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How Grumpy Patients Can Cost Hospitals Big Bucks

Cheryl Clark, for HealthLeaders Media, January 20, 2011

Under the proposed regulations, 30% of a hospital's value based purchasing score will be weighted on patient experience based on the answers they give to eight survey questions.

Not only is 30% too high, but even 20% is unfair, says Vincent Fitts, associate vice president of informatics for the Greater New York Hospital Association.

"Wholly separate from the apparent regional bias in HCAHPS results and the fact that large urban hospitals generally fare worse, the current formula penalizes hospitals that treat a higher-than-average percentage of patients for whom English is a secondary language – even though they tend to express satisfaction with their care," Fitts says.

"We simply don’t think HCAHPS scores accurately reflect patient experience in the New York metropolitan area.”

The questions cover communication with doctors and nurses, responsiveness of hospital staff, pain management, communication about medicines, cleanliness and quietness of hospital environment, discharge information and overall rating of hospital.

I asked Nate Kaufman, a hospital analyst who flies around the country consulting with healthcare systems and physicians about the Affordable Care Act, what he thought about a "grumpiness differential."

He has a much different perspective. In his view, those hospital groups that are complaining doth protest way too much.

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2 comments on "How Grumpy Patients Can Cost Hospitals Big Bucks"


Jean Budding (2/4/2011 at 2:07 PM)
I agree with Nate Kaufman. Iowa hospitals have been paid unfairly. -Tweener hospitals are reimbursed lower than most hospitals in the nation. The big states didn't care when our reimbursement was 65% of cost. We have great patient scores. And, based on personal experience in Arizona, we have excellent care.

Richard Buchler (1/25/2011 at 5:12 PM)
We have to be careful that we don't make decisions based on opinions versus facts. The only fact in this story is that hospitals in these regions receive lower scores on patient satisfaction. There may be a large population of inherently unhappy people in these regions, but nothing in the original Press Ganey report nor this article supports that conclusion. It is just as likely that those hospitals provide care that is less satisfying to patients than hospitals in the rest of the country.