American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Consumer Assessment of Healthcare Providers and Systems

Consumer Assessment of Healthcare Providers and Systems (CAHPS®) surveys ask consumers and patients to report on and evaluate their experiences with health care. These surveys cover topics that are important to consumers and focus on aspects of quality that consumers are best qualified to assess, such as the communication skills of providers and ease of access to health care services. CAHPS originally stood for the Consumer Assessment of Health Plans Study, but as the products have evolved beyond health plans, the name has evolved as well to capture the full range of surveys. The acronym "CAHPS" is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).

All CAHPS surveys are in the public domain, which means that anyone can download and use these surveys to assess care experiences. Users of CAHPS survey results include patients and consumers, quality monitors and regulators, provider organizations, health plans, community collaboratives, and public and private purchasers of health care. These individuals and organizations use the survey results to inform their decisions and to improve the quality of health care services.

  • Using the CAHPS Name
    Use the full name "Consumer Assessment of Healthcare Providers and Systems (CAHPS)" to refer to the program only. In the text of written documents (journal articles, press coverage, etc.), spell out the name the first time that it appears, followed by CAHPS in parentheses: "Consumer Assessment of Healthcare Providers and Systems (CAHPS) program." Please indicate that this is a program of the U.S. Agency for Healthcare Research and Quality.

Principles Underlying CAHPS Surveys

To ensure standardization and ease of use, the survey development teams follow several principles that underlie all CAHPS survey products.

Emphasis on Consumers and Patients

CAHPS surveys focus on aspects of care that meet two criteria:

  • The people who received care are the best and/or only source of the information. CAHPS surveys do not attempt to collect information that can be gathered more effectively through other means (for example, through medical records or from physicians).
  • Consumers and patients identified the information as important to them. The CAHPS program devotes substantial resources to identifying and confirming issues that are salient to health care consumers and influence their decisions.

Reporting on Actual Experiences

While CAHPS surveys are similar to patient satisfaction surveys, they are not the same. As with satisfaction surveys, CAHPS surveys can include ratings of health plans or providers (such as doctors, hospitals, and nursing homes). But they go beyond ratings by asking patients to report on their experiences with health care services. Reports about care are regarded as more specific, actionable, understandable, and objective than general ratings alone.

Standardization Across the Board

In order to support valid comparisons and benchmarking across health care settings and over time, all CAHPS surveys are standardized in the following aspects:

  • The instrument. The contents and format of survey instruments are standardized so that everyone administering the survey is asking the same questions in the same way.
  • The protocol. The protocols for fielding the survey are standardized so that everyone adopts the same approach to drawing the sample, communicating with potential respondents, and collecting the data. This is important because the method of survey administration can affect the data.
  • The analysis. CAHPS surveys include a set of analysis programs and instructions to minimize variations in how sponsors and vendors process and interpret the results of the surveys.
  • The reporting. CAHPS surveys benefit from a well-tested approach to presenting survey results. Users of survey results have access to reporting measures as well as guidelines that reflect best practices in reporting.

Having all survey sponsors follow the same guidelines ensures that any survey sponsor's results are comparable to those of other sponsors. This comparability is what makes the information useful for quality improvement as well as public reporting.

Applicability Across Heterogeneous Populations

All CAHPS survey products are developed with an eye toward making them useful for various segments, particularly vulnerable populations. The CAHPS Health Plan Survey, for example, was designed to be administered to people with any type of coverage, including Medicaid, Medicare, and commercial insurance, and across the full range of delivery systems. The Health Plan Survey can also capture information about the experiences of special groups, including children and adults with chronic conditions and disabilities.

Extensive Testing with Consumers

The CAHPS Consortium subjects all survey instruments to testing with members of the target population. As part of the cognitive testing process, the CAHPS Consortium tests the wording and formatting of survey instruments to maximize comprehension and usability. Findings from this testing contribute to improvements in question wording and navigation. In addition, extensive field testing ensures that survey administration guidelines and protocols are based on sound evidence.

Meaningful Information

To ensure that the surveys generate information that is meaningful to consumers and other audiences, reporting measures and their labels are developed in conjunction with the survey instruments.

Input from All Affected Parties

The survey development process includes frequent opportunities for major stakeholders, including clinicians, administrators, and accrediting bodies, to learn about the instrument and provide feedback.

Public Resource

All CAHPS products, resources, and services are in the public domain. Technical assistance, including general guidance as well as project-specific advice, is available to all users at no charge through the CAHPS Help Line (cahps1@ahrq.gov or 800-492-9261).