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Exploring the Link between Employee Engagement and CAHPS Scores

Updated: Jun 26, 2019

On August 16, 2017, CMS unveiled the Hospice Compare website to allow consumers to compare hospice providers based on specific quality indicators.

Although the hospice industry was initially a bit wary of how Hospice Quality Reporting Program (HQRP) data would translate into meaningful comparative data for consumers, the industry is now realizing that Hospice Compare is rapidly becoming one of the primary influencers for family members when selecting a hospice provider for their loved one. Furthermore, hospices are finally realizing that CAHPS scores are the greatest differentiator between hospices.

Realizing this, hospice leaders are scrambling to improve CAHPS scores. Sadly, in my humble opinion, hospice executives are missing the mark – BIG TIME – when implementing plans to improve CAHPS scores. The “secret sauce” that everyone is seeking is right in front of our eyes and it’s called employee engagement. Hospices with employees that are truly engaged have lower employee turnover and deliver higher quality care. In turn, quality care leads to higher CAHPS scores.

According to Becker’s Hospital Review, Employee Engagement must be a primary goal for eliminating turnover by “ensuring engaged employees.” reports that the Hospice RN turnover rate in 2016 was 18.73% while the Hospice Aide turnover rate was 23.52%. These numbers almost always reflect high costs (average turnover cost for an RN is between $36,000-57,000), lower CAPHS and public reporting scores for the hospice.

Employee engagement doesn’t just affect turnover. When employee engagement is low then productivity and morale is low, the bottom line is negatively affected, and customer satisfaction shrinks. Having been in the hospice industry for over 22 years, I have seen numerous occasions when low employee engagement led to poor documentation (and we all know what headaches that can lead to) and more importantly, poor patient care.

Step-by-step improvement

May I offer these three steps as place to start in improving employee engagement:

The first step is getting a clear picture of the present engagement within your hospice. This can be accomplished through a formal survey, informal verbal surveys and exit interviews.The second step is to take the results and create a customized action plan that addresses any opportunities for improvement.The final step is investing in company-specific training for your leaders, managers and all other employees. The focus of the training includes incorporating ideas for creating a positive work place culture within your organization. A positive work place culture is instrumental in high employee engagement.

Employee engagement isn’t a fad. It is critical to the success of your program and the hospice industry as a whole. Choosing to ignore the importance of employee engagement puts a hospice organization at risk on many levels: day-to-day operations, quality of care and ultimately, CAHPS scores. In the hospice world, it is all about the people who are cared for and those providing the care. Not losing sight of that can only make us better.


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this is great!

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