HCAHPS Scores Show Wide Variation

Other hospitals on the negative side of the scorecard include 88-bed Lehigh Regional Medical Center, in Lehigh Acres, FL and 146-bed St. Joseph's Hospital of Philadelphia. Of Only 35% of St. Joseph's patients and 39% of patients at Lehigh said they would definitely recommend the hospital to family and friends, with 28% and 26% saying they would probably or definitely not recommend their hospitals.

There's a huge gap between 98% and 35%.  HealthLeaders asked some of these hospitals to explain the difference.

Beverly Smith, Westlake Regional's patient representative, says she calls patients on the phone and speaks to them in person after they've been discharged. It's been her full time job for the last five years. She reads each question to each patient and notes their response on the form.

The reason Westlake gets such good responses, Smith says, "is we just have excellent doctors and nurses."

Cohen says that CMS does adjust for patient factors that might influence how someone may respond to a survey, such as education, age, and how the responder rates their own health status. And there is a correction for phone versus mailed surveys, because patients asked questions by a live human during a phone call are apparently less likely to give a negative response.

There is no adjustment for self-administering hospitals versus those who hire a vendor.  

"We feel we would get better responses doing these on a one-to-one" Smith says. Besides, she adds, Westlake "could not afford a vendor or a company (to do these surveys) at the time we started (doing them)," Smith says.

The hospital also is the biggest employer in community of 15,000 people, and Smith attends the same church as many town residents.

Smaller, specialty surgical hospitals tend to do well on the HCAHPS "would you recommend" question, especially if they are newer and physician-owned as many of them are.

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