CAHPS Insider: July 2025

Proposed Rule

CMS has released the Calendar Year (CY) 2026 Home Health Prospective Payment System (HH PPS) Proposed Rule, which includes significant updates to HHCAHPS Survey.

Beginning with the April 2026 sample month, CMS is proposing to implement changes to the HHCAHPS Survey as part of broader efforts to enhance the Home Health Quality Reporting Program (HH QRP). These updates are designed to improve data accuracy, reflect evolving patient care standards, and align with statutory requirements.

Proposed changes include:

• A revised HHCAHPS Survey, being reduced by 8 survey items and including the addition of three new questions. For a crosswalk of the proposed changes to survey measures, please click here. Any additional changes will be communicated in future editions of the Insider.
• The calculation of the Summary Star Rating would be updated
• There would no longer be case adjustments for diagnoses of schizophrenia or dementia
• The addition of a mode adjustment with mail only being the reference mode

New measures would be publicly reported beginning in October 2027. A CMS Fact Sheet summary of the Proposed Rule is available here. Stakeholders are encouraged to review the proposed changes and submit public comments by August 29, 2025 on the Federal Register here.

Preview Reports

Preview Reports with results from the HHCAHPS Survey from Q1 2024 – Q4 2024 (January 2024 – December 2024), including Star Ratings, are available under the For HHAs tab on the HHCAHPS website. You must be logged on to view your report. These data will be displayed on Care Compare in July 2025.

For additional information, please visit the Understanding the HHCAHPS Survey Preview Reports document on the HHCAHPS website.

Coordination Team Quarterly Review

The July 2025 HHCAHPS Coordination Team Quarterly Review (CTQR) newsletter has been published under the General Information tab on the HHCAHPS website. This quarter’s edition contains information about the HHCAHPS Coordination Team’s oversight activities.

Please reach out to the HHCAHPS Survey Coordination Team at hhcahps@rti.org or 866-354-0985 if you have any questions.

Final April 2025 IPRs Now Available in iQIES

The Final April 2025 Interim Performance Reports (IPRs) for the expanded Home Health Value-Based Purchasing (HHVBP) Model are now available in the Internet Quality Improvement and Evaluation System (iQIES).

These quarterly reports provide home health agencies (HHAs) with their cohort assignment, 12 months of performance year measure data, and an interim Total Performance Score (TPS).

Agencies will receive an April 2025 IPR if they were Medicare-certified before January 1, 2023, and meet the minimum data threshold for at least one quality measure during the reporting period.

Minimum thresholds:

OAS CAHPS Participation for ASCs

The requirement for Ambulatory Surgical Centers (ASCs) to participate in the OAS CAHPS Survey began January 2025. If your organization has not started fielding the survey or began late, please review the advice below.

• Confirm eligibility. First, confirm your ASC is required to participate in the survey by reviewing the guidelines here.
• If, according to the guidelines above, you are not required to participate but need to submit a Participation Exemption Request (PER), please complete the PER form here.
• If you are eligible for the survey and have already contracted with a CMS-approved survey vendor to administer OAS CAHPS but did not start in January 2025, your vendor will submit the appropriate notification to CMS.
• If you are eligible for the survey and have not yet contracted with a survey vendor, work to find a survey vendor and begin fielding the survey as soon as possible.
• CMS will evaluate the impact of the missing data at the end of the four-quarter period and will reach out if they require any additional information.

OQR and ASCQR Reports Now Available On HQR

The Outpatient Quality Reporting (OQR) program and Ambulatory Surgical Center Quality Reporting (ASCQR) program are now accessible through the updated Performance Report dashboard in the Hospital Quality Reporting (HQR) system.

This enhanced dashboard allows users to confirm data submission, validate detailed metrics, and compare performance against state and national benchmarks. All data previously found in Facility, State, and National (FSN) reports is now available in one centralized location.

Reports remain exportable in both CSV and PDF formats for your convenience. This short video demonstrates how to access your reports.

Proposed Rule

CMS has released the Calendar Year (CY) 2026 End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) Proposed Rule, introducing several updates, including proposing changes to the ICH CAHPS Survey.
Changes proposed to take effect with the Spring 2026 fielding include:

• Removing 23 questions, bringing the survey from 62 to 39 questions
• Adjustments to case-mix analysis

For a detailed look at survey revisions, please click here.

Although CMS is currently working on developing and testing a web with mail follow-up mode, no survey administration changes are proposed with the new survey in Spring 2026.

A CMS overview Fact Sheet is available here. Stakeholders are encouraged to review the full proposed rule and submit comments by August 29, 2025, on the Federal Register here.

Vendor Authorization Deadline

All ACO REACH participants must authorize a CAHPS survey vendor by July 28, 2025 to remain compliant for Performance Year 2025. Vendor authorization can be completed on the ACO REACH CAHPS website.

As a reminder, each year REACH ACOs are required to contract with a CMS-approved survey vendor, sign a BAA, and authorize your vendor by the deadline.

Vendor authorization instructions are available here.

PY 2026 ACO REACH Model Changes

CMS has announced several key updates to the ACO REACH Model for Performance Year (PY) 2026. The updates focus on strengthening financial accountability, enhancing incentives for quality performance, and advancing equity in care delivery. Highlights include increasing the Quality Withhold to boost rewards for high-performing ACOs, adjusting risk corridors and benchmarks to promote earlier and more equitable savings distribution, refining risk adjustment methodologies for accuracy, and implementing targeted changes for High Needs ACOs to better support vulnerable populations. For a full description of changes, please click here.