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Patient Experience Scores Skew by Region, Providers Say

Cheryl Clark, for HealthLeaders Media, January 18, 2011

A federal proposal to base 30% of hospital "incentive" payments on patient experience scores is meeting with strong resistance, in part because of concerns that culturally, patients in some parts of the country are just harder to please.

"We have to look at the data, but there's a perception that some parts of the country do better than other parts," says Blair Childs, senior vice president for public affairs for Premier Healthcare Alliance, a performance improvement group with 2,400 hospitals. "It might be less a function of what the hospital does than the attitude of the population. For example, In New York City, they are grumpier than they are in Minneapolis."

For example, patients in New York, New Jersey, and Pennsylvania, one of nine survey regions in the country, are indeed less likely to answer "definitely yes" that they would recommend the hospital where they received care to friends and family than patients in the other eight regions, according to charts from 2010 Press Ganey surveys. Other possible answers are "probably yes," "probably no," and "definitely no."

The Press Ganey survey found that 73% of patients in New England states, from Connecticut and Massachusetts, Maine, New Hampshire, Rhode Island and Vermont, are likely to recommend, versus 64% in New York, New Jersey and Pennsylvania.

Patients in Great Plains states such as Iowa, Kansas, Minnesota and Nebraska are among the likeliest to recommend. They scored 72%, while south central region patients in Arkansas, Louisiana, Oklahoma and Texas score 71%. 19 states along the lower eastern seaboard, in the southeast, and in the west from California to Washington were 68% likely.

Press Ganey surveyed patients with that and other questions used in the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) questionnaire. Under the federal proposal for Hospital Inpatient Value-Based Purchasing incentive payments, patient experience scores will be used to determine 30% of reimbursement for discharges at more than 3,000 hospitals.

The Centers for Medicare & Medicaid released a 126-page document Jan. 7 detailing how it will make value-based purchasing incentives. There is a 60-day comment period which ends March 8. The nine-month measurement period to determine the scores begins July 1.

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8 comments on "Patient Experience Scores Skew by Region, Providers Say"


R Daniel King (1/20/2011 at 7:47 AM)
Presently, hospital organizational culture thrives in two environments: political or accountable. The majority function in a political environment where leadership chooses the politically protected and politically isolated creating a win/lose polarizing environment that fosters dependency and mistrust that leads to failure in patient and financial outcomes. In an environment of accountability everyone is accountable, starting with leadership, creating a win/win innovative environment that fosters interdependency and trust that leads to excellence in patient and financial outcomes. Simply stated, it's the culture stupid, and the dominance of the win/lose political environment where hospital departments function as bunkers where the politically protected fight and scheme to preserve the status quo and the politically isolated struggle and mostly fail to inject excellence. This environment is why hospitals have almost as many annual preventable deaths as all of World War II. That fact alone sums up the patient experience and the only way to lower it is the hospital industry realize it has a leadership chasm that has led to a quality chasm that is unaffordable thanks to the decades of command and control self-serving regulations inflicted by CMS. Until the federal government and hospital leadership accept this fact, because cultural change starts with leadership, the nation's health care delivery system will remain operationally inefficient and quality challenged on a path to economic Armageddon. And nothing in the present design of ObamaCare will deter this ending, if anything it will accelerate it.

Michael Krivich, FACHE, PCM (1/19/2011 at 1:43 PM)
As difficult as this appears to be, providers need to begin looking outside of themselves and using Customer Experience Management to solve this challenege. Individuals are only "patients" 1/3rd of the time you interact with them. The other 2/3rds of the time they are customers. CEM requires the organization to manage the individuals experience across all touch-points beginning to end. Only then when you are actively managing customer experiences and meeting expectations, will you be able to improve satisfaction, revenue and market share. It is not impossible if you apply innovation, creativity and learnings from other industries.

Micahel Krivich (1/19/2011 at 1:29 PM)
It's time for the healthcare industry, namely hospitals and health system to manage customer experiences though customer experience management programs. More than just the "patient" experience, it forces the organzation to understand and manage those experiences enhancing that experience. CEM leads to higher quality, lower cost, increased revenue and market share. It forces an organzation to look outside-in instead of inside-out based on the view of their customers. Individuals aree only patienst in only 1/3rd of the time you interact with them. The other 2/3rds of the time they are consumers. So maybe its time to start lisening to them and using that to drive change.