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OUTPATIENT AND AMBULATORY SURGERY
OAS CAHPS®
Presented by: Jay Bishop, COOJ. L. MORGAN & Associates
January 2016
THE FOLLOWING INFORMATION IS GIVEN TO PROVIDE A HIGH LEVEL OF THE OAS CAHPS SURVEY PROCESS.
HOPD’S OR ASC ARE ENCOURAGED TO REVIEW THE OAS CAHPS
GUIDELINES ON THE CMS WEBSITE FOR DETAILED INFORMATION.
HTTPS://OASCAHPS.ORG
J. L. MORGAN & Associates
OBJECTIVE
INTRODUCTION AND BACKGROUND ON OAS CAHPSCOMPONENTS OF THE SURVEYSURVEY METHODOLOGYPARTICIPATION AND ELIGIBILITY REQUIREMENTSROLES AND RESPONSIBILITIESREPORTING RESULTSNEXT STEPS
J. L. MORGAN & Associates
INTRODUCTION TO OAS CAHPSOUTPATIENT AND AMBULATORY SERVICES CAHPS® (OAS CAHPS) SURVEYDEVELOPED BY THE AGENCY FOR HEALTHCARE RESEARCH AND QUALITY (AHRQ) AND ITS CONSUMER ASSESSMENT OF HEALTH PROVIDERS AND SYSTEMS (CAHPS®) CONSORTIUM IN 2012. • DEVELOPED TO PROVIDE A STANDARDIZED SURVEY
INSTRUMENT TO ASSESS PATIENT EXPERIENCE• OUTPATIENT SURGICAL CARE WHO VISITED A MEDICARE-CERTIFIED
HOSPITAL OUTPATIENT DEPARTMENTS (HOPDS) • AMBULATORY SURGERY CENTERS (ASCS) FOR A SURGERY OR
PROCEDURE.• CRITICAL ACCESS HOSPITALS
• SURVEY WILL BE AVAILABLE ON A VOLUNTARY BASIS BEGINNING WITH JANUARY 2016 DISCHARGES.
OAS CAHPS GOALS
PUBLIC REPORTINGPRODUCE COMPARABLE DATA PROVIDE MEANINGFUL COMPARISONS ALLOW CONSUMERS TO MAKE INFORMED CHOICES
REPORTING MEASURES AND RESULTSTHREE COMPOSITE MEASURES
• DID THE HOPD OR ASC STAFF GIVE CARE IN A PROFESSIONAL WAY?
• DID THE HOPD OR ASC STAFF COMMUNICATE WITH PATIENTS ABOUT WHAT TO EXPECT DURING AND AFTER THE PROCEDURE?
• PREPARATIONS FOR DISCHARGE AND RECOVERY – “PAIN, NAUSEA OR VOMITING, BLEEDING, OR POSSIBLE SIGNS OF INFECTION…”
TWO GLOBAL ITEMS• HOW DO PATIENTS RATE THE OVERALL CARE FROM THE
HOPD OR ASC?• WOULD PATIENTS RECOMMEND THE HOPD OR ASC TO
FRIENDS AND FAMILY?
J. L. MORGAN & Associates
REPORTING MEASURES AND RESULTSOAS CAHPS DOES NOT FOLLOW “TOP
BOX” SCORINGRESPONSES ON A 3-POINT SCALE• “YES, DEFINITELY”• “YES, SOMEWHAT”• “NO”
THE FINAL COMPOSITE SCORE REPORTED AVERAGES THE PROPORTION OF THOSE RESPONDING TO EACH ANSWER CHOICE IN ALL QUESTIONS IN THE COMPOSITE.
(EXAMPLE: 7/10 = 70%)
OAS CAHPS METHODOLOGY
METHODOLOGY FOLLOWS CLOSELY ALONG WITH HCAHPS
GOAL OF 300 ANNUAL SUBMISSIONS PER CCN (25 / MONTH)ANYONE WITH < 300 SUBMISSIONS: REPORTED AND NOTED WITH A “*”
FOOTNOTEDATA SUBMITTED MONTHLY TO VENDOR FOR SAMPLING
VENDOR MUST ATTEMPT TO CONTACT EVERY PATIENT IN THE SAMPLE
MINIMUM OF FIVE CALLS ATTEMPTEDCALLS AT DIFFERENT TIMES OF THE DAY AND DIFFERENT DAYS OF
THE WEEKPROXY’S ARE NOT PERMITTED
J. L. MORGAN & Associates
COMMUNICATING WITH PATIENTHOPD’S OR ASC SHOULD NOT DO ANY OF THE FOLLOWING: SEND OR PROVIDE INFORMATION TO PATIENTS IN ADVANCE PROVIDE A COPY OF THE OAS CAHPS SURVEY QUESTIONNAIRE INCLUDE WORDS OR PHRASES VERBATIM FROM THE OAS CAHPS SURVEY ATTEMPT TO INFLUENCE THEIR PATIENTS ANSWERS TO THE OAS CAHPS SURVEY QUESTIONSOFFER INCENTIVES OF ANY KIND TO THE PATIENTS FOR PARTICIPATING (OR NOT) IN THE SURVEYHELP THE PATIENT ANSWER THE SURVEY QUESTIONSASK PATIENTS WHY THEY GAVE A CERTAIN RESPONSE OR RATINGINCLUDE ANY MESSAGES OR MATERIALS PROMOTING THE HOPD OR ASC SURVEY
ROLES AND RESPONSIBILITIESHOPD OR ASC
• CONTRACT WITH AN APPROVED OAS CAHPS SURVEY VENDOR TO CONDUCT THEIR SURVEY.
