Preparing for the Required OAS CAHPS Survey

Thank you for joining us for our 2024 webinar series.

We have our first of three webinars, and this one is with regards to preparing for the required OAS-CAHPS survey.

It is a requirement, so it is something that we want to make sure that everybody understands what is required of us and how we achieve that requirement.

On the discussion today, I have two of my colleagues: Carrie Jacobs and Ryan Schumacher.

I am the director of US Membership Services.

I am also the CEO of San Antonio Eye Center.

Carrie Jacobs is the EVP of Operations for CHW Vision Institute and also a board member for us.

Ryan Schumacher is the CEO of Satisfied Patient and comes to us as a new educational partner.

Ryan has provided many resources to his clients in terms of helping us with accreditation requirements such as getting patient surveys done, tracking them, reporting them, and making sure the data is available.

By means of his clients, he was asked to also look into OAS-CAHPS.

Ryan has a lot of experience with vetting the vendors and understanding the rules and requirements of CAHPS.

He developed a program that works with the OAS-CAHPS so he can provide surveys not only for accreditation but also those that meet the OAS-CAHPS requirements.

On today's agenda, we're going to cover a few items.

First, we will go over what OAS-CAHPS is, what it means, what the requirements are, and what we have to do as ASCs to report.

Then, we will go through the survey process, how the survey is conducted, what the survey means, and what questions are being asked.

Along with that, we will discuss how to select a vendor.

There are 16 vendors available to all of us as ASCs, and we'll go through the selection process and some of the questions you should ask.

After that, we'll follow up with some questions and answers along the way.

To the attendees, if you have any questions that come up, we ask that you submit them via the Q&A process.

You can submit those questions, and at the end, when we get to our question and answer session, we'll be happy to address those questions that are asked of us.

With that, I'm going to turn it over to Carrie Jacobs to begin the process.

Thanks, Albert.

Hello, everyone.

Thank you for joining us today.

We are hoping to go over the OAS-CAHPS survey with you, the nuts and bolts of what we need to be doing, and hopefully answer any questions along the way.

If there's anything that we can't answer, we will definitely circle back.

This webinar is being recorded, and the recording will be available after as well.

So, what is OAS-CAHPS?

If you've been in the ASC world for any number of years, you've heard about this.

As you know, it's been kicked down the road many times.

We are finally at the point where it is no longer being kicked down the road, and we are in the short window of needing to start reporting in 2025.

The OAS-CAHPS survey collects patient information and feedback in Medicare-certified ASCs through a 32-question survey.

These surveys look at asking patients about their experience with your facility, your staff, communication about their procedure, how they were prepared for discharge and recovery, the overall rating of your facility, and recommendations for your facility.

There are many different categories being looked at, but in a nutshell, there are five basic categories with this survey.

Yeah, great.

Carrie, back to that previous slide here real quick.

I just want to jump in on a couple of things to add some additional value.

As Carrie mentioned, 32 questions—that is a lot of questions for anyone to answer.

One thing to keep in mind: these questions cannot be changed or modified.

As much as everyone on this call would like to change those, shorten those, or reduce those, you cannot.

You need to stick to the 32 questions in that OAS-CAHPS survey from CMS.

Another thing to keep in mind with this is that it's anonymous.

Your patients are going to complete these surveys, and we'll talk about how they do that a little later.

But it is an anonymous survey unless you add an additional question.

Think about adding and going from 32 to 33 questions.

The 33rd question is consent to share.

The 33rd question is: "Carrie, you've completed these 32 questions.

Would you be willing to share your name and contact information with the ASC so they can contact you and follow up with any questions you have regarding the results of your survey?"

We recommend adding that 33rd question.

It gives you the consent to contact the patient, you know who it is, and makes the survey a little more meaningful.

But it is an anonymous survey.

The other thing to point out is questions.

I encourage everyone to look at the questions.

There's a link in several links Carrie mentioned earlier.

This will be sent out to everyone.

There are a lot of links to help you guys.

Our goal here today is to educate everyone and really give you the tools you need to make the best decision for your business.

In this PowerPoint, there's a link to about five different things.

One of those links is a link to the 32 survey questions.

I encourage you to read through those.

There are some head-scratchers in there as well.

For example, questions 27 through 32 are demographic questions.

Think about that.

Everyone on this call knows you can go into your practice management system today.

You can run a report, and you can generate your demographics.

You know exactly what your demographics are for your clinic or your ASC.

So, there are some questions in there.

Again, we don't make the rules; CMS makes the rules.

We want to make sure you guys just understand what the protocols are, what the questions and procedures are, and how best to follow those.

So, that’s it.

If you want to, yeah, thank you.

Thank you so much, Ryan.

Now, my understanding is that the majority of these questions are going to be related to the patient experience at the facility.

A lot about communication, how well the patients were communicated with, did they understand what’s happening, did they gain consent, and how the patient perceived their experience.

Then you have the less majority, which is on the demographics.

But to your point, Ryan, you still have all of those questions that are in addition.

