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Hospitals are in constant pursuit of both quality and patient satisfaction, and it is easy to assume that good marks in one will mean good marks in the other. That often is not the case, however, and hospital quality leaders must be careful not to assume correlation.
The importance of patient satisfaction has increased in recent years, particularly with the implementation of Hospital Value-Based Purchasing (HVBP), part of CMS’ effort to link Medicare payment to a value-based system. Under the HVBP, hospitals are paid for inpatient acute care services based on the quality of care rather than just quantity of the services, with poorly performing hospitals receiving less reimbursement. Patient satisfaction is one of the metrics used to determine quality, via the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey, the first national, standardized, and publicly reported survey of patients’ perspectives of hospital care,
There can be some overlap in the measures used to compute scores, such as Medicare’s star ratings and HCAHPS, but the scores must be interpreted correctly, says Emma Mandell Gray, a senior manager at ECG Management Consultants, who specializes in care model transformation and performance improvement.
Research has shown that there often is no correlation between patient satisfaction and hospital quality scores, but Mandell says that may be changing. (See the story in this issue for more on the research.) As the healthcare environment continues to transition toward value and patient satisfaction, and experience measures are being integrated into overall quality scores, additional emphasis is being placed on these areas, Mandell says. That will help to ensure a positive correlation between patient satisfaction and hospital quality scores, she says.
There are good reasons a hospital may have good quality scores and poor patient satisfaction scores, or vice versa, Mandell says.
“Hospitals are, oftentimes, a place where patients go as a last resort, admitted to the ED appropriately or not appropriately, and are a place where providers have to deliver difficult news to patients,” she says. “Those participating in patient satisfaction surveys often only remember the outcomes of the situation, such as a death or a diagnosis of cancer, so the scores become skewed.”
(See the story in this issue for more on the accuracy of patient satisfaction scores.)