Higher Readmission Penalties Linked to Low HCAHPS Scores

Cheryl Clark, 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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