• AUTHORIZE THE CONTRACTED SURVEY VENDOR TO COLLECT AND SUBMIT OAS CAHPS SURVEY DATA TO THE OAS CAHPS SURVEY DATA CENTER ON THE FACILITY’S BEHALF.
• WORK WITH THEIR APPROVED VENDOR TO DETERMINE WHEN DATA WILL BE SUBMITTED
• USE A SECURE METHOD TO TRANSMIT MONTHLY PATIENT INFORMATION FILES
ROLES AND RESPONSIBILITIESOAS VENDOR
• Work with appropriate HOPD/ASC staff to create monthly patient information files.
• Receive and perform checks of the monthly patient information files provided by HOPDs and ASCs data integrity.
• Apply filter criteria, sample patients following the sampling protocols
• Administer the OAS CAHPS Survey in accordance with the protocols and oversee the quality of work performed by staff and any subcontractors, if applicable.
• Prepare and submit data files to the OAS CAHPS Survey Data Center following OAS guidelines
• Review all data submission reports for client facilities to ensure that data have been successfully uploaded and received.
PATIENT ELIGIBILITY REQUIREMENTS ONE OUTPATIENT SURGERY/PROCEDUREAT LEAST 18 YEARS OF AGE REGARDLESS OF INSURANCE OR METHOD OF PAYMENT;PATIENT’S SURGERY OR PROCEDURE MEETS PROJECT
ELIGIBILITY DEFINITIONS, WHICH ARE AS FOLLOWS: A PROCEDURE IS OAS CAHPS-ELIGIBLE IF IT HAS A
G-CODE OF G0104, G0105, G0121 OR G0260, OR A SURGERY, DIAGNOSTIC PROCEDURE, OR OTHER
TYPE OF PROCEDURE IS OAS CAHPS-ELIGIBLE IF IT HAS A CPT-4 CODE IN THE 10021– 69990 RANGE,
DOMESTIC U.S. MAILING ADDRESS; NOT DECEASED; DO NOT RESIDE IN A NURSING HOME OR HOSPICE
“NO PUBLICITY” PATIENTS AND CERTAIN DIAGNOSIS SUCH AS HIV/AIDS ARE REMOVED
SURGICAL CATEGORIES ASSIGNED
Surgical Category Assigned
Type Description
Category 1 Gastrointestinal CPT code(s) in range 40000–49999 or G-code(s) G0105, G0121, or G0104
Category 2 Orthopedic CPT code(s) in range 20000–29999 or G-code is G0260
Category 3 Ophthalmology CPT code(s) in range 65000–68899
Category 4 Other CPT code(s) or G codes not in the range for surgical categories 1, 2 or 3
OAS ELIGIBLE EXAMPLES
• COMMON PROCEDURES WITHIN OAS CAHPS• COLONOSCOPIES (CODE 45378)• INJECTION FOR PAIN MANAGEMENT (27096)• HERNIA REPAIR (49560)
• CODES NOT WITHIN THE OAS-CAHPS RANGE OF ELIGIBLE CPT CODES.
• DIAGNOSTIC IMAGING PROCEDURES• PRE-VISIT TESTING• POST-VISIT FOLLOW-UPS• RADIOLOGY, LAB, PHYSICAL THERAPY OR DIAGNOSTIC
IN SUMMARY
NEW CAHPS® SURVEY TO EVALUATE PATIENT EXPERIENCE FOR OUTPATIENT SURGERY AND
AMBULATORY SERVICES.VOLUNTARY IN 2016, 2017 UNDETERMINED
WILL FOLLOW METHODOLOGY CLOSELY WITH HCAHPSWILL BE PUBLICALLY REPORTED IN JANUARY 2018
Thank You for your Time
J. L. Morgan & Associates7057 Meadowlark Drive| Birmingham, Al 35242
205-995-7153 | Fax: 205-995-7141
www.Jlmorganandassociates.com