So, 32 questions, that’s a lot.

And then, if you add supplemental, you recommended adding that one supplemental, but can you add additional supplemental questions?

You can.

You can add comments at the end of each section.

For example, you know, let’s say you have the questions about the anesthesia list.

If you want to add a couple of comments to those sections, you can.

Again, you’re just increasing the number of questions, but you can get some comments back for each one of those sections if you want to.

You can add supplemental questions.

We do recommend adding the 33rd question and then each one of those subsections.

Again, there’s a link in the appendix of this presentation or a key link slide that takes you to those exact 33 questions, and you can see all those.

So, in your experience, I just have a quick question.

32 questions seems like it could take 30 to 45 minutes to answer these if I’m having to do them on paper or on the phone.

How long does it typically take to complete a survey?

Yeah, it depends on how it’s administered.

I think, you know, one of the questions— I think it depends is a short answer.

There are three ways these are administered.

We’ll talk more about it a little later, but there are phone, email, and snail mail.

It depends on how much time you have to conduct each one of those, and I’ll talk a little bit more about those later.

Yeah, and we’ll dive into a lot of the nitty-gritty on this.

But I think, really, to point out here early on, where it says Medicare-certified ASCs, that doesn’t mean it’s Medicare-only patients that are being surveyed.

Correct?

Yeah, they’re going to take a sample of your Medicare patients and all your patients in doing it.

And I do believe that the patients have to be at least 18 years old.

That’s correct.

So, starting January 1, 2025, so less than six months away, the OAS-CAHPS survey will be required for our ASCs if you’re Medicare-certified.

So, basically, if you haven’t started vetting your vendors yet, now is the time to be doing it.

Because there is a setup period, which we’ll talk more about here in a few minutes.

So, to start the reporting period, you want to make sure everything is set up soon.

ASCs that do not participate—so if you are a Medicare-certified Ambulatory Surgery Center and you do not participate in this—there will be a 2% penalty or cut to your Medicare reimbursements.

And I believe that is in 2027. Is that correct, Ryan?

I don’t know when the actual cut occurs.

I think I don’t know the answer to the exact timing of that.

Brian, how many surveys do we have to have completed in order to meet this 2% requirement?

Yeah, the target from CMS for completed surveys, Albert, is 200 completed surveys.

Can we get them all done in the first month if we do it at the patient’s expense?

Exactly right.

So, I think that’s what everyone would love to do.

Great point.

We’d all love to just get them done, you know, January 1.

Unfortunately, you can’t.

You have to spread those out throughout the calendar year.

If you’re starting in January 1, again, they’re looking at that time frame from January 1 through December 31 of the calendar year.

When you take those 200 surveys and divide it by 12, you’re really only looking at 17 completed surveys per month.

So, I think that’s something to keep in mind.

This can seem a little scary for everyone, but depending on your patient volume and the number of surgeries you’re performing, getting responses from 17 patients per month—even though it is 32 or 33 questions depending on which way you go—shouldn’t be that hard.

So, the reporting requirement is not that I send the survey or 17 people to contact.

I have to give them all of my data for that month?

Yeah, specifically the data, Albert.

You know, and each CMS vendor talks a little bit more in depth about this, but there is basically a data set that the CMS vendors require.

In that data set is your CCN or provider ID, as it’s commonly referred to.

Each ASC has a unique one of those.

The medical record number of the patient, the date, the time of the appointment, and the CPT code are very important.

One of the things we’ve been seeing over the last year is the CPT code is not being entered into a lot of surgery cases.

I can’t explain why some of the Practice Management Systems, too, also don't have a dedicated field to enter the CPT code.

Encourage everyone on this call to go back to your practice management system.

If that CPT code field is not there, again, we’re dealing with the back end of those practice management systems.

The front end is super important as well, but the CPT code is in there again.

Medical record number, their normal name, address, and email.

And your chosen vendor should be able to provide you with exactly the requirements that you need in a report to submit to them on a monthly basis.

Those data fields you can work with your PM system and make sure that you're getting the right reports pulled.

So, again, another reason to choose your preferred vendor as soon as possible.

That way, you can start working together to ensure that the data is getting pulled correctly and that you have clean submissions going to your vendor, which can be submitted to CMS.

Yeah, great point, Gary.

Have you guys, you know, so we talk about the timing here.

October 1st, I think you know, one of the things, obviously, you have to start at the beginning of a quarter.

To Car’s point, you could start October 1st.

Some people may have just started July 1.

Have you and Albert decided kind of where you guys are going to start?

Yeah, so, all right.

See, we started.

We’re looking to start October 1st, but we’ve asked that the data not be submitted until that last quarter of the year.

It was just basically to make sure that we’re doing what we need to do, the system’s working, and we’re getting the data the correct way.

We did look at the report from our vendor, and I’m sure all the reports are going to be similar.

The report’s pretty extensive.

It pulls a lot of fields.

There are like 50 fields that it pulls information from.

So, we had to have a custom report built.

So, we are starting October 1.

