Business Intelligence (BI) for Patient Engagement 

For something as complex as improving patient engagement and CAHPS scores? A concise, two-word answer is at the top of CareXM’s list: Business intelligence. 

What is CAHPS and Why Does It Matter?

Consumer Assessment of Healthcare Providers and Systems (CAHPS) is an annual Medicare and Medicaid Services (CMS) survey to improve scientific understanding of the patient experience. Patients and caregivers complete the survey. 
 
CAHPS surveys matter because they evaluate patient and family member experiences. CAHPS presents itself as the source for consumer rankings for Home Health CAHPS and CAHPS Hospice, as well as other aspects of the healthcare spectrum. 

Referral organizations seek improved health outcomes and care plans for their patients. They want to ensure quality of care and responsive health plans for their clients. They use survey administration scores to decide where to forward business. As such, The CAHPS Hospice Survey and Home Health CAHPS measures are an critical funnel for referrals and funding. 

Why Do CAHPS Scores Matter More NOW for 2022?  
 In 2020 CMS announced CAHPS’ impact will increase from 20% to 25% of Medicare-Certified Home Health competitive ratings. 

Now that 2021 healthcare research and quality data is in the books, savvy administrators need a game plan for 2022 and beyond, especially in value-based care models.  

What is Business Intelligence’s Role in Increasing CAHPS? 

According to Gartner Research, Business Intelligence gives providers fresh insights to what is really going on within our organizations. 

BI, says Gartner, is a blend of applications, infrastructure, tools, and best practices which empower organizations to optimize patient outcomes. CIOs and admins, says Gartner, must “master” BI analytics “to achieve cost, quality, and consumer and patient experience objectives.” 

CareXM respectfully adds to that list the fact that BI analytics improve CAHPS scores. 

Patient outcomes influence CAHPS, so BI is a direct lifeline to amping CAHPS Hospice Survey or Home Health Survey results. 

CAHPS Keys for HHH: Customer Experiences in After-Hours Triage 

In Home Health Hospice (HHH), understanding then improving the after-hours experience is the secret sauce to improving CAHPS and patient engagement strategies. 

Most administrators do not really know what happens at the patient interaction level of our operations after the end of the traditional work day. 

The actionable data derived from a sound BI strategy with a patient engagement platform will help identify what is truly happening in your after-hours operations. 

Data removes emotion and opinion to allow this clarity of understanding. This is critical for any certified home health agency.  

How Well Do You Know Your After-Hours Organization? 

Ask yourself if you know the answers to these questions: 

• How quickly are you responding to after-hours urgent needs? 
• How many visits are your nurses actually doing in a given shift? 
• How many calls are your nurses actually managing on any after-hours shift? 
• What kinds of calls are they managing? 
• Are after-hours RNs taking calls that should be happening during the daytime? 
• Is the workload of after-hours calls compromising their ability to quickly respond to after-hours crises? 

Understanding Why Patient Engagement Is Important – to Outcomes and CAHPS 

Did answering those questions cause discomfort? 

The answer to this will determine how well you do on CAHPS. 

To help your journey to “BI Meets Healthcare,” CareXM is here to help. 

BI Best Practice: Providence Health 

One of the largest healthcare organizations in the country, Providence, utilizes CareXM’s Business Intelligence to improve their after-hours hospice operations. 

Terri Warren, MSW, Chief, Hospice and Palliative Care of Providence, says Providence did not have the desired depth of understanding. 
 
Providence, she says, was attempting change in an “incremental” manner. The results were not acceptable, nor agile enough for this change-agent executive. 

Working with CareXM gave Providence actionable data. This data objectively, unemotionally answered the quiz questions above for the organization managing 13 different hospice sites. 

Warren credits these insights for increasing patient engagement and, thus, increasing patient and caregiver scores to the hospice CAHPS survey questions 10 percentage points from one year to the next. 

“The big game-changer piece that we don’t really talk about enough is the data collection,” says Mackenzie Daniek, BSN, RN, CHPN, CHPCA, and Director, Providence Hospice of Seattle. 

One insight that made a world of difference was the fact that nearly 20% of the hospice’s after-hours calls were for medication refills.  
 
This type of “healthcare as usual” need is ideally managed by day staff case management. When case managers do their job, it frees up after-hours triage nurses to have the bandwidth for addressing pain management or other crisis calls.  
 
Providence went to work, guiding prescription refills via case management. 
 
The results were profound.  

“Our scores went up 10 percentage points in a year,” adds Providence’s Daniek. 

BI Best Practice: Hospice of Chattanooga 
 
Another organization, the Hospice of Chattanooga, leveraged their BI by hosting daily meetings to review the CareXM insights associated with CAHPS goals.  
 
Actionable data, versus an emotional rollercoaster account from triage nurses, provided them with clear direction for improving case management. 
 
The team categorized the types of calls being received, then analyzed how to relieve after-hours staff of non-urgent matters that could/should be best addressed by day staff. 
 
The data helped the hospice improve quality and productivity through greater accountability.  
 
The after-hours, on-call team was freed up to operate from a stronger, more present emotional state, yielding better patient care, happier, more productive and accountable teams, and better CAHPS hospice results. 

Conclusion: Make 2022 Your Year for BI Engagement/Enhancement  

Starting in 2021, Hospice CAHPS survey questions have had more of an impact than ever on your Medicaid and Medicare referral business. 

Make a New Year’s Resolution now to understand what is truly happening in your after-hours business with Business Intelligence.

Insights from actionable data will help transform your patient experiences. 

Insights from actionable data will help make your staff more accountable. 

Insights from actionable data will help free your after-hours clinicians, enabling them to truly direct their expertise for patient outcomes and their own job satisfaction. 

And, yes, actionable data, an outcome of Business Intelligence, will improve your CAHPS survey success.