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Higher Readmission Penalties Linked to Low HCAHPS Scores

Cheryl Clark, for HealthLeaders Media, December 12, 2012

Hospitals that struggle with high rates of 30-day readmissions and fear federal penalties may look at their patient experience scores for clues on what might be driving their negative scores.

That's according to Press Ganey, which conducts Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys as required by the healthcare reform law's value-based purchasing regulations. The company found that hospitals that perform well on patient experience measures also have lower 30-day readmission rates and are least likely to receive a substantial readmission penalty.

But the opposite also is true, the survey company found. Hospitals that score the lowest in patient experience are most likely to be penalized the maximum 1% of their Medicare-base DRG, signaling that there may be a connection with leadership priorities and culture at those hospitals, says Nell Buhlman, Press Ganey's VP Product Strategy.

"What this study shows," adds Press Ganey CEO Patrick Ryan, "is that when one is focused on that patient experience, it has dramatic impact on your overall operating performance in a hospital."

For example, hospitals that did poorly, scoring between zero and 19 VBP points for answers patients gave to their HCAHPS survey questions, experienced a 0.4% reduction in Medicare payments, on average. While hospitals that scored in the highest brackets in HCAHPS survey questions, between 80 and 100 points, received on average a .1% readmissions penalty.

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2 comments on "Higher Readmission Penalties Linked to Low HCAHPS Scores"


Michael Solomon, Ph.D. (1/24/2013 at 3:57 PM)
Recognizing that patient satisfaction may be a factor in helping patients avoid returning to the hospital is a good starting point, but the emphasis on HCAHPS diverts attention from the more important goal of having patients who are actively engaged in managing their health and healthcare post-discharge. Providing a patient with a discharge summary and education materials about his or her condition and helping a patient comply with having a physician exam post-discharge are practices shown to be related with reduced readmissions. Except for the patient-provider communications item, the HCAHPS does not measure these important indicators of actively engaged patients. Programs to reduce preventable readmissions should move beyond satisfied to actively engaged patients. A reliable and valid measure of patient activation, known as the PAM-13 exists. Interventions such as web-based self-management tools have been shown to increase patient activation.

Steve Wilkins (12/13/2012 at 11:37 AM)
Correlation is not the same as causality. The conclusions drawn linking patient experience (as nebulously defined by HCAHPS) to reduced hospital readmissions sure seems like a big reach to me. Steve Wilkins, MPH Mind the Gap www.healthecommunications.wordpress.com