We will not actually report until January 1.

It was just to make sure it works, and we are exactly the same as Albert.

So, we are in the process of finalizing three vendors.

We’re meeting as a committee to approve the vendor we’re going with.

Our goal is October 1, so the contracts I have in hand are all October 1.

That way, we can, like Albert, make sure that we are getting the data pulled from our PM system and that everything is aligned well.

Then we’ll start reporting January 1.

Yeah, super smart, guys.

You’re doing a great job and doing it the right way.

The thing that Albert mentioned is really the pro tip or one of the key takeaways in this.

Keep in mind, you can start in October and not submit the data to CMS.

That gives you three months, a quarter, to work out the kinks.

If you’re not collecting email addresses, for example, as diligently as you’d like to be, because you’ve selected a vendor who’s going to survey based on email, that gives you kind of three months to establish those internal workflows and processes to help collect email, etc., as well.

And keep in mind, there is a list of 16 CMS-approved survey vendors.

We’ll have a link to these vendors that will be available to you in the recorded session in the handouts.

Be aware that you have to make sure they are CMS-approved.

If you choose a vendor based on price or something else that seems attractive but they’re not part of the approved vendor list, it won’t be validated.

So, do keep that in mind.

And 16 is actually a lot.

If you’re vetting and you’re just starting a process and want to vet multiple, this can be time-consuming.

I would say, from my standpoint, if a vendor was not responding to me, they were marked off the list right away.

So, take that list, and know who will share that with you, of course, here coming up.

Talk to your colleagues, too, to see who maybe they’ve used or are choosing to use and why, and get some feedback on that.

All right, so we talked about who has to follow these guidelines.

Medicare-certified ASCs.

I think a key point here is your patient demographics and your case volume.

If you have fewer than 59 eligible patients annually—remember, they have to be over 18.

There are some criteria as to whether a patient qualifies or not.

They have to have a U.S. mailing address, they need to be over 18, and they can’t reside in a nursing home.

These are just some examples.

There is a list of eligibility or disqualification requirements, so you want to know what those are.

In ophthalmic ASCs in particular, they have two eyes, right?

So, they’re not considered two patients.

Each patient is an individual.

Your vendor will also be able to sort out if it is a duplicate.

If you have a patient with two or more procedures because they have two eyes, they’re only going to be counted as one.

So, there are some criteria here that will exempt your facility if you don’t have the encounters.

And one other thing, Carrie, just to add to what you provided here is that in that document, or in this presentation that Carrie mentioned, again, there’s a key link slide.

In that link, if your volume is 59 or fewer and you need to fill out the exception, there is a direct link to the participation exception request form in this document for you.

All right, thank you, Ryan.

Awesome.

Well, one of the things, you know, as we transition to how the survey is conducted, and just a little bit of background, you know, Albert touched upon this at the beginning.

You know, we help ophthalmic practices and ASCs measure and improve the patient experience in their clinics and their ASCs.

Almost two years ago, our customers reached out to us and said, "Hey, help us navigate these upcoming OAS caps requirements." So, that’s what we’ve been doing.

As you start to dig into it and you’re learning today, maybe some of you for the first time, the survey is delivered by three options.

There are vendors from those 16 approved vendors who, for example, only do mail.

And by mail, I mean legitimate snail mail—lick a stamp, send it, may or may not get there.

They do mail.

That is an approved form of conducting the survey.

The other form is phone.

And again, phone is a bit of a challenge, right?

So, you now have a vendor who’s calling you.

How many calls are you answering from unknown numbers?

I think that’s a question you have to ask yourself.

And again, these are not our rules; we’re just sharing what those rules are.

So, the survey, again, is delivered by mail and also by phone.

They’re literally, Albert, back to your question earlier, reading you these questions over the telephone, and then you’re providing an answer back to them.

That can take quite a bit of time, as can mail.

It’s common sense here.

The most effective way, the most streamlined way, you know, all the data points to it.

It doesn’t matter what survey you’re looking at—email is the gold standard of the three options in terms of response.

I’m not saying that anyone has to do that.

If you want to use mail, you absolutely can use mail.

But email is a great piece of this.

Most practices, most ASCs, as part of the patient intake process, scheduling process, you’re collecting that email address when they will provide it to you.

One thing I encourage you guys to do today—you don’t have to make a decision on a vendor—but you can put a placard up at your intake.

Make sure you’re collecting those email addresses.

It’s now, again, we have kind of a joke—everybody already has your social security number, but not everybody has your email address.

So, put a little placard up on your front desk, asking them just to say, "Hey, we’re updating our records.

We’d like to have your email address."

Email is king in this world right now for this.

Obviously, I’m going to say that it’s not on here, and fingers crossed CMS will make changes in the future, but text messaging is not an option.

It is not an acceptable method to deliver the survey.

And Ryan, I would add one little caveat.

I think that most clinics are collecting email addresses.

It’s a common way that we are doing reminders and communicating information.

