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Dec 1 -- The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment by January 30, 2024 on CMS' intention to collect information through CMS–10500: National Implementation of the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) Survey.

As documented in the CY 2022 OPPS/ASC Final Rule (86 FR 63863 through 63866), OAS CAHPS Survey data will be linked to reimbursement beginning with CY 2024 for Hospital Outpatient Departments (HOPDs) and CY 2025 for Ambulatory Surgery Centers (ASCs). ASCs will continue with voluntary implementation of the OAS CAHPS Survey throughout CY 2024.

HOPDs and ASCs contract with a CMS-approved, independent third-party survey vendor to implement the survey on their behalf and to submit the OAS CAHPS data to CMS. CMS publicly reports comparative results from OAS CAHPS after each facility has conducted data collection for 4 quarters. Data from OAS CAHPS enable consumers to make more informed decisions when choosing an outpatient surgery facility, aid facilities in their quality improvement efforts, and help CMS monitor the performance of outpatient surgery facilities. Considering the increasing Medicare expenditures for outpatient surgical services from HOPDs and ASCs, the implementation of OAS CAHPS provides CMS with much-needed statistically valid data from the patient perspective to inform quality improvement and comparative consumer information about specific facilities. The information collected in the OAS CAHPS survey will be used for the following purposes:

-- To provide a source of information from which patient experience of care measures can be publicly reported to beneficiaries to help them make informed decisions for outpatient surgery facility selection;
-- To aid facilities with their internal quality improvement efforts and external benchmarking with other facilities; and
-- To provide CMS with information for monitoring and public reporting purposes.

As of July 2022, there were 6,758 Medicare-certified ASCs and 4,773 HOPDs. In 2010, 48.3 million surgical and nonsurgical procedures were performed; approximately 25.7 million procedures were performed in HOPDs and 22.5 million were performed in ASCs. OAS CAHPS is designed to measure the experiences of care for patients who visited Medicare-certified HOPDs or ASCs for a surgery or procedure to inform quality improvement and comparative consumer information about outpatient facilities.

Patients 18 years old and older who had both medically and non-medically necessary surgeries and/or procedures are eligible. The survey includes questions about patients’ experiences with their preparation for the surgery or procedure, check-in processes, cleanliness of the facility, communications with the facility staff, discharge from the facility, and preparation for recovering at home. The survey also includes questions about whether patients received information about what to do if they had possible side-effects during their recovery. OAS CAHPS is designed to be national in scope and will require standardized administration protocols.  In 2019, CMS conducted a mode experiment to assess the feasibility of implementing web-based survey administration.  In the CY 2022 Final Rule, which was published on November 16, 2021, CMS confirmed plans to add two new web-based modes of survey administration to the existing mail only, telephone only, and mail with telephone follow-up of non-respondents survey modes already implemented. These two new web modes are: web with mail follow-up, and web with telephone follow-up.

The survey is voluntary since its implementation in 2016 and will continue to be voluntary through CY 2023 for HOPDs and 2024 for ASCs. The survey will be required and linked to reimbursement in CY 2024 for HOPDs and CY 2025 for ASCs. If an HOPD or ASC does not conduct and submit OAS CAHPS as part of the quality reporting requirement, they will receive a reduction of 2.0 percentage points in their annual fee schedule update.

Number of Respondents: 2,534,643
Total Annual Responses: 2,534,643

CMS OAS CAHPS: https://www.cms.gov/data-research/research/consumer-assessment-healthcare-providers-systems/outpatient-and-ambulatory-surgery-cahps  
AHRQ OAS CAHPS: https://www.ahrq.gov/cahps/surveys-guidance/oas/index.html
Draft data collection instruments and technical documentation: https://www.cms.gov/regulations-and-guidance/legislation/paperworkreductionactof1995/pra-listing-items/cms-10500
FRN: https://www.federalregister.gov/d/2023-26449

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