Tuesday, December 1, 2009

Why should all agencies be asked to complete 300 surveys, regardless of agency size?

We get a lot of questions regarding the fairness of the requirement to conduct 300 HHCAHPS Surveys. For example, why should a smaller agency of 400 patients be required to do 300 surveys (75% of their census) when a larger agency doing 300 surveys could be as low as 1% of their census?

Addressing this question, CMS issued the following statement on page 28 of the
Federal Register, where they outlined the final ruling on HHCAHPS:

"We understand concerns about the sample size. In the practice of statistics however, it is established that the sample size in absolute numbers is more important than the proportion of the population surveyed. Surveying a sample of 300 will produce the same level of precision whether the sample is 10 percent, 1 percent or even 0.01 percent of the total population. We understand that 300 may be higher than achievable for some small agencies. However, the larger the sample (even if less than 300), the less the variability in an agency’s ratings over time. Therefore, in the final rule we are moving forward with the sample sizes for HHCAHPS as proposed."

In summary, it's not necessarily fair that 300 is required of a smaller agency. But in order to have more statistically reliable results, a larger number of survey results is necessary. And in the event that your agency isn't large enough to get the full 300, you are just asked to submit the full census to your approved vendor and they will complete as many as possible.

For help with HHCAHPS, or to speak with an HHCAHPS expert, email inquiries@mycahps.com or call 801-293-0700. 

--Craig Christiansen

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