So, I think if the ASC, with the demographics that they require from the clinics, also makes sure that’s a required field, hopefully that will also help to alleviate the need to ask patients for additional information.

Yeah, absolutely.

I have a question for you.

As you and I discussed, as it stands in our current practice, you know, we know that our patients don’t check their mail.

We barely can get them to respond to statements, and we know they don’t even answer our own calls to confirm appointments.

What happens if we follow all the requirements but don’t get our 200 surveys, but yet we surveyed 10,000 people?

That’s a great question.

Yeah, it’d be a great question to ask the vendor, to your CMS-approved vendor that you select.

So, CMS’s guidelines are that you need to follow all of the protocols.

You need to follow all the protocols and procedures that they put in place to survey your patients.

So, definitely recommend doing that.

Our big thing is to think about it from a data perspective.

We’re in the insights business, and if you think about 17 completed surveys per month, I think the big focus in my mind is continuing to focus on how you’re delivering the data.

So, making sure that if you are, Carrie, to your point, manually pulling a list of data every month, what happens when that person is gone?

Is there a backup plan?

Do we have a method and procedure to make sure that if Carrie’s out of the office this month and I’ve got to have my data submitted by the 8th or the 15th for the previous month, who’s going to pick that responsibility up?

So, focusing on data delivery.

We’ve never had any of our customers not meet the 200 completed survey requirements so you know, I can't really answer the question on what happens if they don't.

But, I would say focus on the data delivery.

You know, let the CMS-approved vendors, you know, handle that.

And, you know, I think you have great results.

I think the other key point to focus on, as well as the data delivery, is your team and getting the entire team on board.

Knowing the questions, knowing the knowing the questions that really matter and help to emphasize to the patient how important this survey will be.

Having a visual, something that they're taking home, something that they understand will be happening and the timeline in which it will be happening.

You know, is your vendor going to be reaching out a month later, two weeks later, a day later?

What are the expectations?

Because I think when you ask a patient, we found this in our facility.

If you ask, "We need your help, you're going to be receiving this survey," they're more than happy to help.

It's setting them up for success.

Knowing that it's coming, what the delivery method is going to be, who it's coming from, and if they have some kind of a take-home takeaway that they know or really want, they're pleasers.

They want to give that, want to help, and they want to do a good job for you.

All you have to do is ask and let them know what's going to be happening.

And that will, I think, is also really the second key point to data delivery.

Is utilize your team and really communicate to your patients.

Carrie, I couldn't have said it better.

It's a one-two punch: the data and setting that expectation so they know what's coming.

Right?

And absolutely, you definitely want to give them a one-sheet.

You know, postop, "Hey, you're going to get a call, or you're going to get an email, or you're going to get it in the mail." Absolutely give them that one sheet.

You're already probably giving them something anyway to take home, uh, to let them know.

That's a fantastic point.

To follow that, can you ask the patient how they would like to receive the survey, or does it have to follow a certain protocol?

Yeah, it has to follow.

It's based on the vendor and how you select the vendor.

Right?

So, for example, if you select a vendor who only does mail, um, you know, the patient's only going to get it via mail.

If you select a vendor who does what they call mixed mode, mixed mode would be, for example, email first.

And if they don't take the email survey, then a phone follow-up and then a combination of, you know, reminder emails.

That's typically called mixed mode.

Um, you could set the expectation with them that, "Hey, you know, you're going to get it via email and phone." But the patient doesn't have any option to choose how they want to get it.

It's all vendor.

One other question from one of our audience members.

And they're asking about continuing our regular internal surveys that we have to do for accreditation.

So, my original thought process on handling this would be, yes, you still have to continue to do your internal surveys for accreditation purposes.

And you want to make sure that you're doing those.

If you choose a vendor that has a reporting function and they're going out to get the responses for you in terms of, you know, your patient experience, then I would say you have the ability to use some of those reports from your vendor to say, "I can use that as my survey mechanism for accreditation."

So, I think it just depends on the vendor you pick to answer the question.

Um, continue what you're doing until you know what you get from your vendor.

And once you know what you get from your vendor, you can see if it meets those requirements and get rid of one or the other so that you're doing, you know, what is needed to meet both requirements.

I completely agree.

And I think that that is another vetting question to ask when you are talking to these vendors: Can I extract data to meet my own accreditation requirements for surveys?

Great.

You know how to select a vendor, Right?

So, we’ve all been through this process.

We went through the process for all of our customers.

You know, Carrie and Albert, they’ve been through the process.

Carrie mentioned the first one previously, Right?

And we followed a similar process to this here.

And these are some good questions for you, uh, for everyone to ask on the call.

Uh, but first is responsiveness.

Right?

And that goes for, you know, frankly, any service-based business.

Uh, how responsive to your request are they?

You know, does it take them two weeks to set up a demo?

Um, does it take them a day?

You know, how responsive are they in getting back to you?

With that request is kind of the first one.

The second piece here is how the vendor delivers the survey.

So again, this is important.

Just to recap, you have three ways, uh, to deliver the survey.

First one is mail.

