CAHPS Home Health Care Survey
The CAHPS Home Health Care Survey asks patients who receive home healthcare services about their experiences with home healthcare agencies, providers, and staff. This instrument focuses on patients who receive skilled home health care services from Medicare-certified Home Health Agencies (HHAs). Skilled services refer to health care services provided by nurses and therapists including physical, occupational, and speech-language therapists.
Providers, State agencies, and other organizations that serve patient communities can use the survey results to spur improvements in home health care services and better inform consumers choosing among available sources of care.
How To Get the CAHPS Home Health Care Survey and Administrative Guidance
To access this survey, supplemental questions, and all supporting documentation for survey administration, please visit CMS's website for the Home Health Care Survey. No documentation for this survey is available on AHRQ's website.
For technical assistance with this survey, please contact HHCAHPS@RTI.org or 1-866-354-0985.
National Implementation of the CAHPS Home Health Care Survey
The Centers for Medicare & Medicaid Services (CMS) began implementing this survey on a national basis in October 2009, first voluntarily and then as part of the quality reporting requirements for the home health annual payment update (APU). Use of this survey is required of all Medicare-certified home health agencies that serve 60 or more patients in a one-year period. The survey results are publicly reported on Home Health Compare.
Quality Measures from the CAHPS Home Health Care Survey
The Home Health Care Survey produces the following measures of patient experience:
- Care of patients.
- Communication between providers and patients.
- Specific care issues.
- Rating of care provided by the agency.
- Willingness to recommend the agency to friends and family.
Learn more about the global ratings and composite measures in this survey.
Development of the CAHPS Home Health Care Survey
This survey was developed by the Agency for Healthcare Research and Quality's (AHRQ) CAHPS program. The Centers for Medicare & Medicaid Services (CMS) requested that AHRQ develop this survey in order to better evaluate and understand the quality of care provided by home health care agencies, for which CMS pays the lion's share of costs. Together, Medicaid and Medicare cover over 60 percent of the expense of home health care in the United States, CAHPS Home Health Care Survey (PDF, 585 KB)
The development of the CAHPS Home Health Care instrument followed the standard CAHPS process.
Initial gathering of information. The CAHPS Consortium began the process by conducting a literature review and issuing a call for measures in the fall of 2006. The team used this information to develop an initial list of topics that could be addressed by the survey.
Interviews. The team completed formative research, including interviews with patients who receive home health care and their families, in February 2007. Through this research, the team better understood the issues that are most important to patients and families, their perceptions of home health care, and the language they use to describe it.
Input from experts. Also in February 2007, the team met with a Technical Expert Panel (TEP) to get their input on issues that are important to this community of patients and providers, topics the survey should cover, and priorities. Based on this feedback and the other information they had gathered, the team then designed a draft instrument. The TEP members were asked to comment on the priority they would give items in the draft questionnaire.
Cognitive testing. The team completed multiple rounds of cognitive testing and revised the questionnaire in light of their results and the comments from TEP members.
Field test. A field test was conducted during the first half of 2008 with 34 Medicare-certified home health agencies in 15 States. All participating agencies volunteered to participate. The team made some adjustments to the survey based on analyses of the field test data and submitted the revised survey to the Centers for Medicare & Medicaid Services in the fall of 2008.
Endorsement by NQF. CMS submitted the CAHPS Home Health Care Survey to the National Quality Forum in late 2008. The National Quality Forum endorsed this instrument as a measure of home healthcare quality in March 2009 and renewed its endorsement in January 2015.