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AAMC Submits Comments on Emergency Department Patient Survey Design

February 1, 2013—The AAMC Jan. 31 submitted comments  to the Centers for Medicare and Medicaid Services (CMS)’s request for information (RFI) on developing and designing a survey regarding patient experience of care in the emergency department (ED).

The AAMC highlighted concerns with the expansion of patient experience of care surveys and the unintended consequences that may result from an over-surveyed patient population. There are currently patient experience of care surveys for the inpatient setting, physician offices, nursing homes, and home health agencies. In addition to the ED, CMS is also in the process of adding surveys for the outpatient department, ambulatory surgical centers, and for hospice care.

Patients who receive overlapping care in these settings could receive multiple surveys, leading to confusion as to which clinicians or facilities actually are being assessed. As noted in the AAMC’s comments, this confusion may negatively impact providers in performance-based payment programs that utilize these surveys.

The association reiterated its concerns with the subjective scoring methodology for patient experience questionnaires, and cited research that these surveys can produce inequitable results for subsets of hospitals, particularly those that treat severely ill or disadvantaged patient populations. The AAMC asked that CMS incorporate a case-mix adjustment into the scoring methodology that accounts for socio-economic status (SES).

Lastly, the association recommended general question topics for inclusion in the ED survey, and made recommendations that CMS consider distributing the survey electronically.


Scott Wetzel, M.P.P.
Lead, Quality Reporting
Telephone: 202-828-0495


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