Should Nurses Care about HCAHPS Scores?

HCAHPS scores matter! As nurses, it’s important that we learn what HCAHPS scores are and how they can impact our patients, our daily work, and potentially even our paychecks. 

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I remember when I first became a nurse and we would have monthly staff meetings to discuss various topics and issues that hospital administration had pushed down to us. I often grew frustrated with these meetings because the same topic kept coming up: HCAHPS scores. At which point the majority of the nursing staff would grumble and groan and complain about a standard that was unattainable due to ever-increasing workloads and complexities in the care they provided. Hospital administrators were trying to force the nursing staff to care about an issue instead of assisting them to grow and develop as better nurses by providing ongoing feedback and education.

Improving HCAHPS Scores the Old Fashioned Way

Improving HCAHPS scores is not rocket science. There are simple techniques that can be put in place to impact these surveys. However, it first starts with ensuring nursing and other staff even know what they mean and why they matter.

You can constantly talk about HCAHPS scores without providing baseline knowledge and real-life scenarios of their impact. Nurses need to know why they are important and what it can mean to a healthcare organization if they are not satisfactory. Unfortunately, many nurses have not been properly trained on this information from the manager. Even so, management will still push a focus on HCAHPS scores, when nurses really don’t even know why HCAHPS score matter and how they can positively impact them.  Unfortunately,  hospitals don’t always provide literature, emails, or education on this topic. But instead, assume nurses will do their own personal research on the issue.

Nurses need to understand that HCAHPS scores do matter! They especially matter to nurses because we the on the front lines of patient care and are often the people that patients interact with the most. We’re often the ones that the patients are rating when they complete these surveys, but many of us are never even educated on what criteria is on the HCAHPS survey.

How fair is it be graded on a test you didn’t know how to study for? How can you help with improving HCAHPS scores if you haven’t been given the tools to do so?

Hospitals need to step up to the plate and take on the responsibility of educating nursing staff on what exactly HCAHPS surveys measure and what they can do to improve scores. This process shouldn’t be a monthly blame-session in which the entire department feels defeated, but instead a continuous process that begins at orientation and is evaluated routinely.

But why should nurses be responsible for patient satisfaction surveys? Does it matter if a patient is or isn’t satisfied with the care they receive?

The short answer is: YES! 

So let’s dig into some FAQs and details around hospital HCAHPS scores.

What Does HCAHPS Stand For?

According to ruralcenter.org:

HCAHPS (also known as Hospital CAHPS) stands for Hospital Consumer Assessment of Healthcare Providers and Systems and is a standardized survey of hospital patients that captures patients’ unique perspectives on hospital care for the purpose of providing the public with comparable information on hospital quality.

HCAHPS consists of a standardized survey instrument and a set of data collection and reporting procedures. These are used by hospitals (or their survey vendors) to gather information about patients’ perspectives on care in the organization. The core set of HCAHPS questions can either be added to a hospitals current patient survey, or used as a stand-alone instrument. HCAHPS is part of a public/private partnership dedicated to publicly reporting valid and comparable information on hospital care quality. This information serves the goal of increasing consumers’ knowledge of hospital care. It also provides hospitals with data and benchmarks to gauge their performance relative to others.

Why are HCAHPS Scores Important?

HCAHPS scores are important because:

• Patients can view the results of the HCAHPS scores online and may make decisions about which facilities they go to for procedures and other care
• Reimbursement for hospitals is tied to HCAHPS scores

Specifically, HCAHPS scores are important to nurses because:

• If hospitals are ranked lower in performance, they could choose to have their procedures at other facilities. This would reduce the patients and income of the facility which could result in reduced hours or layoffs for nurses.
• Hospitals with lower reimbursement tend to result to cost-cutting measures like delaying filling open positions, putting nurses on call, and other tactics that can result in unsafe staffing scenarios.

Does HCAHPS Score Impact Reimbursement?

Does HCAHPS score impact reimbursement? You bet your bottom dollar they do!

For the majority of hospitals, a large portion of revenue comes from Medicare dollars administered by the Centers for Medicare & Medicaid Services (CMS). Through the Hospitals Value-Based Purchasing (VBP) program, hospital payments are adjusted for the quality of their care. However, CMS labels it as incentivizing care, as they award the highest payments to the top performers. However, the lowest performers receive less reimbursement and everyone starts out with a lower reimbursement since these incentives are funded by a 2% reduction in Medicare Severity Diagnosis Related Group (MS-DRG).

How to Improve HCAHPS Scores?

One significant strategy thank can be implemented to improve HCAHPS scores is to get everyone on the same page. Many nurses are unaware of how these scores work and how lower scores can have a negative impact on their patients, their work-life, and their paycheck.

I’ve met plenty of nurses who don’t have an interest in whether the hospital makes money, but it does matter. In the simplest terms, if the hospital doesn’t make money they cannot afford to pay nurses. Even the most altruistic and caring nurses aren’t interested in working for free. So reimbursement matters and HCAHPS scores matter!

Nurses shouldn’t be solely responsible for staying up to date on HCAHPS surveys and the real implications it can have on their job security. Instead, hospitals should invest in their nursing staff by making education on HCAHPS scores available and frequently reinforce the methods to improve those scores outside boring meetings. One approach is to incorporate training in competencies that are trained and skilled throughout the year which will always keep nurses up to date with the latest information and tactics to improve scores.