CMS officials to hospitals: Stop misusing HCAHPS measures

In an opinion piece in JAMA, three officials from CMS urged hospital leaders to stop disaggregating measures from HCAHPS for internal use.

According to Lemeneh Tefera, MD; William Lehrman, PhD; and Patrick Conway, MD, all from CMS, HCAHPS "provides valid and reliable measures of hospital quality that can compel hospitals to assess and improve patient experience" — when used correctly.

However, the authors note many hospitals are taking HCAHPS responses, disaggregating them and then linking them to financial incentives for individual physicians or physician groups.

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"This is contrary to the survey's design and policy aim," the authors wrote. "HCAHPS is not suitable for evaluating or incentivizing individuals or groups within a hospital." Instead, the survey is designed to evaluate the entire hospital experience.

Drs. Tefera, Lehrman and Conway also addressed the allegations that HCAHPS' pain control questions have urged physicians to prescribe more opioids, contributing to the opioid addiction crisis in the U.S. They vehemently denied such an effect, saying "there is no empirical evidence the failing to prescribe opioids lowers a hospital's HCAHPS scores."

Overall, the opinion piece urged hospital officials to use HCAHPS results "responsibly" because failing to do so "entail[s] risk."

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