The Obama administration, for better or worse, has trained hospitals' attention on patient experience by tying ratings and payment incentives to how well providers score on surveys. Now the CMS wants to know more about how Medicare patients and their family members perceive care in long-term acute-care hospitals.
The CMS is soliciting feedback on what should be included in a new survey tailored to those facilities. The findings may be posted on the Medicare website for consumers. The surveys also could be used in Medicare's quality reporting program, meaning facilities could get hit with a 2 percentage-point reduction in their payment update for failing to deliver the data.
The use of the Hospital Consumer Assessment of Healthcare Providers and Systems in ratings and payment-incentive programs has been somewhat controversial.
Some experts say it leads hospitals to focus on things that make patients happy, but aren't clinically valuable or even appropriate. Some critics also say the HCAHPS survey is unfair to hospitals that treat disproportionate numbers of patients with complex medical conditions, who are less likely to say they were satisfied with their care.
Long-term-care hospitals are certified as acute-care hospitals but specialize in care for patients who need hospital-level care for an extended period.
Medicare spent $5.4 billion in 2011 on care furnished in 424 such facilities, according to the Medicare Payment Advisory Commission.
Hospitals are expressing mixed reactions to the new long-term-care survey proposal.
“The CMS must carefully balance the value of survey data with the time and resources needed to collect them,” said Akin Demehin, senior associate director of policy at the American Hospital Association.
