Choosing a mode is based on several factors, price being one of them, and the goals and the objectives of the home health agency being the other.

Basically all three modes have unique attributes,  a brief discussion of these is provided:

Mail Mode offers the greatest value for most agencies.  The Mail Mode will require a vendor to send the Survey Questionnaire (as provided by HHCAHPS) a cover letter, and a return envelope.  The survey is mailed to all  eligible clients -  those who do not respond to the first mailing will receive a second, identical mailing.   Because of this, Mail Mode also has the advantage of helping clients more readily identify their home health provider should they ever become hospitalized again.    

Novaetus has created a mail piece that includes a customized letter on an agency letterhead (digitally produced).  HHCAHPS guidelines indicate that the cover letter may be produced on the vendor letterhead.   Our survey package becomes a visually attractive “package” that further enhances your agency’s brand with the patient.

Telephone Mode is more costly because of the amount of resources that need to be dedicated to conducting telephone interviews.   HHCAHPS protocol requires that telephone interviewers call a minimum of 6 times, at different times and different days before they terminate the survey attempt.  Telephone Mode also has a slightly higher response rate for completion of surveys. 

Seasoned surveyors also know that surveys conducted by the phone will also yield more positive comments.  However, CMS is planning on conducting a “mode experiment” to test the effect that the mode has on survey results.   They will develop statistical models to adjust for differences in results of the mode used to collect the data, there by “neutralizing” the mode bias.

Mixed Mode combines both Mail and Telephone Modes.  It, too, is more expensive than Mail Mode.  When Mixed Mode is used the survey vendor will first send out a mailed survey -   the same “package” as that which is sent out in Mail Mode.  Those patients who do not respond to the mailed survey will then have a follow up survey done by telephone.  This will proceed exactly as in Telephone Mode, with 6 attempts made before the survey attempt is terminated. 

Home Health Agencies that have historically have had a poor response on returned surveys may want to consider a “Mixed Mode” approach.