This article written by Laura Landro entitled “Informed Patient: Tying Hospital Payments to Patient Satisfaction” appeared in the Wall Street Journals’ blog on health and the business of health.
In reading this, you will be able to find in your own mind, the problems that this policy poses. Read on….
Hospitals are scrambling to improve customer service in advance of a change tying Medicare payments to higher scores on patient-satisfaction surveys, today’s Informed Patient column reports.
But improving patient satisfaction means engaging hospital staff in the effort — and changing hospital cultures that haven’t traditionally focused on the patient as a customer. Hospitals are hiring consultants and service coaches to help, training employees to be more responsive, bringing in executives with experience in the hospitality industry, and even tying employee compensation to a hospital’s performance on the satisfaction surveys, known as HCAHPS.
Take AtlantiCare, a health system with two hospital campuses in southeastern New Jersey. Bush Bell, AtlantiCare’s corporate director of customer experience and a former hotel-industry executive, tells the Health Blog that while the hospital felt it was doing a good job, patient-satisfaction surveys showed “our customers were telling us we had some things to improve on.”
AtlantiCare developed a “strategy map” to help staffers understand how they can support performance excellence — such as following recommended steps when communicating to patients and family members. “Everyone has to ask, ‘What can I as a front-line nurse, doctor or technician do to help the department be successful?’” Bell says. Bonus payments at the hospital are tied not only to financial objectives but to customer-service scores, and “you get zero bonus if you aren’t successful.”
The Cleveland Clinic, which has styled itself as a leader in the movement, helped form a new Association for Patient Experience and is hosting its third Empathy and Innovation summit next May. More than 40,000 employees have been put through training sessions on delivering the best patient experience, and even staff in the finance department are offered name tags that say “Caregiver.”
James Merlino, a physician who heads the clinic’s Office of Patient Experience, says workers are trained to “take ownership of their domain,” whether it be cleaning the bathrooms or communicating about medications. “We fully believe that cultivating a workforce of highly engaged and satisfied caregivers results in improved patient safety, better clinical outcomes and an enhanced patient experience,” he says.
Gallup research has shown a strong correlation between overall employee engagement and patient satisfaction, Merlino adds. Since 2008, Cleveland Clinic has increased its performance in employee engagement, as measured annually by Gallup, by 34%.
Starting next fall, hospitals will lose 1% of their so-called DRG (for Diagnosis-related group) payments, under which Medicare pays hospitals a flat per-case rate for inpatient care.
But under a provision in the new health law, they will be able to earn back the 1% — and in some cases more than that — based on a performance score made up of clinical quality measures (70%) and patient experience of care (30%). Scores will be based on the higher of achievement of national median performance or improvement from the hospital’s past performance in that measure.
A number of hospitals have protested the 30% given over to patient satisfaction scores, telling Medicare that it puts hospitals that care for sicker patients at a disadvantage.
Consumers can find survey results that compare their hospital to state and national averages in both clinical quality and patient satisfaction at the government’s Hospital Compare site.