Second one is phone.

Third one is email.

And then you can have vendors who do mixed mode.

And so, those vendors are doing a combination.

Typically, the email with the phone follow-up.

So, how is the vendor delivering the survey and what's best for your needs?

Third one is, do you want an automated process or a manual process?

So, are you comfortable with extracting the data from your system, uh, providing that on a monthly basis for 12 months?

Um, or would you like that automated?

Would you like it to be pulled automatically and provided directly to the vendor?

So, those are, that's another question for you, in addition to what you know we’ve already covered today as well.

Cost of service and value.

So again, evaluating, you know, their analytics package.

What insights are you getting?

The actual cost itself.

You know, how many surveys, I think, is super important, right?

Are they averaging them out and ensuring that, you know, hey, we're only doing 17 per month, or we surveying all, you know, all 4,000 surgeries?

And again, you have to make that decision based on what's best for your business and what your business objectives are.

Are there additional objectives other than the OAS caps?

And then lastly, how is the survey data, you know, provided back to you?

Right?

So if you think about it from a, you know, let's just use mail for an example.

If you're selecting a vendor who does mail that goes out, you know, want to Car's Point earlier, you may not get that feedback back from that patient for 90 days.

And so, you know, is that okay?

Am I okay with that?

You have to make those decisions.

But how the survey data is provided back to you is an important process.

Carrie or Albert, anything in the vendor selection process you guys want to add?

I would also add, ask them what their response rate is currently.

They should have a percentage of what their average response rate is.

I think that's important to know too.

What I've seen to be a pretty good average, and Albert and Ryan, you can speak to this too, has been about 35%.

Is a good response rate.

Most definitely.

We were seeing 25 to 30%.

What actually led us to select our particular vendor was the reporting functions that came back.

So, it allowed comparisons not only of our own data but comparisons against other facilities.

So, we were able to see not only how we did in terms of our own ASC, but we could look at different data from different marketplaces to be able to say, as Ophthalmology as a whole, how are we doing with our results and comparison?

So, we could actually do something with the data.

We all have to pay for this.

We don't have a choice.

So, you know, let's make use of the information we're getting and figure out how to make improvements in our surgery.

Sy, yep.

Right?

Here is the list of the 16 approved vendors.

There's also a link on the key link slide, which we've talked about a lot, and it's in the U.

It's one of the final slides of this that we'll get to in a minute.

Satisfied Patient.

We work with Arbor Associates on an automated patient satisfaction survey system that integrates with the CAP surveys.

They're highlighted there in yellow.

And again, that's a partnership with us.

And then us, through IPR, GoPo has negotiated, again, a favorable rate with J Morgan for the CAP survey for its members.

And you can join the IRO GoPo to take advantage of that discount.

So, couple options in there.

You know, again, I recommend you do some demos with a few vendors, so you can kind of compare everything for yourself.

Awesome.

Next is, what do you need to do?

So, I love webinars.

You know, we learned so much.

We're like, "Wow, this is awesome. I love it." And then it's like I leave or I leave a meeting and it's like, "Well, what's the next steps? What are the actions?" And so, that's why this slide is in here.

You know, what do you need to do?

And really, the first thing is, you know, select a vendor based on your requirements.

And you know, the requirements set forth within CMS cannot be changed.

Right?

So, how the survey is delivered, the number of questions.

And so when you think about your requirements, you know, it goes back to, you know, what Carrie and Albert and I've been talking about throughout the webinar today.

But it's, you know, do you want a manual list providing?

Do you want an automated piece?

You know, the Car's point, do you have your staff trained?

Right?

That's a very important component of it.

How much training do you want to do?

How quickly do you need the feedback back to you?

You know, is it important to get something real-time versus, you know, waiting?

So, think about those.

The next piece, obviously after, you know, going through kind of some paperwork and, you know, signing up with a vendor is submitting your vendor as your CMS authorized vendor.

There's a dedicated website for that.

It's a very easy process.

You literally go in there, you select a vendor, you submit them.

The third step: providing your data.

So, you provide your data.

Again, all the CMS vendors will give you the requirements for all the fields.

It's super simple stuff.

Not necessarily super simple to pull it all together, but it's a super simple set of data.

And then collecting the results and making those decisions from those results of how to improve and enhance your ASC.

And then ultimately meeting the OAS caps requirements to ensure you maintain your 2% reimbursement.

So, Ryan, hypothetically, I am selecting a vendor.

Then I want to provide my data manually.

That obviously comes with risk because I'm now dependent on a person.

So, what happens if you forget to send the data?

The person's out.

They go out on FMLA.

They're no longer with the practice or the ASC.

What happens to me as a, you know, ASC in terms of the penalty or me reporting?

Yeah, so CMS loves paperwork.

No surprise, right?

So, in that case, well first thing is everyone needs to ask their vendor, is there a fee?

And that's the first question I would ask.

If my person is out of the office and not provide the data manually, is there a fee?

You know, because I'm going to figure out how to do it, or we're going to have somebody else do it eventually.

