Excellence in Patient Satisfaction Within a Patient-Centered Culture

Abstract

Many Healthcare leaders are anticipating the Centers for Medicare & Medicaid Services' (CMS) value-based purchasing (VBP) program, in which payments are based partially on patient satisfaction. To qualify for incentive payouts, hospital executives need to look intently at ways to boost HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores. A patient-centered culture can help facilitate improvements in HCAHPS scores.VBP AND HCAHPSHospital VBP links a portion of hospitals' Inpatient Prospective Payment System payment from CMS to performance on a set of quality measures. The Hospital VBP program was established by the Affordable Care Act of 2010. Many final rules issued in 2011 outline the parameters of the program for fiscal years 2013 and 2014 (CMS 2012). CMS (2012) clarifies:The total performance score for hospital VBP in FY 2013 will have two components: the clinical process domain, which accounts for 70% of the total performance score; and the patient experience domain, which accounts for 30% of the total performance score. The HCAHPS survey is the basis for the patient experience domain.The HCAHPS survey was the first national, standardized, publicly reported survey of patients' perspectives of hospital care. The survey is designed to produce data about patients' views about care that allow objective, meaningful comparisons of hospitals in areas of importance to consumers. Additionally, public reporting of the results incentivizes hospitals to improve quality of care and enhances accountability in healthcare by increasing transparency (CMS 2010).In summary, VBP provides financial incentives for hospitals that meet certain quality performance standards - including measures that focus on patient perceptions of care. That such measures are included further solidifies the economic significance of providing excellent care. These incentives are anticipated to compel more healthcare leaders to champion the importance of providing patient-centered care.PATIENT SATISFACTION IN A PATIENT-CENTERED CULTUREUnder VBP, it will be more important for hospitals to pay attention to patient satisfaction and the overall patient experience. The program is likely to fuel further interest in patient-centered approaches to care. Patient-centered hospitals look to patients to help define a positive and satisfying patient experience. HCAHPS scores can show hospitals how well they are meeting patients' needs and can call attention to opportunities for improvement (Frampton et al. 2008).Planetree Designated Patient-Centered Hospitals represent the highest level of achievement in patient-centered care based on evidence and standards, and the Planetree Designation Program is the only known program to formally recognize excellence in patient-centered care across the continuum of care (Planetree 2012). Demonstrating the positive association between patient-centered care and patient satisfaction, Planetree Designated Patient-Centered Hospitals consistently exceed national HCAHPS performance benchmarks for patient satisfaction (see Exhibit 1). These hospitals as a group perform better than the CMS national average in all ten of the publicly reported HCAHPS categories, most significantly in overall rating and questions about willingness to recommend (Frampton and Channel 2009).CASE IN POINT AT WINDBER MEDICAL CENTERWindber Medical Center (WMC), a 54-bed hospital in western Pennsylvania, is a Planetree Designated Patient-Centered Hospital. We are the only Planetree hospital in Pennsylvania and one of only 13 hospitals in the country to have achieved Planetree Designation status. …