POLICY NEWS

News and statements from the Patient Experience Policy Forum appear below.

PXPF Submits Feedback to CMS About Proposed HCAHPS Survey Changes - June 10, 2024

This week, the Patient Experience Policy Forum submitted comments to CMS related to proposed changes to the HCAHPS survey instrument that were  announced earlier this year.  CMS is proposing changes that are the biggest revisions to this survey tool in over a decade.  Substantial changes were proposed to the content of the survey, including major changes to questions and survey domains.  The changes, if adopted, will significantly impact this survey, its public reporting and its impact on hospital reimbursement.  The comments submitted by PXPF were developed in collaboration with the PXPF Patient Experience Measurement Workgroup as well as the Experience Leaders Circle (XLC) of The Beryl Institute. 

Read the full comment.


Patient Experience Policy Forum (PXPF) Calls for Action on Pending Telemedicine Legislation Before Congress - August  2, 2021

On June 3rd, the Patient and Family Partnership Workgroup of the Patient Experience Policy Forum released a position paper, “Virtual and Telehealth Recommendations,” calling for a wide range of improvements to telemedicine services including permanent and appropriate reimbursement for telemedicine services, expansion of broadband so that telemedicine can be accessible to all and other technology improvements to help patients, families and caregivers stay better connected inside and outside of healthcare settings. Currently, there are over 20 bills before the Congress, including some with bi-partisan sponsorship, that call for expansion and improvement of telemedicine services across the nation. It is time to support and move these pending pieces of legislation forward. At this moment the value of telemedicine and virtual access to care is clearer than ever and the opportunities to make care more equitable for all are more pressing than ever before.

Read the full statement.


PXPF Comments on Closing the Equity Gap in CMS Hospital Quality Programs - June 28, 2021 

We appreciate the opportunity to provide the following comments in response to the CMS Solicitation of Public Comment regarding Closing the Equity Gap in CMS Hospital Quality Programs, included in the proposed Fiscal Year 2022 updates to the Quality Data Reporting Requirements for Specific Providers and Suppliers, as posted in the Federal Register, Volume 86, Number 88, published on May 10, 2021. Specifically, our comments pertain to the subsection titled, Potential Expansion of the CMS Disparity Methods, pages 25557-25561.

Recommendations for other types of feasibly collected data elements for measuring disadvantage and discrimination: We recommend the collection of a minimum set of demographic data elements for all healthcare patients, inclusive of all payers, as follows: race, ethnicity, sex, sexual orientation and gender identity, primary language, tribal membership and disability status. Furthermore, this minimum data set should be standardized across provider types and care settings—inclusive of hospitals, LTCHs, Rehab Facilities, Skilled Nursing Facilities, Hospices, Medical Groups, etc. Recognizing the importance of language and words, we support ongoing research on the language used to describe categories of race, ethnicity, sex, gender identity and other demographic variables within questions asking for demographic information. This should help to ensure that the questions asking for this information remain relevant to, and consistent with the way that people describe their own identities, facilitating increased question response rates.

Read the full article.


Virtual and Telehealth Recommendations - June 3, 2021

Whether for telehealth appointments or for virtual connection during hospitalizations and long-term care, access to technology has the potential to greatly increase family and care partner engagement with the healthcare team. In order to meet patient needs and involve care partners effectively, healthcare leaders must ensure that technology doesn’t become a social determinant of health. Patients must have access to equipment and technology and should be engaged in developing work flows and policies surrounding the deployment of these technologies and tools.

While hospitals and long-term care facilities work toward making telehealth and virtual engagement available in new ways, it is important to prioritize the work based on what is meaningful for patients and care partners and what is feasible for healthcare organizations. Patients and caregivers have an interest in participating in conversations about virtual and telehealth and contributing to the development of policies and practices that improve health outcomes and the patient experience. With these principles in mind, we advocate for the following:

Read the full article.


Listening To The Voice Of All Patients To Help Heal Health Disparities In A Post-COVID-19 World - May  5, 2021

As representatives of a large and diverse PXPF workgroup focused on measurement improvements, we believe that the fundamental principles articulated a year ago to modernize and democratize patient experience measurement and reporting can and must be rigorously applied to help eliminate racial and ethnic disparities in health care overall and in patient experience in particular. This is a call to action long overdue—and requires the engagement of health care organizations, regulators, policy makers, and all survey sponsors and vendors.

 
Read the full article.


Let patients speak for themselves on the Biden task force and elsewhere 

A new paper published via STAT and authored by Shari Berman, Co-Chair, PXPF, shares that ever since President-elect Biden named his COVID-19 task force, advice for improving its makeup has poured in from all quarters. A recent op-ed by two nurses chided Biden to add a nurse to the task force in part because nurses "give voice to patients".

 
Read the full article.


