Understanding PX Scores and Percentiles

Within Composites, patient experience performance is displayed using two related metrics: PX Scores (Top-Box %) and Percentile Ranks.

The PX score shows how patients rated their experience, while the percentile rank shows how that result compares with other organizations nationally. Together, they help teams understand both what patients are saying and how performance compares nationally.

PX Scores (Top-Box %)

PX scores are calculated using Top-Box scoring, a standard method used in CAHPS surveys.

A Top-Box score represents the percentage of patients who selected the highest possible response to a survey question.

Example:

If a question asks how often a provider explained things clearly and 82 out of 100 patients selected “Always,” the Top-Box score is 82%.

This approach focuses on the strongest signal of patient experience by measuring how often patients report the best possible outcome.

Percentile Ranks

A percentile rank places that score in the context of national performance. It shows how a result compares with scores from other organizations using the same survey standards.

• A score in the 75th percentile performs better than 75% of comparable organizations
• A score in the 90th percentile represents top-tier performance nationally

Percentiles describe relative position, not improvement or grades.

How Scores and Percentiles Work Together

PX scores and percentile ranks answer two different—but equally important—questions:

• PX Score: What are patients saying about their experience?
• Percentile Rank: How does that result compare to other organizations?

Example:

A result of 82% Top-Box and 87th percentile means:

• 82% of patients selected the highest response
• The score performs better than 87% of comparable organizations

Used together, these metrics provide both a direct measure of patient experience and context for interpreting performance.

National Benchmark Ranges by Category

Percentile benchmarks are calculated separately for each CAHPS category. This means that the score ranges used to determine percentiles may differ depending on the measure.

The charts below show the national benchmark distribution used for the Clinician & Group CAHPS categories displayed in Composites.

Example interpretation:

A score positioned near the 50th percentile performs around the national average for that category, while scores near the 75th or 90th percentile indicate stronger relative performance.

Because each category has its own distribution, a similar Top-Box score may correspond to different percentile ranks depending on the measure.

How to Use This in Composites

When reviewing Composites:

• Start with the PX Score to understand the patient experience directly
• Use the percentile to understand how that experience compares nationally
• Focus on categories where both the score and percentile indicate opportunity

This combination helps teams quickly identify where to celebrate strong performance and where to focus attention.