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Patient Experience Scores Skew by Region, Providers Say

Cheryl Clark, for HealthLeaders Media, January 18, 2011

For discharges in FY 2014, which begins Oct. 1, 2013, CMS proposes to add three 30-day mortality scores, eight hospital acquired condition measures and nine patient safety indicators, inpatient quality indicators or composite measures established by the Agency for Healthcare Research and Quality.

The period of evaluation would begin this July and extend nine months to March 31, 2012. Scores achieved during this period would be relayed to the hospital at least 60 days prior to Oct. 1, 2012. Payment based on these scores would begin for the fiscal year starting Oct. 1, 2012.

CMS declined comment on the controversy. In its 126-page proposal, it says in part, "We believe assigning a 30% weight to the patient experience of care domain is appropriate because the HCAHPS measure is comprised of eight dimensions that address different aspects of patient satisfaction."

The proposal also says that "Measures or measurement domains need not be given equal weight, but over time, scoring methodologies should be more weighted towards outcome, patient experience and functional status measures."

In summary, Childs of Premier notes that "it's a different world for hospitals now, with a different approach for payment and performance is being valued in a new way. Management of hospitals have really got to pay attention here."


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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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.