You know, let's say I miss two months.

Is there a fee for once I get you the data with the two-month lag for submitting that?

And a lot of vendors, and again, I don't want to speak for all of them, but you know, we've vetted a majority of them, a lot of them charge a fee.

And it makes sense, right?

Because if you can't deliver the data, there's a pretty robust exception process that the vendor has to go through to file it with CMS to say, "Hey, unfortunately, Albert missed it this month, and here's why he missed it and here's the circumstances." And they use common sense to evaluate that.

But yeah, there is a process.

I'd ask your vendor if there is a fee associated with that process if you do miss some.

Some charge, some do not.

And so what you're saying with that, Ryan, is it is the facility's responsibility to make sure the data gets to the vendor.

The vendor is not going to be like, "Hey Albert, where's your data?"

Yeah.

Well, I think they will.

I mean, a good partner, right, a good vendor is going to come to you and say, "Hey, Carrie, you know, it's the 16th.

We're OCD.

It's, you know, hey, it's the 16th.

You missed it by one day.

I needed it by the 15th." You know, we would tell you, for example.

But, you know, I think that the finer points are in your contract.

And I think it just, I would encourage you, echoing what your question is, is just to look at your contract.

See if I miss providing the data manually and you choose to provide the data manually, is there a fee to that vendor for them to file that exception request with CMS because you missed the data for a particular reason?

After that, Ryan, just so everybody's aware, some of the EMR systems out there already integrate with some of the vendors.

Mine, in particular, NextGen integrates with J Morgan.

But there is a fee for buying the package to help for that integration to occur on a monthly basis or timely basis.

So, not only am I having to report OAS caps, but I also had to pay for this integration module so that my data is now automated.

So, I'm not dependent on a body.

So, there was an additional cost on top of the survey being done that I was not really expecting and didn't really think would be an issue.

But it turned out to be an additional cost that I was not prepared for.

So, I think, you know, talking to your vendor in terms of your EHR or practice management system is also important because you might have not only the survey fee, but you may have an initial setup fee from your vendor in terms of how they can integrate with any of these selected CAPS vendors.

Yeah, totally, Albert.

I mean, I wish you and I would have met previously because we don't charge that fee.

So, we integrate directly with no fee.

So, totally get it.

Valid question.

Definitely ask the question.

You know, if you're doing an automated poll, ask them, "Hey, is there an incremental charge to automate that?"

And yeah, you just need to...

It's unfortunate sometimes that's a surprise, but you know, that's a convenience for you though too, right Albert?

I mean, I know you're probably super happy now that that's going to be completely automated and there's not, you know, humans involved.

And that kind of makes your life a little easier.

Absolutely.

I think the integration is probably most important to us.

You know, we have to do it, make it as simple as possible, and then what do we do with the data?

So to break it down, I think what you said earlier, Ryan, was that we still have to pick our vendor, but we still need to go register and log in at oascaps.org to register our facility, correct?

And what vendor you're using.

So, that's a key piece too.

Your vendor should make sure that you're doing that as well, but you don't want to skip that point.

Yeah, and all the, most of the vendors, I shouldn't say all, but most of the vendors will give you a very simple one-page document.

It just shows you the steps.

It says, "Look, here's how you sign in.

Here's how you, you know, add us as your CMS approved vendor."

But absolutely, 100%, you want to do that.

And they'll walk you through it.

It's a really easy process.

But yeah, great, great question.

There was a question that came in from one of our audience members.

Can you briefly touch on the dos and don'ts and what we are able to tell patients regarding receiving a survey after surgery?

Yeah, there are no don'ts.

So, you know, you control the communication to the patient, which is great.

They're your patient, right?

And so, I shouldn't say there's no dos, but you know, let's just focus on the dos.

And the dos are setting their expectation that they're going to be receiving a survey and then literally telling them who it's from.

So, you know, for example, like we actually show you like, "Here's the caller ID.

It's going to say Arbor Associates.

You know, this is the phone number they're going to be calling from.

This is when you can expect the call."

So, you know, setting those expectations is critical because then it delivers.

Again, you want to make sure you hit those 17 completed surveys per month.

But I would focus on the...

I'm not aware of the don'ts, but definitely those would be the dos.

Mind, I think the don'ts would be you can't coerce your patients.

You have to inform and educate them, but you can't coerce them in any way or, um, say, "If you fill out the survey, you're going to get a gift card."

I mean, anything that would be considered...

I don't even think about that stuff.

You also can't bring up the direct questions from what, from our vendor.

So, you can't say, "You're going to be asked about X, you're going to be asked about Y, you're going to be asked about Z."

What they do tell you to do is, if you know you're going to ask your patients about their privacy or their HIPAA, make sure that you do something along the way, doing the process to emphasize that you are protecting their patient information.

For example, you know, normally when you have a patient come into pre-op, you go and you check vitals and, you know, ask names and different things like that.

Shut the curtain, and when you shut the curtain, you know, "I'm going to close the curtain for your privacy."

