Communication Influences Families’ Hospice Choice, CAHPS Ratings

About 80% of family caregiver survey respondents indicated that they would select a hospice based on the providers’ ability to communicate in a timely fashion. Timely communication can also impact the ratings that family’s give hospices in the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, according to new research conducted by Citus Health. 

The CAHPS survey is one of the most important sources of data on hospice quality. The U.S. Centers for Medicare & Medicaid Services (CMS) requires hospices to give the survey to families following a patient’s death to gauge their satisfaction with the services they’ve received.

Telephonic and other communication technology has become particularly important during the COVID-19 pandemic when much of the nation’s workforce, including many hospice employees, are working remotely or providing virtual visits, as well as to facilitate internal communication among staff.


“Many teams are working remotely for the first time, so they’re not right next to each other inside the same building. This is creating friction in the communication process. Being able to update each member of the care team in real time about any patient care developments has definitely been highlighted during the pandemic,” Melissa Kozak, CEO of Citus Health, told Hospice News. “On the patient and family caregiver front, with family members not being able to visit their loved ones because of quarantine restrictions, they have often felt in the dark about what’s been going on with their ill loved one. I think as consumers there’s more of a demand for real-time communication since many family members are using tools and devices to interact in other areas of their lives.”

Patients and families in increasing numbers are using CAHPS information when choosing a hospice. Likewise, referral organizations such as hospitals, primary care physicians, and nursing homes are using the data to guide referral and contracting decisions.

Respondents to the Citus survey indicated that the ability to communicate with hospice clinicians in real-time would be a significant consideration both when choosing a hospice or when evaluating a provider for the CAHPS survey. More than 300 family caregivers responded to the survey, which Citus conducted in collaboration with Porter Research. They must have had a family member or loved one in hospice care within the previous 12 months to participate.


Among the survey respondents, 43% said they were “very satisfied” with their hospice providers on four of the metrics included in the CAHPS system. Nearly 60% of the respondents indicated that hospices “need improvement” in those four areas, including general communication related to medications, equipment and visits; timely access to help; caregiver training and education; and emotional and spiritual support during and after the hospice stay.

About 78% of family caregivers surveyed would choose a hospice that enables instant communication through computer, tablet or mobile phone. Some of this trend may be generational as more members of the millennial generation begin caring for aging parents.

“The caregivers tend to be the adult daughters and sons of the patients, and technology is already central to their lives in so many ways. The generations that are the family members really caring for these patients find that they don’t want to put up with not having these communication mechanisms,” Kozak said “It almost seems crazy to them that still in 2020 they’re having to wait on hold, a call gets dropped, or they get transferred, or that it takes four calls to get one answer. As people who have grown up primarily with technology, they’re demanding a real-time response.”

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