Research suggests has it that patient experience improvements may have reached their peaks. Have improvement rates bumped their head against a ceiling. Rates went flat since the Centers for Medicare and Medicaid Services (CMS) connected patient experience scores to value-based incentives.
Something about the ceiling observation reminds us of Charles Holland Duell. It’s one of those obscure names from American history. If you don’t recognize the name, he was the US Commissioner of Patents in the late 1800’s. Charles Duell is remembered for supposedly saying: “Everything that can be invented has been invented.”
Are patient satisfaction scores as good as it gets?
Have advances in patient satisfaction scores actually reached their ultimate upper limit? It remains to be seen if the research predicts the future. The study, published in Health Affairs, reports that “patient hospital experience improved modestly, but there’s no evidence that Medicare incentives promoted meaningful gains.”
The research team looked at the impact of CMS’s strategy of “tying payments to performance under the Value-Based Purchasing (VBP) program.” Patient experience improvements were concentrated in the period before the program was implemented.
The VBP incentives may need adjustments. The researchers suggest: “The rewards offered to most hospitals under the VBP program are quite modest and thus too small to motivate change, particularly considering the relatively small individual contribution of each of the eight experience measures.” Also, there is little reason for high-performing hospitals to make improvements.
Researchers concluded: “While certain subsets of hospitals improved more than others, we found no evidence that the program has had a beneficial effect. As policymakers continue to promote value-based payment as a way to improve patient experience, it will be critical to ensure that payment is structured in ways that actually drive improvement.
“Alternative approaches—such as using stronger incentives or more narrowly focused metrics—are needed to clarify how to improve the experience of patients in US hospitals.”
By the way, he didn’t actually say that…
As for the infamous 1899 quote, Commissioner Duell never said that. (A myth that has widely been attributed to him in error.) In fact, Duell was an advocate for innovation. He told Congress that the future of success in America depended on ingenuity and invention. And if patient experience improvements require breakthrough energy, hospitals need to apply a dose of innovation—with or without a connection to value-based reimbursement.