Lessons from the first year of Geisinger’s money-back guarantee

Geisinger Health System has paid out about half a million dollars through its refund program.
It’s been a little more than a year since Geisinger Health System launched its money-back guarantee initiative, and the first 12 months offered key lessons on how to improve the patient experience.

Greg Burke, M.D., the system’s chief patient experience officer, writes in a blog post for NEJM Catalyst that Geisinger has processed hundreds of complaints and paid out about $500,000, a figure that is not a large jump in what it was already paying for financial adjustments as part of its Geisinger ProvenExperience initiative. Through the program’s evolution over the past year, Geisinger developed better ways for patient experience leaders and risk management leaders to work as a team to solve complaints.

“A year after the initiative began, we have learned that ‘making it right’ for patients following service failures has increased the amount of grievances received, has cost a relatively small amount of dollars in relation to the system’s budget, and has added to the overall process of care improvement,” he writes. “I hope that other hospital systems learn from our experience with the refund promise and take steps to disrupt the 'status quo' by offering the same to their patients.”

As ProvenExperience neared its first anniversary last year, Burke said many complaints were linked to long wait times in the emergency department, impolite employees and trouble securing appointments in certain departments. Patients rate their experiences on an app and can request up to $2,000 for an unsatisfactory visit, but differences in opinion on treatment options, for instance, are not included.

More recently, according to the NEJM Catalyst blog post, Geisinger has tested a two-month waiting period between when a patient receives care and when he or she requests a refund. Patient liaisons who resolve these complaints have also been better briefed on what is a quality or experience concern and what is a true regulatory issue.

Geisinger CEO David Feinberg, M.D., said other health systems thought he was “nuts” for following through on a program like ProvenExperience, but argued that offering a money-back guarantee improves patient trust.