Impact of Response Rate on HCAHPS Dimension Scores 

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) performance continues to be an important tool for gauging patient experience. Hospitals strive to achieve high scores in order to improve overall patient experience and maximize returns in the Hospital Value-Based Purchasing (VBP) program. Just as consumers look to online reviews before major purchases, patients now review websites for ratings when selecting a healthcare provider. It is imperative that hospitals accurately capture their patient experience performance in order to maintain favorable scores and remain relevant in the quickly-changing healthcare marketplace.

Recent research suggests that increasing the response rate may be one way to improve a hospital’s score, as a strong correlation exists between response rate and HCAHPS scores.

Survey Says

Utilizing CMS HCAHPS published data, PRC was able to identify and replicate a correlation between response rates and HCAHPS scores nationwide, first published by the Hospital Quality Institute (HQI). In the article, HQI observed, “Each 1-percentage-point increase in a hospital’s HCAHPS response rate is expected to result in a 0.5-percentage-point increase in the mean top-box score.” Utilizing publicly reported data from Hospital Compare, PRC replicated this analysis and identified a similar positive correlation between HCAHPS scores and response rates for hospitals.

This correlation implies that increasing response rates can result in improved HCAHPS dimension scores, as published through the Beryl Institute and HCAHPS Online.

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Response Rate Impact 

When a sample group truly represents the total population, this correlation would be unlikely. Instead, this correlation implies that organizations’ data may not reflect a true representative sample. The key to getting a more representative sample is not administering more surveys, but rather, increasing your response rate to generate more completed surveys from the sample group selected. With increased response rate, hospitals receive valuable feedback from a higher proportion of patients, creating a more representative sample of the total hospital patient population.

In any survey, you are most likely to receive feedback from those patients who were either extremely happy or unhappy with their experience. Responses from a larger percentage of patients (i.e. higher response rate) insures that feedback is also received from those patients in the middle who were satisfied with their experience, but not falling to the extreme on either end of the spectrum. Therefore, the broader range of patient responses allows for a more balanced representation of the true patient population at a facility.

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Get the High Score

Responses from a more representative sample are key to capturing higher patient scores.

These findings suggest that there is a real value in increasing response rates. Higher response rates will give hospitals a more representative sample, allowing them to capture a more accurate, and generally more positive, measure of patient experience.

Raise your Response Rates

Conversely, a low response rate can negatively impact a hospital’s HCAHPS scores. With a low response rate, it may be difficult to rely on patient experience scores to show when improvements have been effective. In these cases, the hospital may not be getting enough responses to accurately showcase efforts made by the hospital staff. In addition to the misrepresentation of publicly reported patient care, this can also have a negative impact on hospital staff. Morale can decline as staff members question their improvement efforts, when the challenge may actually rest in obtaining a representative sample to reflect the patient experience accurately.

Work in Chicago? 

Chicago hospitals have some of the lowest response rates across the country, which means your hospital is potentially leaving money on the table. Check out this recording of PRC’s webinar, “Chicago Exclusive: The Impact of Response Rate on HCAHPS Dimension Scores,” to learn how PRC’s industry-leading response rates yield data that accurately reflect your improvement efforts in HCAHPS scores across every dimension!

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EasyView Insights

So how does your hospital compare? Find out with PRC's Response Rate Insights tool on EasyView. This resource estimates your potential score based on the associated dimension correlation value, the user-selected response rate, and most recent Hospital Compare dimension scores. Once the hospital and response rate are selected, the tool color-codes scores to indicate scores at Benchmark (blue), Achievement (green) and Below Achievement (red) levels. Performance is then translated into estimated VBP points to get a snapshot of the impact response rate can have on your hospital.

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