Providing a better patient experience continues to challenge hospitals and other medical facilities, despite:
- The numerous national conferences examining this issue and proposing means to better achieve it;
- The countless newspaper stories, magazine articles and blogs discussing this over the past several years.
What prompted this deluge of interest?
The Main Catalyst: The Affordable Care Act
Hospitals were traditionally rewarded by CMS for the number of Medicare and Medicaid inpatient discharges from their facilities. However, the Affordable Care Act introduced new performance standards, demanding that better quality of care now also be a requirement for reimbursement. This landmark piece of legislation is revolutionizing the healthcare industry because it impacts the visits of over 100 million people annually.
To emphasize their point, as of FY 2016, CMS will withhold 1.75% of its reimbursement to hospitals (CMS Base Operating Rate) to create its incentive program designed for better quality healthcare. This will amount to an estimated $1.4 billion to be distributed to high performing hospitals. In short, the hospitals falling short in their performance in certain areas will lose money, which in turn will be given to the high performing hospitals.
Defining Better Quality Care
CMS introduced a Value-Based Purchasing system to measure hospital performance in various domains of emphasis. While these quality of care domains certainly have evolved since their introduction in 2012, the patient experience has maintained a consistent 25%-30% weight in the program.
Improving the patient’s experience translates into more dollars for a hospital because their Total Performance Score (TPS) will be higher, even if all other domains just remain the same. As an example, simply increasing the TPS by 8 basis points (e.g., raising a patient experience score from 10 to 18) potentially can mean an increase of over $10 per annual discharge of Medicare patients.
In addition, it is good for future business, since potential patients can easily track a hospital’s ranking online before making their choice of hospital.
Read more about how to improve HCAHPS scores in this blog post.