Patient Satisfaction & HCAHPS Reimbursement

There’s no question about it—healthcare is quickly becoming a consumer-driven industry. As a result, healthcare facilities must now compete with one another to gain new patients and maintain their loyalty. For many of these institutions, that means earning high patient satisfaction scores that demonstrate their value to consumers eager to invest in a trusted healthcare partner.

But building a robust consumer base isn’t the only benefit of high patient satisfaction scores. Medicare payment systems have shifted in recent years, inextricably linking patient satisfaction scores with reimbursement rates. These shifts have positioned high-quality patient care as paramount to an institution’s viability and directly shaped every healthcare administrator’s patient satisfaction strategy.

What are HCAHPS Scores?

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scoring system helps hospitals and their governing bodies evaluate patient satisfaction through quantitative measurements. The HCAHPS survey can be broken down into a series of questions that evaluate key elements of the patient experience, including communication with doctors and nurses, the responsiveness of hospital staff, hospital cleanliness and noise level, pain management, and availability of information. Scores are provided for each of these areas and more and then calculated into a single, overall patient satisfaction rating.

While the Centers for Medicare & Medicaid Services (CMS) implemented the HCAHPS survey in 2006, public reporting of scores did not occur until 2008. In publicizing survey scores, CMS hopes to empower consumers to make objective and meaningful comparisons between healthcare institutions and incentivize those institutions to improve their quality of care.

Do HCAHPS Scores Impact Reimbursement?

Since 2012, HCAHPS patient satisfaction scores have played a pivotal part in hospital reimbursement through the Hospital Value-Based Purchasing Program. But how exactly does patient satisfaction impact reimbursement? According to the program, the higher a hospital’s HCAHPS scores, the higher their reimbursements will be, and vice versa.

As a result, low HCAHPS scores impact a hospital’s bottom line in two ways: by hindering their reputation among consumers and limiting the amount of funding they receive from Medicare. In 2016 alone, $1.5 billion in value-based incentive payments was available to hospitals. Those that had the highest HCAHPS scores, among other key factors, received the most financial support, while those with exceptionally low scores received financial penalties.

Do High Patient Satisfaction Scores Equal Better Health?

There is substantial debate surrounding the relationship between high patient satisfaction scores and clinical outcomes. While some studies have found a correlation between patient satisfaction and clinical outcomes, others question the implications that patient feedback can have on physician behavior.

In an article published in the Journal of the American Society of Plastic Surgeons, a group of physicians expressed concern over healthcare professionals avoiding difficult questions—including those related to a patient’s weight, drug and alcohol usage, and other lifestyle habits—in an effort to increase satisfaction scores. They also pointed to unnecessary hospital admissions, the over-prescription of drugs, and needless testing as further examples of healthcare professionals’ attempts to keep patients happy while jeopardizing the quality of care provided.

These factors are important for healthcare leaders to keep in mind as they navigate HCAHPS scores. For many, the key to achieving higher patient satisfaction and, in turn, reimbursement, lies in having an honest, open, and empathetic approach to care rather than simply satisfying all of a patient’s desires. When done effectively, this approach can simultaneously lead to higher patient satisfaction scores and improved patient outcomes.

How to Improve Patient Satisfaction Scores

Improving patient satisfaction scores is best achieved through a multifaceted approach focused on three crucial elements: improving the quality of care provided, fostering a strong patient-practitioner connection, and creating a space for success.

Improving the Quality of Care Provided

While each hospital has its own unique set of challenges to overcome before it can improve the quality of care it provides, all hospitals, at a baseline level, must focus on:

