Does HCAHPS help or hurt?

Starting this month, hospitals that can't keep their patients happy will face up to a 1 percent reduction in Medicare payments under pay for performance.

Some hospitals, however, say a big chunk of the scoring system for Medicare reimbursements (30 percent) will be based on something they have very little control--patient satisfaction.

Regardless, hospitals are certainly paying attention to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey scores, which value at nearly $1 billion in payments to hospitals over the next year, The Wall Street Journal reported.

"I don't know anybody in my field who isn't totally preoccupied with it," said John M. Haupert, chief executive of Grady Memorial Hospital in Atlanta.

Only 57 percent of respondents gave Grady an overall rating of nine or 10, compared with Medicare's national base line of 66 percent. Grady estimates the hospital will lose $230,000 because of low patient-experience scores.

The scores may unfairly penalize safety-net and big, teaching hospitals, The Hospitalist noted. Safety-net hospitals perform more poorly than other hospitals on nearly every HCAHPS measure of patient experience, and teaching hospitals and other large hospitals score more poorly than small community hospitals, the article noted.

Grady has spent $4 million on upgrades. Still healing from the bad publicity of a patient falling from a window due to understaffing, the hospital has committed to turning around its reputation for outstanding patient care, the WSJ noted.

But it's not only about fancy TVs and gourmet meals. Grady doubled the number of TV channels in patient rooms and added ESPN because "the requests for pain medicine go down during the afternoon football game," Grady's Chief Nursing Officer Rhonda Scott said in the article.

As the Centers for Medicare & Medicaid Services has asserted--as the basis for value-based purchasing--patient satisfaction is linked to better patient care.

The Hospitalist encouraged best practices for improved patient experience, including joint physician-nurse rounding, conducted hourly, as well as patient and family communication.

According to Peter Short, senior vice president of medical affairs for Northeast Hospital Corp. in Massachusetts, addressing the clinical, physical and emotional needs of patients takes very little extra time.
For more information:
- read the WSJ article
- here's the Hospitalist article

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