HCAHPS: Missing the Measure of Experience vs. Satisfaction

patient satisfactionEveryone is in favor of improving patient care. And, as the theory goes, the government’s incentive system of rewarding quality performance—HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems)—is the universal pathway.

But this year, the healthcare reform’s pay-for-performance method is more penalty than reward. “Medicare is giving bonuses to a majority of hospitals that it graded on quality,” Kaiser Health News reports, “but many of those rewards will be wiped out by penalties the government has issued for other shortcomings, federal data show.”

The Centers for Medicare and Medicaid Services (CMS) describes the HCAHPS survey as “the first national, standardized, publicly reported survey of patients’ perspectives of hospital care.” It remains to be seen if the survey meets its first goal, “to produce data about patients’ perspectives of care that allow objective and meaningful comparisons of hospitals on topics that are important to consumers.”

Understandably, the revenue connection has hospitals and health systems diligently tracking HCAHPS scores. But a more-than-fair observation reminds everyone that “patient experience” is not the same as “patient satisfaction.” Moreover, critics wonder if HCAHPS is actually the best representation of “topics that are important to consumers.”

Things Hospital Patients Say They Really Want

Asking the consumer public—patients, prospective patients, friends and family—what they want or value the most in a healthcare experience often differs from the 21 “patient perspective” HCAHPS survey.

What patients say—in a routine visit to a doctor’s office or an in-patient hospital stay—include things that more the “experience” in the direction of “satisfaction.” Some frequently cited examples (a partial list, in random order) include:

  • Hospital Patient Portal Online
  • Improved “face time” with provider (including eye contact, empathy, and connectivity)
  • Improved communications skills including avoiding jargon and technical/medical terms
  • In office (free) Wi-Fi availability
  • Online tools for access to test results, pay bills, etc.
  • Physician-patient email
  • Printed (and easily understood) summary of diagnosis, treatment plan, follow-up
  • Reduced wait time
  • Same day or next day appointments
  • Text or voicemail notice when office is behind schedule
  • Transparency regarding cost of care

HCAHPS is a fact of life for hospitals and administrators and managers who will continue to be challenged by the ways and means of improving the numbers. But it’s important for hospitals to recognize that HCAHPS isn’t the only means to view, and properly gauge patient experience or patient satisfaction. What’s more, from a marketing point of view, satisfaction surveys look backward, and they don’t tell you how many prospective patients never made an appointment or declined to use the facility.

The needs, interests and wants of patients are far broader in scope, and (admittedly) difficult to identify, quantify and deliver experience to positive satisfaction.

FURTHER READING: For more on this topic…

1,700 Hospitals Win Quality Bonuses From Medicare, But Most Will Never Collect, Kaiser Health News

The Ideal Doctor Revealed: What Patients Want Most Before You Say Hello

Patients Want Online Appointment Scheduling

Lonnie Hirsch

Lonnie Hirsch

About Lonnie Hirsch

Co-Founder of Healthcare Success Strategies, Lonnie has consulted for over 2,000 health care clients during his 20-year career. Lonnie writes for many healthcare publications, and also has spoken at hundreds of venues nationally. His topics include patient experience, customer service, marketing, branding and business development.

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