As of July 2011, a patient’s satisfaction with their hospital experience formally became the next “pay for performance” measure in the Centers for Medicare and Medicaid (CMS) value-based purchasing payment model for hospitals across the country. Providers that accept federal government payments, increasingly, are held accountable for using evidenced-based practices and delivering positive outcomes.
Now CMS has pulled the trigger on the much anticipated HCAHPS (health consumer assessment of health provider services) program. HCAHPs data on hospital performance—attainment of a required baseline measurement and then improvement beyond that—will be used to calculate reimbursement payments for the coming year, including a hospital’s ability to earn back payments that CMS has withheld. For our hospital, approximately $770,000 has been withheld by CMS for clinical measures and $330,000 for patient satisfaction measures—totaling $1.1 million. This dollar “take back” will increase over time.
NYHQ has a robust and successful program to improve and maintain clinical core measures, and we have spent the past 18 months focused on improving patient satisfaction levels by improving the patient’s experience.
Improving that experience is both simple and complex. In our staff education process, we ask our people to put themselves in the patients shoes, rather than focus on scores and data. If we understand how the patient feels about how we treat them, we should be able to improve that experience tenfold, and then make it the best in the nation. In summary, here’s how a patient’s perception of their experience now impacts an institution’s ability to obtain reimbursement:
1. Health care team provides medical care for a patient
2. Each patient forms perception of their care based upon totality of experience with all providers and the institution
3. After returning home, each patient is surveyed (by CMS HCAHPS survey administrators, such as Press Ganey); patient evaluates experience and rates it, including if they would recommend the care to others
4. Data from the patient’s evaluation and rating of the hospital are analyzed by CMS and aggregated with reponses from across the country
5. As of July 1, results count toward level of reimbursement dollars an institution will earn back from funds witheld by CMS
Our Office of the Patient Experience guides employees and medical staff about the factors that shape a patient’s experience, including courtesy, communication and control of pain. For example, a new initiative called HUSH (Help Us Support Healing), focuses attention on the patient’s opinion of noise levels and sets guidelines on how to minimize it for a quieter healing environment.
The patient’s perception of their experience has always mattered. Now, the patient’s voice about that experience will have an impact on the bottom line. We embrace this and have committed our organization to providing an experience that patients know has contributed to their clinical outcome and that they can recommend to others with pride and enthusiasm.
Stephen S. Mills, F.A.C.H.E.