Increasing ICH CAHPS Survey Response Rates
folder_openOther Announcementscalendar_todayPosted February 19, 2021

In recent years, we have seen a slight, steady decline in the In-Center Hemodialysis (ICH CAHPS) Survey response rates. Due to the small sample sizes at most participating facilities and the fact that most in-center hemodialysis (ICH) patients receive dialysis for many years, many ICH patients are asked to participate in the survey up to two times each year. End-stage renal disease experts, survey experts, and other stakeholders continue to stress the critical importance of the need for patient engagement in terms of the ICH CAHPS Survey. We are sharing some patient engagement ideas in hopes that the information is useful in keeping ICH patients invested in the survey.

Ideas for ICH Patient Engagement

  • Consider using a poster/flyer or other awareness materials within your facilities, providing a heads-up to patients that their participation in the ICH CAHPS Survey is important.
    • The Coordination Team developed a CMS-approved ICH CAHPS poster/flyer that contains information about the survey; the template (without official CMS logo) can be found on the ICH CAHPS website: Approval for using this exact template is not necessary; however, please contact the Coordination Team at to obtain the template version that includes the official CMS logo.
    • ICH facilities are also permitted to create their own poster/flyer or other awareness materials, with approval from the Coordination Team. Materials can be submitted for review to Please keep in mind that the survey name included on the mail surveys that patients receive is “Medicare In-Center Hemodialysis Survey.”
  • Show patients the ICH CAHPS Survey envelope so they can easily recognize it should they receive one in the mail. The new envelope template that will be used starting with the 2021 Spring Survey can be found in Chapter 5 and 7 in the ICH CAHPS Administration and Specifications Manual: The Coordination Team can also email the envelope template to ICH facilities upon request.
  • Communicate to patients the purpose of the survey, why their responses matter, and how they can access the survey results on the Care Compare website at
  • Explain to patients that the survey is conducted every spring (April-July) and fall (October-January) and that they may be asked to participate up to two times a year. Make sure that they know that they may be contacted via mail or phone (or both) by an independent vendor.
  • Let patients know that they may receive the ICH CAHPS Survey and that honest feedback is appreciated. Make sure they know that no one from the facility will know who receives the survey, who responds to the survey, or how they answered any of the questions.
  • Discuss publicly reported survey results and facility scores with patients and the facility’s plans, if any, to improve patient care based on survey results.

Things to Keep in Mind when Implementing Patient Engagement

Although patient engagement is critically important, ICH facilities should make sure to keep the following in mind when implementing any patient engagement techniques:

  • Patients receiving ICH treatment are an especially vulnerable population, relying on an ICH facility and its staff for life-sustaining care. Some patients might be reluctant to participate in the ICH CAHPS Survey or provide feedback on the dialysis care they receive for fear of retribution by facility staff. Participation is always voluntary.
  • Patients may be reluctant to provide survey responses that accurately reflect their experience with the care provided by their ICH facility because they might perceive that government agencies are not responsive to patients’ concerns. Facilities should not imply or persuade patients to respond to items in a particular way.
  • If patients ask ICH facility personnel to help them complete the survey, facility staff should instruct them to ask a family member or friend for help. Staff at a dialysis facility are not allowed to help patients complete the survey.
  • If sample patients have any questions about the survey, facility staff should instruct them to call their ICH CAHPS Survey vendor’s toll-free telephone number, which is included in the prenotification and mail survey cover letters. Staff at a dialysis facility should not attempt to answer survey-specific questions asked by the patient.

Please note that in an effort to increase response rates, CMS is working toward the end goal of improving the ICH CAHPS Survey. If any changes are made to the survey, they will be shared with survey vendors and ICH facilities. At this point, we do not have a solid timeframe for any potential changes, as a final decision depends on a number of factors. In the meantime, we hope that the information provided here will help ICH facilities employ useful patient engagement tactics to help increase ICH CAHPS Survey response rates!