Yes, CMS has once again delayed rolling out the OAS CAHPS patient satisfaction survey, but it might be wise to shop now for a survey vendor (osmag.net/jDZF9h) to partner with before data collection becomes mandatory, which is believed to be a question of when, not if. Medicare will update its proposed OAS CAHPS rule next month, issue a final rule in November and could finally launch the Consumer Assessment of Healthcare Providers and Systems Outpatient and Ambulatory Surgery Survey on Jan. 1, 2019.

OAS CAHPS survey vendors will charge surgical centers and hospital outpatient departments a reported $10 to $25 per completed survey. They'll ask your Medicare patients 37 questions about how well they were treated before, during and after their procedures — as well as their highest level of education and primary language. Here are important factors to weigh as you compare vendors.

1. Collection method

As the pay-for-reporting program is currently structured, CMS-approved vendors will contact your patients with a telephone call, a mailed survey or with a mailed survey and follow-up phone call. No email. "I don't think much will change from the original proposed rule, except hopefully the addition of an electronic version," says Crissy Benze, MSN, BSN, RN, senior consultant at Progressive Surgical Solutions, a division of BSM Consulting. "Start reaching out to vendors now to gather information about their services and decide which one you're going to partner with."

The addition of an e-mail option might add another variable to consider, but still ask vendors how they will contact your patients and decide which option is best for your facility and patient population, says healthcare attorney Mark Weiss of Santa Barbara, Calif.

Mr. Weiss says working with a vendor that relies exclusively on paper surveys creates a potential issue. Will patients throw them away and not respond, preventing your facility from collecting the 300 completed surveys a year that CMS requires? If you're already sending out your own paper patient satisfaction surveys, Mr. Weiss says it might make sense to partner with a vendor that conducts phone call surveys, so your patients don't get confused when 2 envelopes show up in the mail.

When considering vendors who contact patients by phone, ask for detailed information about who places the calls and what type of customer service training they have. "The reps won't be employees of your facility," says Mr. Weiss, "but it's not a stretch to think patients will associate the interactions with your facility."

2. Cost

• Will the cost be based on the number of completed surveys or the number of mailed surveys sent out and phone calls attempted?
• Are there start-up costs associated with initiating the service?
• What are the specific terms of the contract and is there a cost incentive to sign a multiple year agreement?
• Is there an early termination fee if your facility decides to cancel the service?
• You can add up to 15 questions to the survey that vendors will ask patients on your behalf. How much, if anything, would customizing the survey with supplemental questions cost?

Mr. Weiss says one vendor he spoke to charges $10 per survey if the number of patients reached exceeds 500, which is easy to surpass if your facility is performing thousands of cases per year. He therefore suggests you work with a vendor who has a sliding scale of costs based on volume.

Another piece of advice from Ms. Benze: If your facility uses a billing company, the company will need to produce and send monthly reports to vendors that note patients who are eligible to survey. Check with your billing company in advance to determine how much this service will cost and how often these fees will be assessed (for example, will you have to pay a one-time implementation fee or monthly fees?).

3. Turnaround time

Todd Albertz, vice president of surgical and specialty services at the Cincinnati (Ohio) Eye Institute, had interviewed a couple of vendors and even settled on a negotiated price for implementing the surveys when he learned the program was delayed.

"We could have stopped," he says. "But we had put a lot of work into preparing for the program's launch and decided to keep the process moving forward to see what educational benefits we could get from it for self-improvement purposes."

The data surveyors collect is intended for Medicare quality reporting purposes, but you can learn from the feedback. "You can find out, for example, that your patients don't understand the type of anesthesia they receive and take steps at the scheduling and pre-op phone call levels to correct that," says Mr. Albertz. "Since the requirement went away, we've still used the data as an internal educational tool."

Mr. Albertz's facility used to send satisfaction surveys and postage-paid envelopes to every patient. The postage costs alone added up quickly; the facility did 14,000 cases a year and 90% of the surveys were returned. That's not even factoring in the labor costs of logging and processing the responses. Now, his facility receives data from his outside vendor within 30 to 40 days of it being collected.

"We were able to cost-justify working with an outside vendor for that reason alone," he says. "The feedback you get from patients is a great tool if you learn from it."

Does it make sense to add even more questions to a survey that many experts deemed too labor intensive to begin with? It might if you're doing away with conducting your own satisfaction surveys, like Mr. Albertz has done. Keep in mind, however, that the vendors will reach only a fraction of your patient population, especially if you run a high-volume facility.

"If you're doing 8,000 cases a year, and getting 300 surveys completed to meet the CMS requirement, you won't get a good sampling of your patient population," says Ms. Benze.

4. Ease of interaction

You're responsible for providing vendors with complete, accurate and valid patient files that contain required administrative information with respect to how patients meet eligible survey criteria. You must work with vendors to establish a HIPAA-compliant portal that lets them extract patient data and mine the information to compile a sampling of your patient population.

After discussions with vendors about pricing and the methods they'd use to contact patients, Mr. Albertz settled on a vendor who's based 10 miles from his facility. "We decided to go with a local provider," he explains. "Working with a vendor requires some level of integration with your facility's software. You can share patients' records electronically anywhere in the country, but I figured it would be easier to work with someone close by if issues arise."

5. Right-sized fit

The CMS-approved vendors have backgrounds in working with healthcare providers, but that doesn't mean they're all equally qualified to handle the specific needs of your facility.

"Partner with someone who understands surgery, who knows where this program is heading with respect to our industry," says Mr. Albertz. "It's important to work with a vendor who you can springboard questions off of and have a dialogue about the challenges you're facing."

For example, it might not make sense to sign on with a large company that's known for conducting patient satisfaction surveys for large health systems. "You don't need that level of work — and the fees that go along with it — at the surgery center level," says Mr. Albertz. "Find a vendor who is growing in the ASC space and has a platform in place to support your level of need."

Part of the culture

You should already be implementing processes and facility upgrades that are designed to improve the patient experience, says Mr. Weiss. He adds, "You can't flip the switch on good customer service when vendors start reaching out to your patients."

Your staff can't discuss the actual OAS CAHPS survey questions with patients, but that shouldn't prevent them from talking about the ways they focus on patient-centered care. "They have to become their own biggest fans and sell the efforts they're making to improve the patient experience," says Mr. Weiss.

In the end, guiding your staff on providing excellent customer service and emphasizing patient safety is more important than talking about the actual survey, says Ms. Benze, who adds, "That's ultimately what this is really all about." OSM