HHCAHPS
HHCAHPS (Home Health Care Consumer Assessment of Healthcare Providers and Systems) is the standardized CMS survey that measures patients' experience of care from Medicare-certified home health agencies. Administered by approved third-party vendors, its results are publicly reported on Care Compare and feed both the Patient Survey Star Rating and the Home Health Value-Based Purchasing model.
How the survey works
Each month, the agency's contracted survey vendor samples eligible patients who received skilled home health visits and administers the survey by the approved modes. Eligibility rules exclude certain patients, such as those receiving hospice care, and agencies with too few eligible patients in the prior year can request an exemption from participation. The agency's job is upstream: contract with an approved vendor, submit accurate monthly patient files, and keep contact information clean at intake. Agencies may not administer the survey themselves or attempt to influence responses. CMS has streamlined the survey instrument and administration options in recent rulemaking, so agencies should confirm current requirements with their vendor.
What HHCAHPS measures
The survey captures the patient's view of dimensions that clinical measures miss: whether the care team communicated clearly, whether care was delivered professionally, whether medications, pain, and home safety were discussed, an overall 0 to 10 rating of the agency, and whether the patient would recommend it to family and friends. Results are adjusted for patient characteristics and survey mode before public reporting, so differences between agencies are intended to reflect experience rather than demographics.
HHCAHPS in HHVBP: two measures carry everything
In the expanded HHVBP model's CY2026 measure set, HHCAHPS accounts for 20% of the Total Performance Score through only two remaining measures: Overall Rating of Care and Willingness to Recommend, weighted 10% each. Earlier versions of the model spread survey weight across more measures. The consolidation cuts both ways. Agencies no longer manage five separate survey scores for payment purposes, but every returned survey now concentrates its impact on two global judgments, which are shaped by the whole experience: scheduling reliability, communication, and how problems get resolved.
Common pitfalls
- Dirty contact data at intake, which silently shrinks the survey sample and can cost the agency its star rating
- Treating the vendor relationship as set-and-forget instead of auditing monthly file submissions
- Reviewing scores annually instead of monthly, long after the underlying service failures
- Ignoring verbatim comments, which usually name the exact scheduling or communication breakdowns to fix
- Attempting to cherry-pick or coach patients, which violates survey protocols and puts the agency at compliance risk
Frequently asked questions
Is HHCAHPS participation mandatory?
Yes, for Medicare-certified home health agencies above the minimum patient-count threshold. Participation is tied to the quality reporting program, so failing to conduct the survey properly can trigger a payment update penalty. Very small agencies can file for an annual exemption.
How many HHCAHPS measures count in HHVBP for 2026?
Two. The CY2026 measure set keeps only Overall Rating of Care and Willingness to Recommend, each worth 10% of the Total Performance Score, for a combined 20%.
Can we see which patients gave low scores?
No. Responses are confidential, and vendors report results in aggregate. Agencies can, however, analyze results by time period and review anonymized comments, which is usually enough to localize the operational cause.