The Accountable Care Organization Realizing Equity, Access, and Community Health Model (ACO REACH Model) Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey was developed by the Centers for Medicare & Medicaid Services (CMS). The ACO REACH Model is a redesigned and expanded version of the Global and Professional Direct Contracting (GPDC) Model. The new name and design of the survey better align with its purpose: to enhance the quality of care for Medicare beneficiaries through improved care coordination between providers and recipients.
What is the ACO REACH CAHPS survey?
The ACO REACH CAHPS survey instruments seek feedback about beneficiary experience of care with the REACH ACO. Most questions are about experience in the last six months with the provider the beneficiary saw most often at the REACH ACO.
What is the ACO REACH Model?
The ACO REACH Model was implemented in January 2023. It includes five new policies related to health equity, some changes to risk adjustment, and additional application scoring criteria. Organizations that participate are called REACH ACOs. The ACO REACH Model is focused on provider-based organizations and for three types of participants.
- Standard ACOs: These ACOs are organizations that are familiar with serving patients under original Medicare, including those who only have Medicare coverage, or have both Medicare and Medicaid coverage. These organizations may have previously participated in other Medicare savings programs, like the Next Generation ACO Model or Pioneer ACO Model.
- New entrant ACOs: These ACOs are comprised of organizations that have not generally provided services to an original Medicare population.
- High needs population ACOs: These ACOs serve original Medicare beneficiaries with complex needs, including those beneficiaries who are dually enrolled in Medicare and Medicaid.
Is participation in the ACO REACH CAHPS survey mandatory?
ACOs participating in the ACO REACH Model are required to use the ACO REACH CAHPS survey. Only vendors that have applied and been approved by CMS, such as Press Ganey, can administer the ACO REACH CAHPS survey.
What types of questions does the ACO REACH CAHPS survey ask?
The ACO REACH CAHPS survey asks questions related to the patient experience from the patient’s perspective and impacts the ACO’s Quality Score.
The questions are related to the following domains:
- Getting timely care
- Shared decision-making
- How the patient rates the provider
- Care coordination
- How courteous and helpful the office staff is
- Health promotion and education
- Stewardship of beneficiary resources
- Access to specialists
- Activities of daily living
There is an ACO REACH CAHPS survey for standard ACOs and new entrant ACOs, and a survey for high needs population ACOs. Although the surveys have similarities, there are additional questions on the survey for individuals with high needs, such as questions related to the patient’s family support.
Who receives the ACO REACH CAHPS survey?
CMS randomly selects a group of Medicare beneficiaries who have received primary care services from the REACH ACO in the past year. Only beneficiaries who are 18 years old or older can participate.
The patients who are selected receive up to two mail surveys and six phone calls during a 13-week data collection period.
How do I administer the ACO REACH CAHPS survey?
Organizations participating in the ACO REACH Model are required to participate in the ACO REACH CAHPS survey, so no extra registration is necessary. CMS publishes a list of vendors that are approved to administer the survey, including Press Ganey. Participating ACOs must choose an authorized vendor from the list.
Why is this patient experience survey important?
The ACO REACH CAHPS survey measures the experiences of people receiving care from ACO REACH participants. It helps the organization understand the patient experience, which can lead to improved clinical outcomes and lower use of inpatient and emergency department services.
How does the ACO REACH CAHPS survey benefit patients?
When patients have a more positive care experience, they tend to more closely adhere to their care plans, which can help them have better outcomes. Additionally, the results of the ACO REACH CAHPS will be shared on the CMS ACO REACH website.
How does the ACO REACH CAHPS survey improve healthcare delivery?
The ACO REACH Model is designed to improve health equity, and the ACO REACH CAHPS survey measures whether the model is working for patients. The ACO REACH Model serves to improve healthcare delivery and care coordination for underserved communities to diminish healthcare disparities.
How can my organization get started with the ACO REACH CAHPS survey?
ACO REACH Model participants are required to administer the ACO REACH CAHPS survey and should consult a CMS-approved survey vendor, such as Press Ganey, to implement the survey and help leaders stay up to date on all associated requirements. Press Ganey also offers continuous member experience insights through flexible outreach options, consulting solutions, industry-leading expertise, and compliance management to assist participating plans in adhering to survey requirements.
The ACO REACH CAHPS survey is a valuable measurement tool for CMS to gauge the effectiveness of the ACO REACH Model on the experience of Medicare beneficiaries receiving care from REACH ACOs. To ensure your organization complies with CMS requirements, it’s important to understand the basics of the survey program, how to implement the survey, and benefits of partnering with Press Ganey to administer the ACO REACH CAHPS survey.
Read more about Press Ganey’s CAHPS surveys regulatory offerings or speak with a regulatory expert to learn how your organization can best measure patient experience.