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CAHPS Overview Clinician & Group Surveys: Practical Options for Implementation and Use

Slide Presentation from the AHRQ 2011 Annual Conference

On September 18, 2011, Christine Crofton made this presentation at the 2011 Annual Conference.

Slide 1

CAHPS Overview
Clinician & Group Surveys: Practical Options for Implementation and Use

AHRQ Annual Meeting
September 18, 2011

Christine Crofton, PhD
CAHPS Project Officer

Slide 2

Overview of the afternoon

  • Overview of CAHPS Surveys & Design Principles.
  • CAHPS Clinician & Group Survey: An Introduction to the 2.0 Version.
  • Implementing CAHPS C&G Surveys: Strategies and Opportunities.

Slide 3

Overview, Cont'd

  • Assessing CAHPS C&G Survey Results: What the CAHPS Databases Can Do for You.
  • Improving Patient Experience in Primary Care: Resources & Examples including the CAHPS Survey for the Patient-Centered Medical Home.

Slide 4

Overview, Cont'd

  • Reporting on Patients' Experiences with Primary Care: Resources & Examples.

Slide 5


  • Integrated system of products and strategies.
  • Obtain assessments from consumers of the quality of care that they receive in different settings which.
  • Inform selection decisions.
  • Identify areas where providers and organizations can improve their services.
  • Provide quality information to care providers and other audiences.

Slide 6

The CAHPS Team

  • Grantees, currently RAND and Yale.
  • User Network Contractor, currently Westat.
  • AHRQ staff.
  • Stakeholders from other government agencies, such as CMS, NIDDR, CDC.
  • Stakeholders from other private organizations, non-profits and advocacy groups.

Slide 7

CAHPS Ambulatory Care Surveys

  • Health Plan Survey:
    • Adult and child.
    • Medicare, Medicaid & commercial.
    • Managed care, FFS, PPO.
    • NCQA version.
    • Disenrollee.

Slide 8

CAHPS Ambulatory Surveys, Cont'd

  • Clinician & Group Survey:
    • Adult and child.
    • Visit-based and past 12 months versions.
    • 4 point and 6 point scale version.
    • Patient Centered Medical Home.

Slide 9

CAHPS Ambulatory Surveys, Cont'd

  • ECHO Survey (Behavioral Health Care).
  • American Indian Survey.
  • Home Health Care Survey.
  • Surgical Care Survey.
  • Dental Survey.

Slide 10

CAHPS Facility Surveys


Hemodialysis Facilities

Nursing Homes:

  • In-person interview for long-term residents.
  • Recently discharged short-stay residents.
  • Residents' family members.

Slide 11

CAHPS Supplemental Item Sets

  • Children with Chronic Conditions.
  • People with Mobility Impairments.
  • Health Literacy.
  • Cultural Competence.
  • Health Information Technology.

Additional item sets for:

  • Health Plan Survey.
  • Clinician & Group Survey.

Slide 12

CAHPS Surveys

CAHPS Core Questionnaire Items + Supplemental Items = CAHPS Survey

Slide 13

Principle 1: Emphasis on Patients

CAHPS surveys ask about aspects of care:

  • For which patients are the best or only source.
  • Which patients have identified as important.

Slide 14

Principle 1: Emphasis on Patients

Only the patient knows:

  • How well their pain was controlled during a hospital stay.
  • Whether a provider explained things in a way that was easy to understand.
  • How often the provider's office staff treated him or her with courtesy and respect.

Slide 15

Discovering What Patients Want to Know

  • Focus groups with members of target population.
  • Focus groups with other individuals.
  • Literature reviews.
  • Environment scans.

Slide 16

Discovering What Patients Want to Know (Continued)

  • Interviews, meetings with key informants:
    • Gatekeepers, providers, advocacy groups.
  • Stakeholders:
    • Policy makers, health care quality orgs.
  • Technical expert panel members.

Slide 17

Principle 2: Reporting About Actual Experiences

Survey focus =

Patient experience of care
rather than simple satisfaction.

Slide 18

Principle 2: Reporting About Actual Experiences (Continued)

Reports of experience are more:

  • Actionable.
  • Understandable.
  • Specific.
  • Objective.

than general ratings.

Slide 19

Principle 2: Reporting About Actual Experiences

How satisfied were you?
How often did this provider:

  • Explain things in a way you could understand?
  • Treat you with courtesy and respect?
  • Listen carefully to you?
  • Spend enough time with you?
  • See you within 15 minutes of appointment time?

Slide 20

Principle 3: Standardization

  • Instrument:
    • Every user administers items the same way.
  • Protocol:
    • Sampling, communicating with potential respondents, and data collection procedures are standardized.

Slide 21

Principle 3: Standardization, Cont'd

  • Analysis:
    • Standardized programs and procedures.
  • Reporting:
    • Standard reporting composites and presentation guidelines.

Slide 22

Standardization: Recommended Data Collection Protocols

Dual mode data collection:

  1. Advance notification letter.
  2. 1st mailing of questionnaire packet.
  3. Reminder post card.
  4. Replacement mailing of questionnaire packet.
  5. Offer telephone interviews to mail nonresponders.

Slide 23

Principle 4: Multiple Versions for Diverse Populations

  • Designed for all types of users:
    • Medicare.
    • Medicaid.
    • Commercial population.
  • In English and Spanish.

Slide 24

Principle 5: Extensive Testing with Consumers

Cognitive testing:

  • Confirms that items, response options are understood as developer intended.
  • Is conducted in iterative rounds.
  • In English and in Spanish.

Slide 25

Principle 5: Testing with Consumers, Cont'd

Cognitive testing:

  • Participant "thinks out loud" while completing the questionnaire.
  • Participant is interviewed in detail after completing the questionnaire.

Slide 26

Principle 5: Testing with Consumers, Cont'd

Field testing:

  • To assess the effectiveness and feasibility of survey administration procedures and guidelines.
  • To determine validity, reliability and other psychometric properties.

Slide 27

Obtaining Technical Assistance


Page last reviewed October 2014
Internet Citation: CAHPS Overview Clinician & Group Surveys: Practical Options for Implementation and Use. October 2014. Agency for Healthcare Research and Quality, Rockville, MD.


The information on this page is archived and provided for reference purposes only.


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