In November, the Agency for Healthcare Research and Quality (AHRQ) released a new version of the Clinician and Group CAHPS Survey (CG CAHPS) in response to the large-scale adoption of telehealth services resulting from the COVID-19 pandemic. SPH Analytics applauds the work done by AHRQ and the CAHPS Consortium to address patient experience with telehealth visits. 

Telehealth usage surged in the spring as people looked for safer options to connect with their doctor. This rise in telehealth usage has been well documented and is confirmed by SPH research, where we saw a nearly 25% increase in reported telehealth visits pre- and post-declaration of the pandemic by the World Health Organization. SPH did find that interest in telehealth visits with one’s personal doctor was significantly higher than with an unfamiliar doctor.

Telehealth Findings: SPH National Survey Pre/Post-Pandemic

The CAHPS surveys, the industry gold-standard for measuring member and patient experience, were not designed to prompt respondents to think about care received regardless of whether it was in person, by phone, or by video. With the surge in telehealth appointments, AHRQ has been working to address this new consideration.  

In addition to modifications to the health plan CAHPS surveys to address care received through telehealth, AHRQ has released a new CG CAHPS 4.0 survey. This version is officially still in beta since it hasn’t yet gone through the standard field testing. Because of this, the official CAHPS trademark is still pending.

CG CAHPS 4.0 – New Visit-Based CAHPS Survey

AHRQ supported the development of the Visit Survey 4.0 to be responsive to the large-scale adoption of telehealth as a result of the COVID-19 pandemic. The CAHPS team recognized the need for a survey to assess patient care experiences regardless of the way the visit took place and that asks specifically about the use of technology. Currently there is only an adult version of the survey, though it is available in both English and Spanish. AHRQ is considering the development of a child/pediatric version of the survey but does not have an anticipated timeline.

Unlike the CG CAHPS 3.0 survey which asks respondents to think back on the last 6 months, the 4.0 version asks specifically about the most recent visit. The major differences between the 3.0 and 4.0 versions are summarized below:

Composite Measures

The new survey instrument asks questions that can be grouped into these composite measures:

Access Composite

  • Was that recent visit as soon as you needed?
  • Did your most recent visit start on time?

Communication Composite

  • During your most recent visit, did this provider explain things in a way that was easy to understand?
  • During your most recent visit, did this provider listen carefully to you?
  • During your most recent visit, did this provider show respect for what you had to say?
  • During your most recent visit, did this provider spend enough time with you?

Care Coordination Composite

  • During your most recent visit, did this provider have the medical information they needed about you?
  • Did someone from this provider’s office follow up to give you those results?

Office Staff Composite

  • Thinking about your most recent visit, was the staff from this provider’s office as helpful as you thought they should be?
  • Thinking about your most recent visit, did the staff from this provider’s office treat you with courtesy and respect?


  • Using any number from 0 to 10, where 0 is the worst visit possible and 10 is the best visit possible, what number would you use to rate your most recent visit?

Additionally, AHRQ has added a series of questions that specifically address the efficacy of visit technology:

  • Did this provider’s office give you all the instructions you needed to use video for this visit?
  • During your most recent visit, was the video easy to use?
  • During your most recent visit, were you and this provider able to hear each other clearly?

AHRQ announced in their webcast on December 17 that they are also working on a CG CAHPS 3.1 version that will instruct respondents to think about all types of visits while maintaining the 6-month reference period. 

“This is a welcome, remarkable and responsible development from AHRQ, and a tribute to their ongoing and responsive dedication to improving the patient experience of care,” observed Clifford Rowley, MPH, who has over 15 years’ experience in CG CAHPS applications and development. “While dedicated professionals will be looking forward to the results from the beta test of CG CAHPS 4.0, we, and our patients, may be best served by recognizing that both this version, and the upcoming CG CAHPS 3.1 version, are not mutually exclusive, either/or alternatives, but complementing high-value tools to further strengthen the delivery of patient care.”

For more information on the CG CAHPS 4.0 beta and to access the full survey instrument, visit the AHRQ website. SPH can assist health plans, health systems, and provider organizations that are interested in collecting information about experiences with telehealth using this new survey instrument. 

Read more about the CG CAHPS survey here and see how SPH’s survey management and administration can give you the best measurement and analysis of your patients’ satisfaction and general experience with their PCPs and physician practice.

CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).

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