CAHPS® for Medical Groups and Provider Organizations

What's happening?

In response to growing interest in measuring and reporting the quality of care provided by medical group practices, a team of researchers has been adapting the CAHPS® survey for use at the level of providers and medical groups. To construct the standardized survey instrument, the team conducted an extensive literature review and drew upon the CAHPS® 2.0 survey, the Pacific Business Group in Health (PBGH) Physician Value Check Survey used previously in California, other provider-level surveys, focus group research findings, cognitive tests of survey items with patients, and input from various stakeholders. Following initial development, the instrument was field tested in 42 physician organizations located in eight sites across the country (Boston, Denver, Knoxville, St. Louis, and four sites in California). Based on the results of widely accepted tests of statistical reliability and validity, the G-CAHPS survey appears to perform well as a tool for assessing consumer experiences with their medical groups.

• In California, the Pacific Business Group on Health (PBGH), through the California Collaborative HealthCare Reporting Initiative, has implemented the Consumer Assessment Survey (CAS), a four-page version of the G-CAHPS survey. The survey was fielded to 59 of the largest medical groups in California. It captures approximately 70 percent of the commercially insured HMO and POS population statewide. Purchasers will be reporting the results to consumers during the fall 2001 open enrollment period to facilitate their selection of health plans and medical groups. PBGH anticipates that medical groups will use the comparative survey results for quality improvement, and that health plans will use them to compute performance payments to providers and to meet NCQA's accreditation requirements.
• In Minnesota, the Minnesota Health Data Institute (MHDI) is coordinating the implementation of the G-CAHPS survey to provide comparative information that can help consumers choose care systems offered through the Buyers Health Care Action Group (BHCAG). The MHDI project will coordinate implementation of the survey at the care system level in order to produce plan-level information for use by State of Minnesota employees during open enrollment and by the State Medicaid agency, which will use the findings to monitor the performance of Medicaid managed care plans.

What's in the G-CAHPS survey?

The current "beta" version of the G-CAHPS survey consists of 43 core questions plus 19 supplemental items. The core survey includes questions that ask respondents for global ratings of care as well as reports of specific experiences with the medical group. Of the four global rating items, three (rating of specialist, personal doctor or nurse, and all care) are from the CAHPS® 2.0 survey while the fourth, a global rating of the medical group, is a new item. All global ratings have a 0-to-10-point response scale. Reporting questions ask respondents about access and wait times, patient-doctor communication, trust, continuity of care, coordination between primary care and physicians and specialists, the referral process, preventive care, experiences with the office staff, and patient demographics. Like the CAHPS® 2.0 survey for commercially insured populations, the G-CAHPS questionnaire asks about experiences in the last 12 months.

Who is involved?

Researchers from Harvard, RAND, Research Triangle Institute, and the Pacific Business Group on Health (PBGH) have come together to conduct this National project. Funding for the development and testing of G-CAHPS comes from the California HealthCare Foundation and the Agency for Healthcare Research and Quality (AHRQ), formerly the Agency for Health Care Policy and Research (AHCPR).

For Further Information

Copies of the National G-CAHPS beta survey and the California CAS (Consumer Assessment Survey) instruments are available through the CAHPS® Survey Users Network (SUN) by calling toll-free 1-800-492-9261. You may also call the SUN Helpline for specific questions about the G-CAHPS survey. Questions about the CAS instrument and its implementation in California may be directed to Cheryl Damberg, Director of Research and Quality, Pacific Business Group on Health (PBGH) at (310) 396-7036.

For more detailed technical information, you can review the final G-CAHPS National Field Test Report, a 117-page document plus appendices describing the development and testing of the G-CAHPS instrument. This document is also available through SUN.

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