Patient and family recommendations for addressing visitation policies during COVID-19 –  September 4, 2020

The COVID-19 crisis has called on healthcare organizations globally to take measures to provide for the safety and well-being of both those served and those who work in healthcare every day. While actions have varied across organizations, and virtual opportunities sprang into existence in many places, the impact of decisions around visitation and the presence of that support must be revisited and understood. It is essential to acknowledge and act on the need for policies and practices that ensure this basic need for care partners is met and the associated evidence-based outcomes that result from effective patient and family engagement are realized. To address this moment of challenge, and the decisions related to visitation, we offer the following recommendations.

Read the full statement. 

Community Briefing and Conversation: Addressing Visitation and Access for Guests and Care Partners


We must partner with patients as we redefine healthcare in the post-COVID-19 era - June 16, 2020 

A new position paper from PXPF published via Becker's Hospital Review and authored by Shari Berman, Co-Chair, PXPF; Courtney Nataraj, Patient Adviser and Board Member, PXPF; Charisse Montgomery, Program Coordinator, PXPF, advocates for policy change to improve the patient experience during and beyond the COVID-19 pandemic.

 
Read the full article.


It’s Time To Take Patient Experience Measurement And Reporting To A New Level: Next Steps For Modernizing And Democratizing National Patient Surveys PX Policy Forum Comments on Proposed Updates for HCAHPS to assess communication about the cost of care - March 16, 2020 

A new position paper from PXPF published via Health Affairs Blog and authored by PXPF Co-Chairs Rick Evans and Shari Berman and members Esther Burlingame and Stephanie Fishkin proposes that while standardized Consumer Assessment of Healthcare Providers and Systems (CAHPS) measures have played an important role in efforts to improve patient experiences, it is time for a comprehensive effort to modernize and democratize all surveys and related data used to assess patient experiences with care. The article highlights the major improvements needed to modernize national patient experience surveys, by making the data more accessible and understandable to all health care stakeholders.

Read the full position paper.

 

Publish question-level benchmarks: Provide the full distribution of survey response options and linear mean scores for each question, for every hospital/entity, to allow access to national benchmarks that are vendor-neutral. Publish benchmarks by peer groups: Provide results by facility type (teaching, safety-net, urban, rural); size (small, medium, large); and ownership (non-profit, for-profit) to compensate for inadequacies in case-mix adjustment. Level the playing field: Continually refine case-mix adjustment models to assure fair and valid comparisons across health care organizations. Refine invitation messages: Test and implement messages and marketing techniques that motivate increased patient responses, especially among hard-to-reach populations. Include patient narratives: Add open-ended survey questions to capturepatient feedback that complements and expands on data obtained from standardized closed-ended questions. Update survey content: Routinely update survey topics and question wording based on patient, family, and caregiver input, using evidence-based research methods. Publish trend data: Provide results over time in order to track improvements or declines in performance. Provide access to adjustment software: Create open access to analysis programs that provide the variables and algorithms needed for easily replicating CMS adjustment methodologies. Align regulatory and certification standards: Coordinate CMS survey requirements with programs such as ANCC/Magnet, Joint Commission, NCQA, URAC, etc. to reduce data collection burden on patients and health care organizations. Enhance public reporting: Provide patients and families with easily accessible and relevant information to support health care decision-making, and identify ways to increase consumer awareness and use of public reports. Include all payers: Include patients in survey samples that are covered by all payers -- including Medicare, Medicaid, and commercial plans – to achieve more representative results. Expand survey modes: Develop and test new survey administration methods such as email, IVR, and web and smartphone applications to support more efficient and timely data collection.

PX Policy Forum Comments on the Value of Patient Narratives in the CAHPS for MIPS Survey - September 27, 2019 

The Patient Experience Policy Forum (PXPF) is a broad-based coalition of health care organizations and patient and family advisors engaged in advocacy and action to give a greater voice in health care policy to those working to improve the patient and family experience. We appreciate the opportunity to offer comments on the proposed rule updates to the CMS Quality Payment Program, specifically in regards to endorsing the addition of open-ended questions on the CAHPS for MIPS Survey.

Read the Full Summary.


CMS Introduces HCAHPS Survey Individual Question Top-Box Scores to the Summary Analyses Page - December 10, 2018 

Read the Full Summary.


PXPF Policy Update: CMS request for comments related to pain measurement - September 6, 2018 

We want all members to be aware of an opportunity to comment on recent proposed changes to the HCAHPS Pain Domain.  A document (attached below) – prepared by our PXPF Workgroup on Measurement - walks through the background on this issue and how you or your organization can offer comments.  At PXPF's recent meeting with CMS this spring, one of the things they suggested the PXPF can do is to promote the process to give comments to CMS.  This effort is one way we can do that.

Letter from PXPF Workgroup on Measurement
Issue overview and comment opportunity summary


PXPF Meets with CMS Leadership - May 10, 2018 

On Thursday, May 10, 2018, a delegation from the Patient Experience Policy Forum (PXPF) met with leaders from the Centers for Medicare & Medicaid Services (CMS) in Baltimore to discuss topics related to patient experience measurement and patient/family engagement.

Read the full meeting summary.

Video Resources

State of PX Policy: An Update from the PX Policy Forum

Community Conversation: Updates and a Focus on Telehealth Advocacy

Patient Experience Policy Forum - Formal Charter Announcement