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HCAHPS: Revised for 2025 Confirmed Changes

August 21, 2024

CMS confirmed several changes for HCAHPS process and included several survey changes confirmed in the following final rule that can be viewed here. These process and survey changes are listed below and will begin with discharges from January 1st, 2025, forward.

  • Survey Modes of Data Collection
    • In response to growing demand for cost-effective internet-based options, CMS will allow hospitals to use new mixed-modes consisting of: Web-Mail, Web-Phone, Web-Mail-Phone. (These same options have been approved for the official OAS CAHPS implementation.) In the mode experiment, these web-first modes yielded improved response rates, a long-standing goal for CMS. Phone-only, mail-only, and mail-phone are still approved.
    • With no hospitals using IVR since 2016, CMS will eliminate this survey mode.
  • Data Collection Period
    • To accommodate the new mixed-mode options, CMS will extend the data collection period after first contact from 42 to 49 days, to allow adequate time for secondary mode outreach. The 2021 mode experiment also found a statistically significant increase in completed surveys from underrepresented groups during the day 43 to 49 period.
  • Limit on Supplemental HCAHPS Questions
    • National survey response rates have been on the decline and appear to decrease as the number of supplemental items increase. CMS is implementing a new rule to limit the number of supplemental questions to 12, to prevent survey length from negatively impacting response rates. This limit is consistent with other CAHPS surveys. PRC will review the count of supplemental items and reach out to hospitals who are currently over that amount.
  • Spanish Translation for Survey
    • Hospitals will be required to collect the preferred language or language spoken at home from every patient and provide this field in the data file.
    • Vendors will be required to administer the Spanish translation of the survey to all Spanish language-preferring patients.
  • Proxy Respondents
    • CMS will allow proxy respondents to complete the HCAHPS survey on behalf of a patient, but still wants to encourage patients to respond when feasible.
    • CMS has received ongoing feedback from stakeholders asking for proxies to be permitted, and in the 2021 Mode Experiment, they found that allowing proxies respondents did not impact HCAHPS scores.
  • Survey Changes
    • Several questions will be removed from the survey, including those in the Care Transition composite and the call button question.
    • Several questions will be added to the survey, including topics like Restfulness of the Hospital Environment, Care Coordination, and getting timely help, and getting enough information about symptoms to watch out for.
    • Due to these changes, VBP scoring is changing as well. Find out more about that here.

For additional information on the survey changes, please click here for an additional resource outlining all the specific changes, and reach out to our CAHPS® team at [email protected] with any further questions.