The Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey is a vital tool for capturing the experiences of families and caregivers with hospice care. In Q2 2025, the Centers for Medicare & Medicaid Services (CMS) implemented several key changes to the survey process. This blog analyzes the impact of these changes, using specific return rate data to show how each intervention contributed to a significant increase in survey participation.
Quantifying the Impact: What Drove the Increase?
1. Shortened Survey & Prenotification Letter: +2.9% at Day 42
CMS introduced a more concise survey instrument and added a prenotification letter to inform potential respondents about the upcoming survey. Comparing Q1 and Q2 2025 samples at day 42, the average return rate rose from 27.8% to 30.7%—an increase of 2.9 percentage points. This improvement is directly attributable to the combined effect of the shorter survey and the prenotification letter, which together made the process more accessible and encouraged greater participation.
- Q1 2025 (Day 42): 27.8%
- Q2 2025 (Day 42): 30.7%
- Increase: +2.9% (Shortened survey & prenotification letter)
2. Expanded Return Window: +1.2% from Day 42 to Day 49
A second major change was the expansion of the survey return window. By allowing more time for families and caregivers to respond, CMS enabled additional returns beyond the initial 42-day period. In Q2 2025, the average return rate increased from 30.7% at day 42 to 31.9% at day 49—a further 1.2 percentage point gain attributable to the extended window.
- Q2 2025 (Day 42): 30.7%
- Q2 2025 (Day 49): 31.9%
- Increase: +1.2% (Expanded return window)
3. Daily Return Rate Trends
The daily return rate data for Q1 and Q2 2025 further illustrates the cumulative effect of these interventions. Q2 samples consistently outperformed Q1, with the most pronounced gains occurring after the introduction of the prenotification letter and the shortened survey, and a steady climb continuing as the expanded window allowed more responses to be collected.
| Day | Q1 2025 Avg | Q2 2025 Avg |
|---|---|---|
| 30 | 20.2% | 24.1% |
| 35 | 24.9% | 28.2% |
| 40 | 27.1% | 30.6% |
| 42 | 27.8% | 30.7% |
| 49 | — | 31.9% |
Why This Matters
Higher survey return rates mean more reliable CAHPS Hospice data, which in turn gives providers and policymakers a clearer understanding of family and caregiver experiences. These improvements support quality initiatives, regulatory compliance, and public reporting—ultimately benefiting patients and their loved ones.
Additional Opportunities
Besides the improvements outlined above, additional return rate gains can be realized by taking advantage of the new web-mail mode that was recently approved by CMS. If your organization is interested in optimizing your return rates by adopting this new mode, please contact sales for more information!
Conclusion
The Q2 2025 CAHPS Hospice survey results demonstrate that targeted CMS interventions—especially the shortened survey, prenotification letter, and expanded return window—can meaningfully boost response rates. Of the total 4.1 percentage point increase, 2.9% is attributable to the survey and notification changes, and 1.2% to the longer return window. The adoption of web-mail mode along with continued monitoring and analysis will help hospices build on this progress and achieve even higher response rates in the future.