The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a national, standardized survey designed to support quality improvement. In this report, the Flex Monitoring Team (FMT) summarizes reporting rates and performance among all U.S. Critical Access Hospitals (CAHs) for the calendar year 2018, including state-specific HCAHPS reports. Using publicly reported data from HCAHPS on Hospital Compare, as well as suppressed data from the Medicare Beneficiary Quality Improvement Project (MBQIP), the percentages of patients reporting the highest response on each measure were summed and averaged across all reporting CAHs within a state and all other states with appropriate weights applied to all calculations.

The highest national performances rates for individual measures were related to staff providing recovery information, doctor and nurse communication, while three measures were notably lower: explanations for medications, understanding of post-discharge instructions, and patient rating of the hospital environment.

The FMT also found that HCAHPS participation among CAHs has continued to increase nationally, from 49.0% in 2012 to 85.7% in 2018. However, the number of completed surveys per reporting CAH has also changed over time as an increasing number of CAHs report less than 100 surveys completed and a decreasing number report more than 300 surveys. This may be due to an increased focus on encouraging CAHs to report HCAHPS data, resulting in data from CAHs that may be less familiar with strategies to increase their number of completed surveys.

The Flex Monitoring Team also produces state-specific reports with more detailed results.