Assessment of Healthcare Providers and Systems (CAHPS) — Adult Specialty Care 1.0

Purpose: To measure adult consumers' experiences with a specific specialty care physician and practice.

Format/Data Source: Survey comprised of 31 core items with an additional 64 supplemental items specific to adult specialty care. Supplemental items focus on additional aspects of care, including: (1) after hours care, (2) costs of care, (3) doctor role, (4) doctor thoroughness, (5) health improvement, (6) health promotion and education, (7) help with problems or concerns, (8) other doctors, (9) provider communication, (10) provider knowledge of specialist care, (11) doctor recommendation, (12) shared decisionmaking, (13) wait time, (14) care received from specialists, and (15) most recent visit. All questions were answered on a 4-point frequency scale. Responses covered experiences in the last 12 months and were compiled into a nationally available database.1

Date: Measure released in 2008.1

Perspective: Patient/Family

Measure Item Mapping:

  • Establish accountability or negotiate responsibility: 2, DR1
  • Communicate:
    • Between health care professional(s) and patient/family: 14, 15, CC1, SD1, SD2
  • Interpersonal communication:
    • Between health care professional(s) and patient/family: DC1-3, SD3
  • Information transfer:
    • Between health care professional(s) and patient/family: 10, 12, 22, SP2
    • Participants not specified: 18
  • Assess needs and goals: SD1, SD2
  • Monitor, follow up, and respond to change: 22
  • Support self-management goals: 17, DC4, SP5, SP6
  • Health care home: 1, 2
  • Medication management: COC1, COC3

Development and Testing: The draft instrument was revised based on a literature review and feedback that was provided from extensive field tests with various health care organizations, cognitive interviews, and stakeholders.1 The final instrument is endorsed by the National Quality Forum as well as the Ambulatory Care Quality Alliance (AQA).

Link to Outcomes or Health System Characteristics: The CAHPS survey questions and data have been used for evaluating patient experiences with care delivery.2 Measure scores related to communication and care coordination were shown to be higher (more favorable) for patients seen by physicians in large, integrated medical groups compared with other practice settings.3 Study populations enrolled in care management programs also showed trends toward higher ratings of patient experience with provider communication via the CAHPS.4

Logic Model/Conceptual Framework: None described in the sources identified.

Past or Validated Applications:

  • Setting: Specialty care (outpatient) in the United States
  • Population: Adult specialty care patients
  • Level of evaluation: Health Care Professional(s)

Notes:

  • The final survey includes 3 variations of a multi-item instrument: (1) Adult Primary Care 1.0, (2) Adult Specialty Care 1.0, and (3) Child Primary Care 1.0, which has a beta adaptation (Child Primary Care 2.0). Core question items are the same across the non-beta versions, but wording (patient vs. child; primary care physician vs. specialist) changes according to the instrument. All questions are answered on a 4-point frequency scale. Supplemental items focus on additional aspects of care (shared decisionmaking, costs, prescription medications, etc.). The survey also includes questions to obtain health status and demographic data.
  • All instrument items are available online.1
  • The core instrument contains 31 questions; 9 were mapped.
  • The supplement contains 51 items; 21 were mapped.
  • Validated versions are available online for adult and child, in both English and Spanish.1

Sources:

1. CAHPS Surveys and Tools. Agency for Health Research and Quality. Available at: https://cahps.ahrq.gov. Accessed: 20 September 2010.
2. Agency for Health Research and Quality CAHPS Web site, CAHPS Bibliography. Available at: https://cahps.ahrq.gov. Accessed: 16 September 2010.
3. Rodriguez HP, von Glanh T, Rogers WH, et al. Organizational and market influences on physician performance and patient experience measures. Health Serv Res 2009;44(3):880-901.
4. Isetts BJ, Schondelmeyer SW, Heaton AH, et al. Effects of collaborative drug therapy management on patients' perceptions of care and health related quality of life. Res Soc Adm Pharm 2006;2:129-42.

Return to Contents

Measure #4c. Consumer Assessment of Healthcare Providers and Systems (CAHPS) — Child Primary Care 1.0

Care Coordination Measure Mapping Table

 Measurement Perspective:
Patient/FamilyHealth Care
Professional(s)		System
Representative(s)
Care Coordination Activities
Establish accountability or negotiate responsibility

□

  
Communicate

□

  
   Interpersonal communication

■

  
   Information transfer

■

  
Facilitate transitions

 

  
   Across settings

 

  
   As coordination needs change

 

  
Assess needs and goals

■

  
Create a proactive plan of care

 

  
Monitor, follow up, and respond to change

□

  
Support self-management goals

■

  
Link to community resources   
Align resources with patient and population needs   
Broad Approaches Potentially Related to Care Coordination
Teamwork focused on coordination   
Health care home□  
Care management   
Medication management□  
Health IT-enabled coordination   

Legend:
■ = ≥ 3 corresponding measure items
□ = 1-2 corresponding measure items

Consumer Assessment of Healthcare Providers and Systems (CAHPS) — Child Primary Care 1.0

Purpose: To measure consumers' experiences with a specific primary care physician and practice.

