Development of the CAHPS Item Sets for People with Mobility Impairments

The CAHPS Consortium collaborated with a number of stakeholders, disability researchers and State agencies to develop the Item Sets for People with Mobility Impairments (PWMI). Partners in this work included the following organizations:

• The National Institute on Disability and Rehabilitation Research (NIDRR) within the U.S. Department of Education.
• The Centers for Medicare & Medicaid Services.
• The Centers for Disease Control and Prevention.
• The George Mason University Center for Health Policy, Research & Ethics.

Outlined below are some of the key steps in the development process.

Technical Expert Panel. A Technical Expert Panel (TEP) met in September 2005. This diverse group of disability researchers offered valuable consultation and feedback regarding the development of the PWMI Item Set for the Health Plan Survey. TEP input was essential to ensuring that the content of the PWMI Item Set is salient to stakeholders.

Feedback from State agencies. In late 2005, the CAHPS User Network conducted interviews with State agencies that used the CAHPS Health Plan Survey in order to better serve their needs. The need for the PWMI Item Set was reaffirmed through these interviews, as many States expressed a strong interest in measuring the health care experiences of their Supplemental Security Income (SSI)/aged, disabled, and blind (ABD) populations. These agencies also wanted a set of items that would allow them to compare these populations' experiences with those of other populations under their coverage, much in the same way that the CAHPS Children with Chronic Conditions item set allows sponsors to compare the experiences of children with special health care needs to those without special needs. The CAHPS Team incorporated this valuable feedback into the development of the PWMI Item Set for the Health Plan Survey.

Field testing. Two State Medicaid agencies, MassHealth and the Wisconsin Department of Health and Family Services (WI DHFS), collaborated with the CAHPS Team to test the PWMI Item Set with their beneficiaries. WI DHFS incorporated a number of draft items, as well as the screener, into their version of the CAHPS Health Plan Survey for Medicaid populations, which they administered to SSI beneficiaries who had recently enrolled in managed care. MassHealth, which administers the Health Plan Survey annually to its beneficiaries, also incorporated a number of the PWMI items into the survey they fielded in 2006.

Cognitive testing. In the spring and summer of 2006, the CAHPS Team cognitively tested the draft items that were included in these two agencies' surveys and refined the items accordingly.

Version for the Health Plan Survey. The Item Set for People with Mobility Impairments was released for use with the CAHPS Health Plan Survey in 2007.

Version for the Clinician & Group Survey. In 2017, the CAHPS Team released a shorter set of items to focus on experiences with care in doctors’ offices only.