SATISFACTION SURVEY ASCs must collect at least 300 completed surveys per year, or an average of 25 per month.

The name's a mouthful: OAS CAHPS. It stands for Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems. It's a Medicare program designed to let patients compare hospital outpatient departments (HOPDs) with ambulatory surgery centers (ASCs). Beginning Jan. 1, 2018, participation in OAS CAHPS goes from voluntary to mandatory. Here are answers to 10 questions you might be asking.

1. How does OAS CAHPS work?
ASCs and HOPDs must work with CMS-approved survey vendors (osmag.net/k4QKYa). The vendor will administer the 37-question survey to your patients by telephone, mail or mail with telephone follow-up — no email surveys, at least not yet — and then submit the data to CMS.

2. Is this mandatory?
Yes. If you don't participate, CMS may withhold 2% of your Medicare reimbursements.

3. Is a delay possible?
This is a CMS program, so anything's possible. There's a "distinct possibility of a reprieve," says Kara Newbury, JD, regulatory counsel for the Ambulatory Surgery Center Association (ASCA). This could mean a delay in the Jan. 1 start date, fewer survey questions or an email version.

4. How many completed surveys?
ASCs must collect at least 300 completed surveys over each 12-month reporting period (an average of 25 per month). "Small" ASCs that don't do enough volume to collect 300 surveys over a 12-month reporting period must survey all eligible patients.

5. How do I select a vendor?
It depends on factors including cost and the survey mode: by phone or by mail. Some vendors do one or the other, while others offer both, and each has its own cost structure.

"We like the mail survey better, though I know we might get a better response by doing both," says Charles Busack, MHA, administrator of Berks Urologic Surgery Center in Reading, Pa. "But if they offer both, they also might charge you more."

NONE OF YOUR BUSINESS Critics of the OAS CAHPS say 13 of the survey's 37 questions are highly intrusive of your patients' personal information and have nothing to do with the patient's ASC experience.

6. What's the cost?
Annual prices range from $2,000 to more than $10,000. Plus, there's an implementation or setup fee of $250 to $500, though some vendors are waiving that fee during the voluntary period.

Raymond Hino, MPA, FACHE, the administrator for Skyway Surgery Center in Chico, Calif., added questions to the standard OAS CAHPS survey — CMS permits no more than 14 additional questions — which came at an additional cost. He says his facility pays its survey vendor about $4,500 per year.

7. How will my patients react?
"I wonder how many patients are going to take the time to fill out a 37-question survey," says Vicki V. Schultz, RN, CASC, the CEO of Women's Specialty Surgery Center of Dallas, Texas. "We have a 10-question survey, and most patients are so happy to have a procedure completed, they complete it right away so we get immediate feedback. I think OAS CAHPS is going to delay that."

Some have expressed concern over the survey's 13 personal-information questions that have nothing to do with the patient's ASC experience. Example: "Do you speak a language other than English at home?" One industry consultant equates these questions to "data mining your patients," and suggests many patients won't share such information willingly. Ms. Newbury says some of these personal-information questions might be trimmed in any forthcoming adjustment to the requirement.

8. Can I still do my own surveys?
Yes, but CMS offers suggestions in the OAS CAHPS Protocols and Guidelines Manual (osmag.net/XxKuS6) to make sure patients are not "overburdened by multiple surveys."

"We had been doing our own patient-satisfaction surveys, but now we're going to let OAS CAHPS replace those surveys," says Mr. Busack. "The main advantage is that instead of leafing through the manual paper surveys, we'll be able to go onto a portal and have our own dashboard so we can see the results and see how we compare with other surgery centers working with our vendor. I think it will be a better benchmark."

Orthopaedic Outpatient Surgery Center in West Des Moines, Iowa, plans on "doing both" — the OAS CAHPS survey and routine satisfaction surveys, both conducted through its survey vendor — says Vicky Tuel, quality and informatics specialist.

"OAS CAHPS is such a small sampling," she says. "Plus it's 100% anonymous, so we'd have a hard time identifying people and working through a resolution if we want to follow up and figure out how we can do better."

9. Will OAS CAHPS help my facility?
Avoiding the 2% reduction in Medicare payments is the obvious answer, but consider the broader, long-term picture. The survey is designed to produce 3 measurable outcomes:

• comparable data from the patient's perspective that allows objective comparisons between HOPDs and freestanding ASCs;
• public reporting to help consumers make more informed choices when choosing a surgical facility; and
• public reporting of survey results to help surgical facilities in their quality-improvement initiatives.

Mr. Hino, who has a background in hospital management, has gone through this process before — with the same survey vendor — with HCAHPS, the hospital version of OAS CAHPS. Based on past experience, he anticipates good things to come of the program. In fact, he's already seen them after just 2 months of submitting data.

"We noticed in the very first report for our very first month that we scored low on patients responding to the question regarding whether they were given instructions on preventing nausea and vomiting upon discharge," he says. "The national comparison was low, and so was ours, and by seeing this we were able to implement some additional teaching tools to improve our patient-satisfaction scores."

10. What happens next?
Be prepared for Jan. 1. Even if the administration does make changes to the requirement in the 2018 proposed rule, OAS CAHPS will arrive in some way, shape or form.

Surgical facility leaders are inching closer to the Jan. 1 deadline with a sense of cautious optimism and bald anxiety — optimistic over the benchmarking potential, anxious over "putting your reimbursements in someone else's hands," as Heather D. Myers, RN, BSN, the director of Andersen Eye Surgery Center in Saginaw, Mich., describes it.

"Any feedback is helpful, especially if it makes things more efficient, but I'm not loving the idea of doing this," says Ms. Schultz. "I don't want to see us suffer a loss in our Medicare reimbursements. We could choose to take the 2% hit, but who wants to do that?"

Mr. Hino understands the apprehension, but he's decided to look at the bright side. "It's a great opportunity for ASCs to measure ourselves against our peers and to get better as an industry." OSM