HHS is proposing a change to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to address complaints that healthcare providers were penalized if they appropriately limited pain medications.
The HCAHPS survey targets patient satisfaction, but clinicians have reported that they get poor ratings from patients who sought pain medication. The clinicians were left with the choice of taking a hit on HCAHPS or giving into the patients’ demands.
“Many clinicians report feeling pressure to overprescribe opioids because scores on the HCAHPS survey pain management questions are tied to Medicare payments to hospitals,” according to the HHS announcement. “But those payments currently have a very limited connection to the pain management questions on the HCAHPS survey. In order to mitigate even the perception that there is financial pressure to overprescribe opioids, the CMS is proposing to remove the HCAHPS survey pain management questions from the hospital payment scoring calculation. This means that hospitals would continue to use the questions to survey patients about their inpatient pain management experience, but these questions would not affect the level of payment hospitals receive.”
The proposal was part of several new actions the department is taking to combat the nation’s opioid epidemic. The actions include expanding access to buprenorphine, a medication to treat opioid use disorder, a proposal to eliminate any potential financial incentive for doctors to prescribe opioids based on patient experience survey questions, and a requirement for Indian Health Service prescribers and pharmacists to check state Prescription Drug Monitoring Program (PDMP) databases before prescribing or dispensing opioids for pain.
In addition, the department is launching more than a dozen new scientific studies on opioid misuse and pain treatment and soliciting feedback to improve and expand prescriber education and training programs.