Letters: CMS must maintain data integrity in HCAHPS revamp

Regarding the June 10 cover story feature “CMS looks to revise HCAHPS survey; hospitals say it’s long overdue,” while it’s often true that hospitals receive a greater number of completed surveys with an electronic methodology that targets all eligible inpatients, the response rate is consistently lower than seen with phone or mail methodologies alone.

I believe strongly in the value of high response rates, explored in a recently published article in the Patient Experience Journal. Among other things, response rate is important for what it tells us about the representativeness of the surveyed patients, as Dr. Shannon Connor Phillips, Intermountain Healthcare’s chief patient safety and experience officer, expressed in Modern Healthcare’s article.

CMS has maintained methodological rigor throughout the lifespan of the HCAHPS program. I urge officials to maintain this commitment to data integrity as we move forward with a program revised to give hospitals reliable, relevant feedback.

Jose Inguanzo, Ph.D.
President and CEO
PRC
Omaha, Neb.

Regarding the article “Why some CEOs figure Medicare for All is good for business,” although the program sounds like a panacea for the woes of our current healthcare system, there is no “free lunch.” It seems that when people speak of “Medicare for All,” they are thinking in terms of it being free coverage for all. Medicare recipients pay for Part B and Part D, based on income. Is the plan to eliminate all costs to healthcare consumers? Who will pay for this plan?

Although the business owners and union officials quoted in the article said it was good for business and good for the economy, I would suggest otherwise. Some estimates project it would take more than doubling today’s tax rates to achieve the additional $32.6 trillion required for the program. Doesn’t that totally negate the assertion that it will offer either individuals or companies 
any savings?

Providers right now cannot even break even on Medicare payments, driving them to contract with private payers at much higher rates in order to offset the losses from their Medicare patients. If the entire country is reimbursed at a less-than-cost basis, how can we expect providers to continue to enter the field? What will we be left with in terms of expertise and skill? I suspect we will experience even greater shortages than we currently see.

The federal government has a poor record on lowering costs and improving efficiency, and I suspect their control would only expedite the failure of the current Medicare system. All one has to do is ask a veteran about his/her experience with VA healthcare to understand the ineptness of the feds in oversight of national healthcare. Are long wait times, poor care and fragmented services the future for all Americans?

Denise Adema
Fort Myers, Fla.