But the percentages who answered positively to this question declined as the number of beds per hospital went up. For hospitals with 51-149 beds, positive response to communication with nurses was only 76% and for hospitals with 600 or more beds, 73%.
Dennis Kaltenberg, chief science officer for Press Ganey, says it's unclear why survey responses vary so much by region and bed size. "It's difficult to say whether it's the way patients answer questions, or it's the actual (quality of) the services being delivered," he says.
Childs says that assigning a weight of 30% to payment based on patient experience scores is controversial, and Premier is still studying the issue before issuing its written comments to CMS.
"I expect this will be a hotly-debated topic," Childs says.
Under the proposed regulations, hospitals will start receiving adjusted payments based on scores received on the following:
• 17 process of care measures. These include whether a patient with an acute myocardial infarction received an aspirin at discharge, or whether patients received prophylactic antibiotics prior to surgery.
• 8 patient experience of care measures asked within the HCAHPS survey, such as how well they perceived communication with their nurses and doctors, the responsiveness of hospital staff and their perception of the adequacy of pain management. HCAHPS surveys are administered randomly to patients between 48 hours and six weeks after discharge, and is not restricted to Medicare beneficiaries.