HCAHPS, short for the Hospital Consumer Assessment of Healthcare Providers and Systems, is the national standardized survey of patients' experiences in US hospitals. It asks recently discharged adult patients about things like how well nurses and doctors communicated, how quickly staff responded, how clean and quiet the hospital was, and whether they would recommend it. The results are published on Medicare.gov Care Compare and feed into the patient experience part of the CMS Overall Hospital Quality Star Rating.
This guide explains what HCAHPS measures, how the survey is run and how to read the results.
Background
HCAHPS was developed by the Centers for Medicare & Medicaid Services (CMS) together with the Agency for Healthcare Research and Quality (AHRQ). It was implemented nationally in 2006, and the first results were publicly reported in 2008. Before HCAHPS, hospitals used many different private surveys, so results could not be compared. HCAHPS created one common survey and method for everyone.
Most short-term acute care hospitals paid under Medicare's inpatient prospective payment system have a financial reason to take part: hospitals that do not report HCAHPS results face a reduction in their annual Medicare payment update. Other hospitals, such as critical access hospitals, can participate voluntarily.
Who gets the survey
The survey goes to a random sample of adult patients after an inpatient stay, with medical, surgical or maternity care. It is sent between 48 hours and six weeks after discharge. Some patients are excluded, for example those discharged to hospice or nursing homes, and patients whose main reason for the stay was psychiatric. Children are not surveyed.
Hospitals hire approved survey vendors or run the survey themselves under CMS rules. The survey can be done by mail, phone or, in recent versions, web-based modes. CMS updated the survey in 2025, adding and revising some questions.
What the survey asks about
HCAHPS covers a set of topics, reported as measures on Care Compare. They include:
| Topic | Example of what is asked |
|---|---|
| Communication with nurses | Did nurses treat you with courtesy and respect, listen carefully and explain things clearly? |
| Communication with doctors | Did doctors do the same? |
| Responsiveness of staff | Did you get help as soon as you wanted it? |
| Communication about medicines | Did staff explain new medicines and possible side effects? |
| Discharge information | Did you get information about what to do and symptoms to watch for at home? |
| Care transition | Did you understand your care and responsibilities after leaving? |
| Cleanliness of the hospital environment | Were your room and bathroom kept clean? |
| Quietness of the hospital environment | Was the area around your room quiet at night? |
| Overall hospital rating | A rating from 0 to 10 |
| Willingness to recommend | Would you recommend this hospital to friends and family? |
Exact wording and the list of measures change from time to time as CMS updates the survey.
How results are reported
On Care Compare, HCAHPS results are typically shown as percentages, for example the share of patients who said nurses "always" communicated well, or who rated the hospital 9 or 10. Results are compared with state and national averages.
CMS also publishes HCAHPS star ratings, from 1 to 5 stars, for each topic and a summary star rating for patient experience. These are separate from the Overall Hospital Quality Star Rating, although HCAHPS results make up the patient experience group within it. See How CMS Star Ratings Work.
Results are adjusted for differences in patient mix and survey mode so that hospitals are compared fairly. A hospital needs enough completed surveys over the reporting period for its results to be shown, and star ratings require a minimum number of completed surveys.
Why HCAHPS matters
- For patients: it is a consistent way to compare how patients experienced care at different hospitals.
- For hospitals: results are public and affect Medicare payment through the Hospital Value-Based Purchasing Program, which rewards or penalizes hospitals based on quality, including patient experience.
- For quality: communication, responsiveness and good discharge information are linked with patients understanding their care and following instructions after they go home.
What HCAHPS does not tell you
- It measures experience, not clinical outcomes such as infection rates or survival. Look at other measures for those.
- It reflects patients discharged in a past period, often a year or more earlier.
- It does not cover emergency room visits or outpatient surgery. CMS has separate surveys for some outpatient settings.
- Small hospitals may not have enough surveys for results to be shown.
Using HCAHPS when choosing a hospital
If communication and comfort matter to you, compare HCAHPS results among hospitals you are considering, alongside safety and outcome measures. Look for topics where a hospital is much lower than average, such as staff responsiveness or discharge information, and ask about them. Our How to Choose a Hospital guide has a full checklist, and you can browse 4 and 5-star hospitals or 5-star hospitals.
If you receive the survey
Your answers are confidential and reported only in combined form. Honest responses, positive or negative, help other patients and help hospitals improve. If you had a specific problem, you can also contact the hospital's patient relations or patient advocate office directly.