HCAHPS survey to measure pain communication, not management.

Abstract

Starting with patients discharged on January 1, hospitals and vendors administering the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey will ask 3 questions concerning communication about pain during the hospital stay. The 3 questions replace the ones about pain management that have appeared in the survey for the past several years. Items 12, 13, and 14 on the 2018 version of the survey ask recently discharged adults to answer the following questions: These changes stem from a decision announced a year ago by the Centers for Medicare and Medicaid Services (CMS) to remove the survey’s pain management measures from the Hospital Value-Based Purchasing (VBP) Program. The 6-year-old CMS program links an acute care hospital’s performance on a set of quality measures to a portion of the agency’s Medicare reimbursements under the inpatient prospective payment system. A low-scoring hospital can have up to 2% of reimbursements withheld, while a top scorer can receive the equivalent of a 2% bonus. One fourth of a hospital’s total performance score comes from HCAHPS survey data. The survey’s pain management measures had been part of the program since its beginning. CMS indicated that some stakeholders have expressed concern that with inclusion of those measures on the survey, a hospital’s staff could feel pressured to prescribe more opioids so that the hospital would receive higher HCAHPS scores for pain management.