• Conducting Effective Pain Management: No two patient’s pain thresholds are exactly alike. To ensure all patients receive effective pain management, healthcare professionals must be intimately familiar with the methods used to evaluate a patient’s pain levels, including numerical rating scales, visual analog scales, and categorical assessments. Once they have identified their patient’s pain level, healthcare professionals must determine how best to manage it. Administering medication, repositioning the patient, or providing a cold compress are just a few of the many pain management techniques a healthcare professional can deploy. Healthcare professionals should also know how to reassess a patient’s pain after each technique has been administered.
• Minimizing Environmental Stressors: A patient’s surroundings can have a significant impact on their experience in a hospital. Loud noises and bright lights in particular may negatively affect their sleep and anxiety levels, disrupting the healing process. Training staff to pay close attention to their surroundings and empowering them to minimize disruptions helps ensure all patients can reside in an environment that facilitates their recovery.
• Encouraging Professional Development: As healthcare best practices evolve, so must the practitioners that implement them. Creating an organized, ongoing professional development program helps ensure all clinical staff members are up-to-date on new treatment options, pain management tactics, and clinical care requirements. Professional development opportunities have also been linked to increased employee engagement. The more engaged staff members are in their work, the more invested they are in their patients.

Fostering a Strong Patient-Practitioner Connection

Patients often experience a myriad of emotions when they enter the hospital, including anxiety, vulnerability, and fear. To help ease their patients’ concerns and create a positive, nurturing environment, healthcare professionals must strive to create a strong, respectful connection with their patients by:

• Developing a Rapport: Taking a few minutes to engage with a patient before beginning clinical treatment helps healthcare professionals establish a sense of trust with their patients and allay any fears they may be experiencing. The more relaxed a patient is, the better equipped they are to retain important clinical information about their condition.
• Making Care Personal: Healthcare professionals demonstrate commitment to their patients when they make a sincere effort to connect with them. Using the patient’s name, asking questions that involve the patient in their own care (“What matters to you?”), and making eye contact instead of distractedly looking at a computer screen are just a few of the many ways healthcare professionals can foster more meaningful care practices. Punctuality also demonstrates respect for the patient and their schedule. If an organization is struggling to see patients on time, it may be time for them to reevaluate their scheduling processes and/or staffing needs.
• Communicating Consistently: No patient wants to be left in the dark regarding their health. Keeping patients abreast of any updates to their condition helps alleviate the feelings of confusion and unease that often accompany a visit with a practitioner. Teach-back methods and non-medical language also help healthcare providers improve communication and empower patients to take charge of their health.
• Listening: The best insights on how to improve patient satisfaction come from the patients themselves. Hospital administrators are encouraged to examine data from a range of sources to reveal the true voice of the patient rather than relying solely on patient satisfaction scores. Online reviews, social media comments, pulse surveys, and more all help healthcare practitioners glean a comprehensive understanding of the patient experience and identify areas of improvement.

Creating a Space for Success

When it comes to improving patient satisfaction scores, creating a space for success is just as important as improving the quality of care provided and fostering connection. Creating a space for success simply means laying the groundwork for an environment in which all healthcare professionals are supported in their efforts to provide high-quality patient care. This can be achieved through:

• Upgrading Outdated Systems: Slow, outdated systems delay treatment and cause frustration among patients and providers alike. Even small updates to appointment scheduling platforms, waiting room systems and signage, and nurse call buttons can increase a provider’s efficiency and positively impact patient satisfaction.
• Caring for the Caretakers: Healthcare professionals who feel valued at work and find meaning in their profession create better experiences for their patients than those consumed by frustration and burnout. As a result, healthcare administrators must remain constantly in-sync with their employees and ensure they have access to the professional, psychological, and financial support they need to remain engaged.
• Setting Expectations: Healthcare facilities are encouraged to regularly update their website, patient portal, and printed materials to ensure pertinent information is readily available at all times. Including an FAQ section within these materials that addresses prescription refills, after-hours care, and appointment scheduling also helps minimize patient frustration and allow healthcare providers to focus their energy on treatment.
• Ensuring Cleanliness: No one wants to receive care in an environment that doesn’t feel sanitary and safe. By implementing exhaustive cleanliness practices that reach every corner of the building, including waiting rooms, bathrooms, and physicians’ offices, healthcare institutions can better protect their patients and put them at ease.

Improve Your Patient Satisfaction Scores

More than ever before, a hospital’s success is contingent on their ability to prioritize the patient experience. HCAHPS scores are directly tied to hospital reimbursement, putting pressure on healthcare administrators across the country to create environments that foster a safe, comfortable patient experience. For many, that means working directly with their staff to improve their quality of care and ensure they remain engaged at all times.