How Does Patient Satisfaction Impact Reimbursement?

    

The surveys don’t lie. The data on current surveys point to congruence between better provider care, patient satisfaction, and reimbursement.

It is well-documented that when hospitals compete with one another, it typically results in a better deal for patients in the form of lower costs, higher quality care, and better patient outcomes.

At least, that’s the expectation.

After all, patients are customers who can and will take their business anywhere that they determine will offer a better experience, just like consumers of any other product or service.

There is quantifiable evidence in the form of patient experience surveys supporting the notion that quality outcomes and high levels of patient satisfaction lead to quality improvements and better reimbursement pipelines.

One of the most reputable and reliable surveys is the Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS), also known as H-Caps.

Although the H-Caps survey typically measures data relating to the patients’ perspectives of their care experiences, it can also shed light on how hospitals can and should improve processes relevant to care quality, as well as on process impact to reimbursement.

For example, Medicare reimbursements are tied, in part, to the patient satisfaction portion of the survey.

Conversely, compliance regulations are linked to reimbursement penalties for hospitals that fail to meet patient satisfaction metrics. Surveys can allow hospitals to compare themselves to other organizations and identify areas in need of improvement.

Poor survey results could result in hospitals forfeiting some reimbursements. The Centers for Medicare & Medicaid Services currently withhold one percent of Medicare payments, 30 percent of which are tied to H-Caps survey scores, according to the American Medical Association Journal of Ethics.

Patient experience means a lot for brand reputation. There is direct association between brand reputation and the ability to capitalize on market share and reimbursement.

The most competitive hospitals are looking closely at how they engage with their patient groups. They use the patient experience as a valuable tool for strategic and competitive advantage in gaining market share.

Again, using results of patient satisfaction surveys, like H-Caps and Press Ganey, allows hospital marketing managers to tailor loyalty programs―birthday e-cards, appointment reminders, periodic newsletters―to current patients and bolster reputations with prospective patients.

Top-performing hospitals with better patient outcomes are more inclined to have best practices in place, which lead to quality improvement, lower readmissions, and less utilization of unrequired healthcare services.

Some of the best-performing hospitals have standardized best practices in place regarding communicating patient financial obligations. That’s a win-win for improved patient satisfaction and reimbursement when all involved parties are on the same page, especially when the time comes to issue billing statements.

There are no surprises involved and the revenue stream can generally move along more quickly when the hospital uses the same processes and protocols early on during the patient encounter.

The patient satisfaction survey provides feedback that guides hospitals in policies and procedures and allows patients to have a voice in their own healthcare. Informed by survey data, hospitals can initiate procedures to make the patient experience better in terms of effectiveness and affordability.

Significant portions of reimbursement and revenue growth are attained via repeat patient visits. Patients seen in hospital settings are typically chronically or acutely ill and very observant of the type of care and attention they receive while in the facility.

When given a choice, patients visit hospitals they trust to provide the best experience and outcomes―and they share this information with other patients via word of mouth and online reviews.

Hospitals that pay close attention to the patient experience regarding overall care generally advance their financial goals toward greater revenue growth because of a combination of best practices, current technology, and forward-thinking patient communication protocols.

Surveys, adherence to compliance regulations and patient impression of brand reputation all tie into how hospitals are able to generate positive revenue streams while providing quality of care for their patients. Not surprisingly, top performing hospitals with better patient-oriented best practices in place tend to have better outcomes, higher patient satisfaction levels and more consistent revenue streams. All of these attributes combined contribute to and impact reimbursement in a positive way. 

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About The Author - Cody Strate

For more than 10 years, Cody has helped healthcare organizations worldwide eliminate the costs and risks of paper through e-forms and e-signature solutions. In addition to helping others achieve their paperless goals, Cody finds time to put his biochemistry degree to work in the kitchen testing out new recipes on his unsuspecting family.

Feel free to email me here.