What Is HHCAHPS?

The Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) is Medicare’s official patient‑experience survey for home health care. It measures how patients feel about the care they receive — communication, professionalism, education, coordination, and overall satisfaction.

HHCAHPS is a core part of CMS oversight and directly influences:

• Patient Survey Star Ratings
• Home Health Value‑Based Purchasing (HHVBP) payment adjustments
• Care Compare public reporting
• Agency reputation and referrals

For agencies, HHCAHPS is not optional. It is a required component of quality reporting and a major driver of public perception.

I. Who Must Participate in HHCAHPS

CMS requires participation for agencies that meet the following criteria:

A. Eligibility Threshold

Agencies with 60 or more eligible patients per year must participate.

B. Approved Vendor Requirement

HHAs must contract with a CMS‑approved HHCAHPS vendor to administer the survey. Agencies cannot conduct the survey themselves.

C. Exemptions

Agencies with fewer than 60 eligible patients may apply for an exemption each year.

D. Submission Requirements

Survey data must be submitted monthly, and agencies must maintain documentation of compliance.

II. What HHCAHPS Measures

HHCAHPS evaluates several domains of patient experience. Each domain reflects how well the agency communicates, educates, and coordinates care.

A. Communication

Patients are asked whether clinicians:

• Explained things clearly
• Listened carefully
• Treated them with courtesy and respect
• Reviewed medications
• Discussed symptoms to report

Communication is one of the strongest predictors of HHCAHPS performance.

B. Professionalism

Patients rate whether staff:

• Appeared professional
• Maintained a clean appearance
• Respected their home environment
• Demonstrated competence
• Avoided rushed behavior

Professionalism influences both satisfaction and willingness to recommend the agency.

C. Care Coordination

This domain evaluates whether clinicians:

• Communicated with physicians
• Coordinated care with the agency team
• Ensured timely follow‑up
• Provided clear instructions
• Helped patients understand their plan of care

Strong coordination reduces hospitalizations and improves outcomes.

D. Patient Education

Patients report whether clinicians taught them:

• How to take medications safely
• How to prevent falls
• How to manage symptoms
• What to do in an emergency
• How to monitor their condition

Education is essential for both HHCAHPS and HHVBP performance.

E. Overall Satisfaction

Patients rate:

• Their overall experience
• Whether they would recommend the agency
• Whether care met their expectations

This domain heavily influences Patient Survey Star Ratings.

III. How HHCAHPS Affects Star Ratings

CMS uses HHCAHPS results to calculate Patient Survey Star Ratings, which appear on Care Compare.

Star Ratings influence:

• Consumer choice
• Hospital and physician referrals
• Competitive positioning
• Agency reputation

Even small improvements in communication or education can significantly raise survey scores.

IV. How HHCAHPS Affects HHVBP

HHCAHPS is a major component of the Home Health Value‑Based Purchasing (HHVBP) Model.

HHVBP uses HHCAHPS results to calculate an agency’s Total Performance Score (TPS), which determines:

• Positive payment adjustments
• Negative payment adjustments
• Neutral adjustments

Because HHVBP ties payment to patient experience, agencies must prioritize communication, education, and professionalism during every visit.

V. How HHCAHPS Appears on Care Compare

Care Compare displays:

• Patient Survey Star Ratings
• HHCAHPS domain scores
• Agency comparisons
• Public comments (if applicable)

Patients, families, hospitals, and referral partners use Care Compare to evaluate agency performance.

Strong HHCAHPS scores improve visibility and trust.

VI. How Agencies Can Improve HHCAHPS Scores

Improving HHCAHPS does not require major operational changes — it requires consistent, intentional communication during every visit.

Key strategies include:

• Greet patients warmly and use their name
• Explain the purpose of each visit
• Review medications every time
• Ask if the patient has questions
• Provide clear symptom‑reporting instructions
• Confirm understanding before leaving
• Offer a contact card for the agency
• Ask, “Is there anything we can do better?”

These small habits create measurable improvements in patient satisfaction.

VII. HHCAHPS and CMS Oversight

HHCAHPS is one of the four major components of CMS oversight:

1. Quality Measures
2. HHCAHPS Patient Surveys
3. Onsite CMS Surveys/Inspections
4. Care Compare Public Reporting

Together, these elements determine how CMS evaluates home health agencies and how the public perceives them.

VIII. Resources for Home Health Agency Owners

To help agencies improve HHCAHPS performance, BHealthyRN offers:

• HHCAHPS Improvement Checklist (Printable PDF)

This tool should help agencies strengthen communication, education, and coordination — the core drivers of HHCAHPS success.