Patient satisfaction has become a hot topic in recent years. As the healthcare industry continues to beat the drum for increased patient-centered care and consumers demand more transparency in hospital outcomes, providers are creating internal performance goals around HCAHPS scores.
The CMS, which has collected HCAHPS information for two years and started posting it on Hospital Compare last year, has discussed tying reimbursement to patient satisfaction as well. Patient satisfaction also is a component of some of the federal agencys pay-for-performance pilot projects that are ongoing.
High-performing hospitals will focus on patient satisfaction as a matter of course, regardless of how it correlates to other metrics in the hospital, says Jean Chenoweth, senior vice president of performance improvement and the 100 Top Hospitals Program at Thomson Reuters. They view that as part of their obligation to the patient.
HCAHPS reflects the experience of being in the hospital, Chenoweth says. Hospitals with well-designed processes and strong system organization have a culture of performance improvementand they tend to be financially stronger than hospitals that arent high-performers. Patients might not understand the technical aspects of the care they receive, but they will have a good perception of how they are treated. The built-in improvement culture responds to that, she says. Those hospitals are focused on providing overall excellence across the board.
And satisfaction does pay, according to J.D. Power and Associates. The company, which ranks organizations in various industries, runs a Distinguished Hospital Program to award high-quality hospitals.
The HCAHPS surveyviewed as a quality-improvement tool by the industryfits into a larger picture of hospital performance, says Jim Dougherty, executive director of the healthcare practice at J.D. Power.
Research published last year in the New England Journal of Medicine indicated that hospitals with high nurse-to-bed ratios fared better in patient satisfaction and clinical quality. Hospitals can leverage those numbers in other ways that lead to improved operating margins, he says. This is where these link together.
Patient satisfaction is a symptom of value that can be marketed to a community and help a hospital gain market share, Dougherty says. Hospitals that invest more to ensure there is enough staff to respond to patients needs see better clinical outcomes.
In turn, patients are happy with both the attention and care they received and score their experiences higher in the HCAHPS survey. Hospitals take those numbers into negotiations with payers and can command better prices on services, with fewer discounts. Patient satisfaction is not the root cause of all this, but it is the symptom that is measurable, Dougherty says.
J.D. Power examined the relationship between patient-satisfaction scores and financial strength at 1,386 hospitals last year. The analysis looked at four quality metricsacute myocardial infarction, congestive heart failure, pneumonia and surgeryand hospitals with high, midlevel and low satisfaction scores, as well as at overall satisfaction, operating income, average price allowance and nurses per bed.
The 350 hospitals in the high-satisfaction quartile had 1.19 nurses for every patient bed and an operating margin of 0.64%, according to the analysis. The 350 hospitals in the low quartile had 0.91 nurses for every bed and a negative operating margin of 0.27%.
Those are the types of comparisons CEOs want to know, and thats why patient satisfaction remains a key element of hospital performance, Dougherty says. If youre not focusing on that, youre opening the door for your competitor to do it.