Format/Data Source: Survey comprised of 30 core items with an additional 17 supplemental items specific to child primary care. Supplemental items focus on additional aspects of care, including: (1) after-hours care, (2) behavioral health, (3) screening items for children with chronic conditions, (4) doctor communication with child, (5) doctor communication, (6) doctor thoroughness, (7) health improvement, (8) Identification of site of visit, (9) prescription medications, (10) provider knowledge of specialist care, and (11) shared decisionmaking. All questions were answered on a 4-point frequency scale. Responses covered experiences in the last 12 months and were compiled into a nationally available database.1

Date: Measure released in 2008.1

Perspective: Patient/Family

Measure Item Mapping:

  • Establish accountability or negotiate responsibility: 2
  • Communicate:
    • Between health care professional(s) and patient/family: 14, 15
  • Interpersonal communication:
    • Between health care professional(s) and patient/family: DC1-DC4, SD2, SD4
    • Participants not specified: 18
  • Information transfer:
    • Between health care professional(s) and patient/family: 10, 12, 22, SD3
    • Across health care teams or settings: PK2
  • Assess needs and goals: DT2, SD1, SD2
  • Monitor, follow up, and respond to change: 22
  • Support self-management goals: 17, DC3, HI1
  • Health care home: 1, 2
  • Medication management: PM1

Development and Testing: Several rounds of revision of the draft instrument (all versions) were based on literature review and feedback from extensive field tests with various health care organizations, cognitive interviews, and stakeholders.1 The final instrument is endorsed by the National Quality Forum as well as the Ambulatory Care Quality Alliance (AQA).

Link to Outcomes or Health System Characteristics: The CAHPS survey questions and data have been used for evaluating patient experiences with care delivery.2 Measure scores related to communication and care coordination were shown to be higher (more favorable) for patients seen by physicians in large, integrated medical groups compared with other practice settings.3 Study populations enrolled in care management programs also showed trends toward higher ratings of patient experience with provider communication via the CAHPS.4

Logic Model/Conceptual Framework: None described in the sources identified.

Past or Validated Applications:

  • Setting: Primary care (outpatient)
  • Population: Child primary care patients (parents provide information)
  • Level of evaluation: Health Care Professional(s)

Notes:

  • The final survey includes 3 variations of a multi-item instrument: (1) Adult Primary Care 1.0, (2) Adult Specialty Care 1.0, and (3) Child Primary Care 1.0, which has a beta adaptation (Child Primary Care 2.0). Core question items are the same across the non-beta versions, but wording (patient vs. child; primary care physician vs. specialist) changes according to the instrument. All questions are answered on a 4-point frequency scale. Supplemental items focus on additional aspects of care (shared decisionmaking, costs, prescription medications, etc.). The survey also includes questions to obtain health status and demographic data.
  • All instrument items are available online.1
  • The core instrument contains 31 items; 9 were mapped.
  • The supplement contains 17 items; 12 were mapped.
  • Validated versions are available online for adult and child, in both English and Spanish.1

Sources:

1. CAHPS Surveys and Tools. Agency for Health Research and Quality. Available at: https://cahps.ahrq.gov. Accessed: 20 September 2010.
2. Agency for Health Research and Quality CAHPS Web site, CAHPS Bibliography. Available at: https://cahps.ahrq.gov. Accessed: 16 September 2010.
3. Rodriguez HP, von Glanh T, Rogers WH, et al. Organizational and market influences on physician performance and patient experience measures. Health Serv Res 2009;44(3):880-901.
4. Isetts BJ, Schondelmeyer SW, Heaton AH, et al. Effects of collaborative drug therapy management on patients' perceptions of care and health related quality of life. Res Soc Adm Pharm 2006;2:129-42.

Return to Jump Start Guide

Current as of January 2011
Internet Citation: Chapter 5. Measure Maps and Profiles (continued, 3): Care Coordination Measures Atlas. January 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/long-term-care/resources/coordination/atlas/chapter5b.html