Patient Experience
Patient experience, measured primarily through HCAHPS and CG-CAHPS surveys, captures patients' reported perceptions of their care and directly affects CMS Value-Based Purchasing payment adjustments and public reporting on Care Compare for all IPPS hospitals.
What is Patient Experience?
Patient experience refers to patients' self-reported perceptions of the interactions, communications, and responsiveness they encountered during a healthcare episode — distinct from patient satisfaction (which measures whether expectations were met) and from clinical outcomes. HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) is the standardized, federally mandated survey for IPPS hospitals: a 29-question instrument sent to a random sample of adult inpatients post-discharge. HCAHPS domains include communication with nurses, communication with doctors, responsiveness of hospital staff, communication about medicines, discharge information, care transitions, cleanliness of hospital environment, quietness at night, overall hospital rating (0–10), and willingness to recommend. Under the CMS Hospital Value-Based Purchasing (VBP) Program, the Patient and Caregiver Experience domain — driven primarily by HCAHPS — accounts for 25% of the Total Performance Score (TPS). This TPS affects up to 2% of base Medicare DRG payments, creating direct financial stakes for patient experience performance. CG-CAHPS (Clinician and Group-CAHPS) is the outpatient equivalent, used in MIPS reporting. Top-box scores (percentage of respondents answering "Always" or rating 9–10) are the standard comparison metric. Press Ganey, NRC Health, and Qualtrics administer HCAHPS surveys for most hospitals.
Why It Matters for Healthcare Analytics
A 2% Medicare DRG payment adjustment from VBP patient experience performance can represent millions of dollars annually for large hospitals. Tracking top-box scores by unit, shift, and survey domain — alongside operational metrics like nurse response time and medication communication completion — reveals the operational drivers of patient experience scores and allows targeted improvement before the measurement period closes.
How Vizier Tracks Patient Experience
Upload your HCAHPS survey data and ask "Which HCAHPS domains have the lowest top-box scores by unit and how have they trended this quarter?" — Vizier identifies underperforming domains and units, correlates scores with staffing metrics, and benchmarks your performance against national percentiles.