So, you're just making subtle things or you're doing subtle things within your process so that the patients know, "Oh yeah, they do care about my privacy.

I remember that person shut the curtain," or, "That person did X, Y, or Z."

So, I think read through the questions and figure out how you can educate your staff and team to make sure that you put specific emphasis on making sure the patient is aware that you're doing this because they're going to get a question about it.

Yeah, and the reality...

Yeah, I don't even think about that stuff, to be honest with you guys.

I mean, it's, um, you know, I feel like a lot of that is common sense.

Like, yeah, definitely don't, you know, don't incentivize any patients.

Don't, you know, no need to do gift cards.

You know, just let them know a survey is coming.

Let them know who's going to contact them.

And the reality of it is, you know, everyone on this call is delivering an extremely high level of patient satisfaction at their ASC.

You know, and so the majority of your patients are going to be extremely happy.

You know, we want them to take the survey, and they're going to give you good marks, right?

And so then it's, you know, all about focusing on, you know, those improvement opportunities, you know, on a quarterly basis, which we're going to transition to here in a second.

Really quickly, these key links.

So we talked about this slide throughout.

It'll be in the communication that's sent out to everyone who registered and attended the webinar today.

But there's the first link for the survey questions.

There's a participation exempt request in here.

You can click in here, go directly, see the list of vendors.

You can click to schedule a demo with us.

We can show you how it's a fully automated ASC and CAP survey.

You can click to join the IRO GPO and learn about the J Morgan survey.

So all of this is here, all of your resources.

And then transitioning into, you know, what to do.

Right?

So we're conducting this, we're checking the box on OAS caps, and how to improve your ASC.

And, you know, I'll start with kind of just the first one and then turn it over to Car and Albert.

But, you know, one of the things we love with, you know, our deep analytics package is looking at what are those top five opportunities.

Right?

What are those top five opportunities?

You know, chunk it out.

Make it easily digestible for your ASC and work on those areas to improve over time.

So, identifying those trends and top five opportunities is, you know, one of the critical aspects of this.

Carrie, Albert, you know, on your ASCs, you know, what are you guys thinking about, you know, here in terms of improvement?

Well, I think that, um, as you know, a privately owned ambulatory surgery center, you're always about patient satisfaction.

And, you know, I think we have the privilege, especially with ophthalmic ASCs, to, you know, really capitalize on the happy patient experience.

Um, and to identify areas of opportunity, to your point, Ryan, you know, typically tend to be on a communication level.

If it's wait time and they're complaining about wait time, it's probably because they weren't communicated well.

You know, if you're running behind in surgery and the patients that are waiting to be brought back to pre-op aren't communicated with, they're going to express that dissatisfaction.

So the opportunities, I think, to your point, is how do you get in front of them again with staff training and education?

For my facility, I have a really high satisfaction rate, and typically if I have a complaint, it's either about a wait time or it may be regarding anesthesia.

But typically, it's not around how they're treated, or their procedure, or their outcome.

So, I think, you know, especially in ophthalmic centers, the satisfaction tends to be pretty high.

However, there is always that margin for improvement.

How about in your facilities, Albert?

So, I think the great thing about surveys is that you do get feedback, and using the feedback to make improvements is important.

We don't really get patient complaints in terms of their care, the outcomes, the satisfaction.

Where we did learn something with surveys, and we were doing paper surveys since 1981 and we still do paper surveys in addition to now these CAP surveys, we learned a few things with our old ASC, and we built our new ASC three years ago.

For example, it wasn't, you know, wait times.

It wasn't patient care.

It wasn't patient satisfaction.

It was the chairs in the lobby.

Their wood chairs, and, you know, they were in a historic building.

It was in the old ASC, and they were too hard.

The patients and the family members didn't like the chairs.

Parking—we're in downtown San Antonio.

Parking was not very convenient, and it was difficult to get to the ASC because we're on a big city block.

So, as we built our new ASC, we have soft chairs.

We have a bigger lobby.

We have more parking.

But I think, you know, it's just using the results to make changes to your ASC to be able to, you know, have something meaningful come out of something that we have to do, whether we want to or not.

I think that's probably the most important thing: participate in the survey but find a way to use the information you get back so that it becomes meaningful to the ASC, the physicians, and the patients we all serve.

Completely agree, and I think, you know, data is so important to us all.

If you ignore the data, you're not going to make changes to help make your facility run even better.

So I do think the positive, if you're going to find the positive in doing this, is to help augment what you are already doing with patient satisfaction surveys.

If you got to find the positive in those 32 questions, it is to help us be better.

That's why we have you on this call.

You always look at the [Laughter]

All right, so feel free to add any questions that you may have into the Q&A.

We have a few minutes here before we wrap up.

I do have a couple of questions that have come in.

What is the mandatory timing to launch the survey?

I think we covered that, but maybe just recap that again for us.

Ryan?

Yeah, January 1, 2025.

So, everyone has to be live for reporting January 1, 2025.

Okay, are there vendors that are better suited for smaller ASCs who don't have a huge patient volume?

