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Adonis Content Team

April 9, 2024
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What Are HCAHPS Scores & Why They Are Important to Patients

What Are HCAHPS Scores & Why They Are Important to Patients

Introduction to HCAHPS Scores and Their Importance

What are HCAHPS scores and what do they entail? HCAHPS (the Hospital Consumer Assessment of Healthcare Providers and Systems survey) is a tool for measuring patient satisfaction in healthcare. The Centers for Medicare & Medicaid Service (CMS) developed HCAHPS scores to help hospitals and other healthcare institutions assess how well they are serving their patients. This article explains how HCAHPS scores impact healthcare quality. You will also learn why patients care about them and their impact on patient care choices.

Understanding the Components of the HCAHPS Survey

A Patient satisfaction survey forms the basis of HCAHPS scores. The survey has 27 questions across the following categories:

  • Communication with doctors
  • Communication with nurses
  • Communication about medications
  • Pain management
  • Hospital staff responsiveness 
  • Discharge information
  • Overall hospital care rating

Together, responses to questions across these categories paint a holistic picture of the quality of care and communication across the health system.

Interpreting HCAHPS Scores: A Guide

The HCAHPS summarizes current and historical HCAHPS scores for hospitals. You can view these on their website. The following explains the Interpretation of HCAHPS scores; 

  • "Top-box" scores are the most favorable patient satisfaction scores
  • "Bottom-box" scores represent the least favorable category response 
  • "Middle-box" scores record intermediate responses to each hospital patient satisfaction question

The Impact of Patient Satisfaction on Healthcare Organizations

Why are these surveys important? Simply put, hospitals and health systems want to provide the highest quality care. These surveys offer a key indicator of patient satisfaction across the board. Because HCAHPS survey results are public, patient satisfaction doesn’t just mean happier patients, but it ultimately leads to a better reputation and increased revenue. For a health system, increased revenue means improved hiring opportunities, more skilled doctors, and the best in equipment and technology.

On top of increased revenue from a larger number of patients, CMS Hospital Value-Based Purchasing Program uses scores from HCAHPS to determine reimbursements to hospitals. The higher the HCAHPS scores, the higher the reimbursement rates, thus more revenue.

Low HCAHPS scores, on the other hand, result in the following costly consequences:

  • Lower payment from CMS's value-based payment program, thus, lower revenue
  • Reduced patient volume affecting revenue in general
  • Challenges attracting and retaining employees, leading to high employee turnover 
  • Discourages referrals, limiting patient volume and revenues

Strategies for Enhancing Patient Satisfaction

To improve HCAHPS scores, hospitals and health systems can focus on strategies to improve patient satisfaction, such as:

  1. Clear communication: Effective communication between healthcare providers and patients is crucial. Patients value care providers who pay attention to them, and provide honest information about their treatment options. Empathy in patient communication also boosts patient satisfaction.
  2. Improve staff responsiveness: Patients prefer physicians who address their issues promptly. For instance, the use of eSignature Platforms and patient-facing technologies that streamline manual processes can improve responsiveness and overall satisfaction.
  3. Ensure hospital cleanliness: This should be a given, but hospital sanitation has a significant impact on patient satisfaction ratings. Hospitals could easily address this issue by ensuring regular checks and cleaning. 
  4. Prioritize patient pain management: Patients who are in pain are not happy patients. Ensuring patient’s pain is managed properly leads to improved HCAHPS ratings.

Best Practices for Administering HCAHPS Surveys

HCAHPS is a standardized survey, which ensures consistency in each assessment. Hospitals will receive training on proper data-collection techniques before offering HCAHPS surveys. Participating hospitals should submit no less than 300 completed patient surveys annually.

The HCAHPS sampling approach includes a random selection of eligible discharged patients. These are adult patients admitted to the hospital, except psychiatric patients. The survey is also open to non-Medicare or Medicaid enrolled patients.

Patients should take HCAHPS surveys no later than 48 hours following their discharge. It is not permissible to gather data on patients who are still in the hospital. Only hospitals and survey contractors with CMS approval can conduct HCAHPS surveys. 

Leveraging Technology to Improve Patient Satisfaction

Improvements in healthcare technology are reducing the communication disconnect between doctors and patients. Healthcare technology, when used correctly, increases productivity, efficiency, and overall HCAHPS scores. Some examples of how tech can improve the patient experience include:

  • Utilizing a digital kiosk to check in upon arrival at an appointment
  • Access to your medical records from anywhere
  • Direct communication with doctors through online patient portal
  • Telehealth enables you to receive care from your home at the time that works best for you


  1. How is the data from the HCAHPS Survey analyzed? CMS cleans and analyzes the data before calculating scores and reporting. 
  2. Which HCAHPS Survey Results are publicized? Hospital Compare is a public platform that hosts HCAHPS results. These results are usually released on a rolling basis for a period of four quarters. The most recent survey quarter is rolled on while the oldest quarter's data is rolled off.


Today's healthcare industry places a greater emphasis on patient experience. As a result, hospitals must take initiatives to improve both care quality and cost effectiveness. Every day, thousands of patients fill out the HCAHPS survey. Thus, hospitals must take steps to improve their HCAHPS rankings because these rankings ultimately impact their revenue.

Hospitals need processes that allow them to transition from "bottom-box" and "middle-box" ratings to those of "top-box" performance on a regular basis.

Hospitals may improve patient experience and profitability by;

  • Analyzing their existing HCAHPS scores, both aggregate and individual.
  • Evaluating their strengths, weaknesses and opportunities
  • Implementing practical initiatives aimed at boosting those scores
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