Overlap of Reports of Care Coordination and Provider Communication on the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Clinician and Group Survey 3.1 in the United States General Population

The Consumer Assessment of Healthcare Providers and Systems (CAHPS®) surveys are widely used to assess patient experience with healthcare in the United States. These surveys focus on how often specific aspects of care occur, such as how often providers explain things in an easy-to-understand way. Not enough is known about the overlap among the CAHPS Clinician and Group Survey 3.1 multi-item composites (communication, care coordination, access, and office staff). Adults who visited a healthcare provider in the United States within the past 12 months completed an online patient experience survey in either English or Spanish (n=5,129): 58% female, 44% 55 years or older, 27% had a high school education or less, and 33% had a household income of less than $50,000. A four-factor categorical model yielded estimated correlations ranging from 0.65 (office staff with access) to 0.97 (communication with care coordination). The overlap of the communication and care coordination items suggests that they could be scored together as a single composite. Alternatively, users might include additional care coordination items that are distinct from the communication composite, or supplement the survey with direct observation, chart review, and process measures. A bifactor model supported the use of a summary score estimated from the 4 CAHPS composites. The summary patient experience score was most accurate at assessing negative perceptions of care. It could be useful for oversight by stakeholders such as the United States Centers for Medicare and Medicaid Services, for linking payments to performance, and calculating overall value metrics.