Great question.

I'm not sure on that.

Ryan, do you have any idea from your experience?

I don't think it's a size determination in my mind.

I think it really boils down to, you know, how are you going to provide the data?

Are you going to provide it manually or do you want it automated?

Those are the first sets of decisions.

I would encourage you to think about and make.

I think one of the things we did in our evaluation process was, you know, we're sticklers for customer service.

We want to be the best in customer service, so we want to align with our partners who are also the best in customer service.

So, I think that's important.

You know, focusing on that and looking for someone who can meet those needs for your customer service—not size.

Because they're all going to send out surveys based on your volume.

Absolutely.

It may be a question of finances.

Ryan, in my experience, looking at the different platforms out there, the cost is about the same no matter which company you go with.

There isn’t a discount because you only did 900 cases or 700 cases versus us who did 10,000 cases.

The cost is going to be about the same.

The range is very close between all vendors.

Yeah, good point, Albert.

And I would also encourage you to look at, you know, how big of a sample they are going to survey.

Are they going to survey, you know, let’s say you’re doing, you know, for the larger practice, you know, let’s say you're doing 3,000 or 4,000 surgeries a month.

Are they going to send a survey out to all of them that month when we only need 17?

Postage does count.

You're going to pay for it.

So, think about that.

Another question: If you don’t reach the 200 completed survey mark, are you hit with the 2% reduction?

We talked about that a little bit earlier, but let’s circle back on that because I think that can be a little confusing.

I think the question or the answer to that question right now, Carrie, is we don’t know.

What everybody says is follow the proper process, follow the procedures, submit to a vendor, have your vendor send out the surveys.

There’s no clear clarification as to if I did everything I’m supposed to do and I follow the guidelines but I didn’t get the 200 surveys, am I going to be hit with the 2% reduction?

We don’t have a clear answer to that question right now.

So, I would say we don’t know, but it’s in your best interest to try to get to the 200 and do everything that you’re required to do so you can at least come back to CMS and say, well, I did everything I was required to.

It’s not my fault the patients didn’t respond.

I agree with that.

That’s what my understanding is too.

It’s more important that you are making the attempts, that you are doing everything that is within your power.

You can’t control what comes back or doesn’t come back from your patients.

And yes, to the end point, we will see.

Nothing has been delivered from CMS that states specifically if you do not hit 200 you’re going to receive a penalty.

But that can change, as we know, with CMS.

Do you have anything to add to that, Ryan?

I don’t.

Okay, when you say the costs are generally the same per vendor, are you saying the monthly flat rate is similar, or are the vendor costs generally per survey?

I never received a quote per survey.

The cost was based on a flat rate, and it was usually an annual rate broken down by month.

So, we're paying X number of dollars per month.

I never got to a vendor—of the vendors that we did talk to and look at—that said, "Oh, you're going to be charged, you know, X amount of dollars per survey that we send out or email or patient call."

It was more of, "We're going to get X number of surveys done within a given period of time this month or that month, and this is how much it's going to cost you annually."

And the goal was not to do more surveys.

There was a company that did offer us to survey every patient; it was substantially more expensive.

But they did say, "We're at a minimum, we're going to do X to get you to year 17."

So, it was a flat rate per month or per year.

Generally speaking, the vendors tend to all kind of be in the same ballpark as rate.

There’s going to be a range, but I wouldn’t say it’s at opposite ends of the spectrum.

You’re not going to find someone that’s really inexpensive and someone that’s super, super expensive.

They’re generally all about the same.

The other thing I would ask or, you know, I would encourage you to keep in mind is something that was mentioned very early on in the presentation, which is you can only change or start at the beginning of a quarter.

So, keep that in mind because you should really think of the investment as an annual investment.

You’re not going to really want to unwind a vendor or turn off a vendor at one quarter and start one during the middle of the quarter of your calendar year.

The reality of that is probably pretty small.

So, think of it in terms of the annual cost because you do need to submit those results every quarter.

I think we may have tapped out our audience’s questions.

Really great questions, everyone.

We’re all learning together, so this has been really great.

So, thank you all for attending.

We appreciate you spending some time with us.

If you have any additional questions, please feel free to email myself or Diane.

We’ll be happy to get answers for you through either Carrie, Ryan, myself, or any other resource that we have available to us to be able to help along the way in this process.

Today’s webinar is going to be available on demand.

If you weren’t able to attend, you will be able to access that on our website.

It should be available either on Friday, July 12th, or, at the latest, on Monday, July 15th.

We do have a series of webinars, so there are two more programs that will follow for our fall series.

The next one is going to be delivering the premium patient care experience from the practice to the ASC.

That event will be held on September 18th.

It will also be via Zoom and will be at 12:30 Eastern time.

We’d like to thank you all for attending and a special thanks to both Ryan and Carrie for your help in putting this very meaningful event together for all of our members and all of the ASCs out there in the ALIC community.

So, thanks to all of you, and thank you guys for attending.

Thank you.