HCAHPS 2025 changes explained: What medical professionals need to know

By: Kylee Hasenauer, CAHPS Compliance Officer at NRC Health

The healthcare landscape constantly evolves, requiring hospitals to stay agile in pursuing better patient outcomes. 

With the changes to the HCAHPS survey in January 2025, healthcare organizations must prepare to adapt their patient experience strategies meaningfully.

Jason Messerli, Director of Customer Success at NRC Health, said, “This is the largest change in HCAHPS since its inception.” 

For healthcare administrators, patient experience managers, and hospital staff, these shifts present both a challenge and an opportunity to refine how we collect, analyze, and act on patient feedback. 

At NRC Health, we’re deeply committed to helping organizations thrive in the face of these changes. 

Let’s walk through what’s changing, the challenges these updates present, and how to improve your HCAHPS scores.  

Interested in learning more? Watch our CAHPS Insider Live webcast to see what’s coming with the January 2025 HCAHPS changes. 

Here’s a closer look at what healthcare organizations can expect from the HCAHPS changes in 2025. 

New survey administration modes 

The Centers for Medicare & Medicaid Services (CMS) has approved three new survey administration methods. These include: 

• Web-mail: Three email invitations and two mail surveys for non-respondents. 
• Web-phone: Three email invitations followed by up to five phone calls for non-respondents. 
• Web-mail-phone: Two email invitations, one mail survey, and five phone outreach attempts for non-respondents. 

Interactive Voice Response (IVR) is no longer an approved survey method.. 

What does this mean for healthcare organizations? 

Organizations must prioritize email collection at the patient intake stage to take full advantage of web-based survey modes. 

Supplemental questions expanded but capped 

Hospitals can now include up to 12 supplemental questions. 

It’s important to note that the open-ended response box counts as one supplemental question. 

What does this mean for healthcare organizations? 

Evaluate which supplemental questions align most closely with organizational goals and remove redundancies. 

Changes to survey questions and dimensions 

The updated HCAHPS will increase from 29 to 32 total questions, with five questions removed and eight new ones added. 

Some longstanding dimensions, such as “Care Transitions,” will end. Beginning in 2026, new dimensions, including “Care Coordination,” will be introduced. 

What does this mean for healthcare organizations? 

Build a repository of baseline data to stay ahead of these changes so your team can set realistic goals and adequately prepare for public reporting changes. 

The data collection period extended 

The HCAHPS data collection window is expanding from 42 days to 49 days, giving patients an extra week to respond. 

What does this mean for healthcare organizations?  

Plan workflows and timelines to ensure data submission deadlines are met without delays. 

Introduction of proxy respondents  

This addition allows for greater inclusivity in feedback by enabling authorized individuals to complete surveys on behalf of patients.  

What does this mean for healthcare organizations?  

Healthcare organizations can gain more accurate data collection. 

Here’s how healthcare organizations can make the most of the new HCAHPS. 

1. Capture emails more consistently from web modalities 

Web-based survey methods heavily depend on email addresses. Hospitals must prioritize email collection at the point of care.

“If your capture rate is 20%, you won’t see much benefit from adding a web mode,” states Jason Messerly, Director of Customer Success at NRC Health. “It’s critical to refine how your organization collects email data before introducing online surveys.” 

Hospitals should develop transparent processes to capture email addresses. Here are some ways to begin capturing email addresses: 

• Verify email addresses during patient registration. 
• Train staff to educate patients on the importance of providing contact information. 
• Implement privacy policies to build trust and ensure patients feel comfortable sharing their information. 

Make email collection a standard practice, whether through front-desk training, automated patient portals, or virtual engagement solutions.  

2. Reevaluate supplemental questions 

With only 12 supplemental questions permitted, choose ones that provide actionable insights or align with hospital-specific goals. 

Hospitals should consider reevaluating supplement questions by: 

• Focusing on underperforming service lines. 
• Prioritizing demographic groups that are traditionally underserved. 
• Leveraging email-based surveys to capture more qualitative, open-ended feedback. 

Don’t hesitate to engage cross-functional teams to identify the questions that matter most. 

3. Prepare for goal setting 

Hospitals will need to adjust internal metrics and performance incentives. Setting goals without benchmarking new data could lead to frustration. 

Jason Messerli shared a best practice recommendation during our CAHPS Insider webcast: “Gather three months of data before setting goals. That way, you ensure they’re both accurate and achievable.” 

4. Proactively communicate change to stakeholders 

Transitioning to a new survey process will likely have ripple effects like: 

• Survey response rates may shift based on new modes and expanded data collection windows. 
• Staff workflows and patient interaction scripts might need adjustments. 
• Future incentive and penalty programs tied to survey metrics will require updated frameworks. 

Engage internal stakeholders early to ensure alignment and identify potential challenges. 

5. Leverage technology for an easy transition 

Technology will be your greatest ally in complying with the new HCAHPS requirements, from email collection to automated survey distribution. 

Is your patient base predominantly older adults? Incorporate more mail-based modes. 

Serving a younger, tech-savvy demographic? Make web-first modes your priority.  

Data shows that web and phone modalities outperform traditional mail surveys in reaching underrepresented groups, ensuring a more diverse response pool.

However, hospitals need to be strategic in choosing survey methods based on their patient demographics. 

CMS-provided research reveals that web modes attract younger respondents, while traditional modes (like mail) tend to engage patients 65 and older. Jason adds, “If you want to balance representation, your mix of modalities matters as much as your outreach timeline.”

The updated HCAHPS survey presents more than just a compliance requirement for healthcare organizations.

It’s a chance to transform how we listen to and act on patient feedback. 

Every email address captured, thoughtful survey response, and patient-centered act of care brings us closer to redefining the patient experience.

At NRC Health, we’re here to guide you through these changes. From webinars to resources like our CAHPS Insider reports, we offer the expertise and tools you need to stay ahead. 

Want to learn more? Check out our latest NRC Health CAHPS resources or schedule a conversation with our Customer Success team today. Together, we’ll ensure your HCAHPS scores reflect the care and compassion your organization delivers every single day.