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Since the CAHPS program's inception in the mid-1990s, AHRQ has provided guidance on survey design, sampling, and data collection strategies to ensure that survey users have the information they need to collect the most accurate data possible. This guidance reflects decades of research on various ways to improve the reliability, validity, and usefulness of CAHPS surveys.

Recent research by the CAHPS team has focused on survey design, format, and length; the use of incentives to encourage responses; alternative sampling frames and approaches to sampling; and the use of additional modes or modification to existing data collection approaches. 

• Selected Reading: Review a bibliography of published articles on CAHPS survey administration.
• Summary of Key Findings: CAHPS Survey Administration: What We Know and Potential Research Questions (PDF, 738 KB; 15 pages) 

Review this page for general guidance on: 

• Formatting CAHPS surveys. 
• Preparing a sample and collecting survey data. 
• Processing and analyzing CAHPS survey results.

Survey-specific guidance is available on the pages that describe each survey. 

AHRQ does not require the use of a specific methodology for sampling or survey administration. However, we provide guidance in these areas based on best practices in survey design and administration as well as analyses of each instrument’s field test data.

General Guidance on Formatting CAHPS Surveys

Adding Supplemental Items into CAHPS Surveys 

If you are adding supplemental items to a CAHPS survey, you can browse and select items from a catalog of CAHPS supplemental items. The instructions provided for each item ensure consistency across surveys in the location and order of items and enhance the flow of questions in an order in which respondents think about the topics. 

Learn more about supplemental items and instructions for their use. 

Designing and Formatting CAHPS Instruments 

One critical attribute of CAHPS surveys is the consistent design and formatting of survey instruments. CAHPS surveys may be administered via various modes: by mail, web, and/or phone. For each of these modes, the clarity and consistency of the formatting (or, in the case of phone surveys, the approach to asking questions) is crucial to ensuring the reliability and validity of the results. 

Review guidance on formatting CAHPS questionnaires for mail, web, and phone administrations. 

The topic of survey length, design and format was also discussed at the September 2018 research meeting: Advances in Survey Methodology: Maximizing Response Rates and the Representativeness of CAHPS Survey Data (PDF, 442 KB).

Using Translated Surveys

As you consider survey format and your targeted sample, you may also determine the need for CAHPS surveys that are translated into other languages. All CAHPS surveys are available in Spanish, as are some of the CAHPS supplemental items. If you need a CAHPS survey in a language that is not available, you may produce your own translation. To find out more, review guidance on translating CAHPS surveys.

General Guidance on Preparing a Sample for a CAHPS Survey 

The consistency of the sampling process is critical to the comparability of results across multiple survey vendors and sponsors (organizations that fund or oversee the administration of the survey). Some aspects of the sampling process are the same across all CAHPS surveys, but the details vary. Please consult the survey administration guidance for specific surveys to access key information, such as eligibility guidelines for the sampling frame and the recommended number of completed surveys per entity. 

Note about vendors: To generate the standardized data necessary for valid comparisons, AHRQ recommends that CAHPS surveys be conducted by a third-party vendor according to the guidelines provided on this website and in any survey-specific documents. 

Read about: 

• Examples of sample frame elements for CAHPS surveys.
• Calculating the starting sample size for CAHPS surveys.
• Preparing sample files before collecting data for CAHPS surveys.

General Guidance on Collecting CAHPS Survey Data 

Based on extensive research into ways to maximize response rates and the representativeness of survey responses, the CAHPS team recommends using a multi-modal approach to collecting CAHPS surveys. This approach typically takes the form of web with mail (and possibly phone) follow-up or mail with phone follow-up. 

Learn more: 

• Recommended data collection procedures for CAHPS surveys.
• Methods for increasing the number of responses to CAHPS surveys.

Webcasts on Survey Modes and Improving Response Rates 

Improving Response Rates and Representativeness for CAHPS Survey Data: An Overview of Web-First and Other Strategies (Webcast) (January 11, 2024) 

Improving Response Rates and Representativeness for CAHPS Survey Data: An Overview of Web-First and Other Strategies (1:01:18) ) 

• Recent Insights into CAHPS Survey Modes and Response Rates (Webcast) (November 19, 2019) 
• Developing Invitation Messages That Increase CAHPS Survey Response Rates (Webcast) (September 10, 2019) 

Research Meeting on Advances in Survey Methodology 

In September 2018, AHRQ brought together researchers and key stakeholders to share findings about CAHPS survey administration methods, discuss stakeholders' needs and concerns, and identify important research questions. This research meeting focused on two related topics: 

• Improving response rates for CAHPS surveys. 
• Ensuring the representativeness of respondents to CAHPS surveys. 

Read a summary of the September 2018 research meeting: Advances in Survey Methodology: Maximizing Response Rates and the Representativeness of CAHPS Survey Data (PDF, 442 KB). 

General Guidance on Processing and Analyzing CAHPS Survey Results 

As survey responses are returned, it is important to take a few steps to ensure that the data is usable for the survey sponsor’s purposes. 

Read about: 

• Tracking returned CAHPS questionnaires and assessing their completeness. 
• Calculating response rates for CAHPS surveys.
• Preparing Data from CAHPS Surveys for Analysis (PDF, 369 KB) 

Learn about programs and guidance available to support users in analyzing CAHPS survey data.