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Maximizing Healthcare Reimbursement Through Higher Patient Satisfaction Scores

In a consumer-driven industry, healthcare organizations must compete to gain new patients and maintain their loyalty. One effective way is to earn high patient satisfaction scores that demonstrate value to customers seeking a trusted healthcare partner.

But gaining patient trust isn’t the only benefit of high patient satisfaction scores. Medicare payment systems link patient satisfaction scores with reimbursement rates, making quality patient care a primary determinant of an organization’s viability and motivating healthcare administrators to implement patient satisfaction strategies.

Improved patient satisfaction begins with a focus on patient experience.

The relationship between patient satisfaction scores, reimbursement, and health outcomes

The Centers for Medicare and Medicaid Services’ (CMS) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scoring helps hospitals and governing bodies evaluate patient satisfaction through quantitative measurements. CMS has reported scores since 2008 to help consumers make objective comparisons between healthcare organizations and incentivize those organizations to improve their quality of care.

The role of HCAHPS in determining reimbursement

Since 2012, HCAHPS’ patient satisfaction scores have been pivotal in hospital reimbursement through the Hospital Value-Based Purchasing Program. According to the program, hospitals with higher HCAHPS scores earn higher reimbursements.

The HCAHPS survey evaluates key elements of the patient experience, including communication with doctors and nurses, responsiveness of hospital staff, hospital cleanliness and noise level, pain management, and availability of information. Scores for each of these areas and others are calculated into a single, overall patient satisfaction rating.

The link between patient satisfaction and financial success

Low HCAHPS scores can negatively affect a hospital or health system’s reputation and limit the amount of Medicare funding it receives. In 2019, $1.9 billion in value-based payments was available to hospitals for inpatient care. Those that had the highest HCAHPS scores — across the domains of clinical outcomes, safety, person and community engagement, efficiency, and cost reduction — received the most financial support, while those with exceptionally low scores received financial penalties.

The connection between patient satisfaction and better health outcomes

There is substantial debate surrounding the relationship between patient satisfaction scores and clinical outcomes. While some studies have found a correlation, others question the implications that patient feedback can have on physician behavior.

In an article published in the Journal of the American Society of Plastic Surgeons, a group of physicians expressed concern over healthcare professionals avoiding difficult questions — including those related to a patient’s weight, drug and alcohol usage, and other lifestyle habits — in an effort to increase their satisfaction scores. The physicians also questioned unnecessary hospital admissions, the over-prescription of drugs, and unnecessary testing as further examples of healthcare professionals’ attempts to keep patients happy while potentially compromising care quality.

These factors are important for healthcare leaders to consider as they navigate HCAHPS scores. Ideally, achieving higher patient satisfaction lies in having an honest, open, and empathetic approach to care rather than simply complying with patient requests. This approach leads to both higher patient satisfaction scores and improved patient outcomes without jeopardizing quality.

Effective strategies for improving patient satisfaction scores

On a more granular level, improve patient satisfaction scores by using a multifaceted approach that focuses on three crucial elements: improving quality of care, fostering a strong patient-practitioner connection, and creating an environment conducive to success.

Improving quality of care

Every healthcare organization has its own set of challenges to overcome before it can improve the quality of care it provides, but all hospitals must focus on the following:

  • Conducting effective pain management — No two patients’ pain thresholds are exactly alike. Healthcare professionals must be intimately familiar with methods to evaluate a patient’s pain levels, including numerical rating scales, visual analog scales, and categorical assessments. Managing pain levels with medication, repositioning the patient, or other pain management tactics along with reassessing patients’ pain regularly thereafter are primary measures of quality care from a patient perspective.
  • Minimizing environmental stressors — Patients’ surroundings can have a significant impact on their hospital experience. Loud noises and bright lights may negatively affect their sleep, stress levels, and the healing process. Training staff to pay close attention to their surroundings and empowering them to minimize disruptions can help ensure patients will benefit from an environment that facilitates recovery.
  • Encouraging professional development — As evidence-based practice protocols evolve, so must the practitioners who employ them. Creating an organized, ongoing professional development program helps ensure your clinical staff members are up-to-date on new treatment options and clinical care requirements. Professional development opportunities also increase employee engagement. The more engaged staff members are in their work, the more invested they are in their patients.

Fostering a strong patient-practitioner connection

Patients often experience a myriad of emotions when they enter the hospital, including anxiety, vulnerability, and fear. To help ease patients’ concerns and create a positive, nurturing environment, healthcare professionals must strive to create a strong, respectful connection with patients by:

  • Developing rapport Taking a few minutes to engage with a patient before beginning clinical treatment helps healthcare professionals establish trust and help allay any fears they may have. The more relaxed patients are, the better equipped they are to retain important information about their condition and care requirements.
  • Making care personal — Healthcare professionals demonstrate commitment to their patients when they make a sincere effort to connect with them. Using the patient’s name, asking questions that involve the patient in their care, and making eye contact are a few of the many ways healthcare professionals can foster more meaningful care practices. Punctuality also demonstrates respect for patients. If an organization is struggling to see patients on time, it may be time to reevaluate its scheduling and staffing.
  • Communicating consistently — Patients want to be informed. Providing regular updates on their condition helps alleviate feelings of confusion and unease that often accompany practitioner visits. Teach-back methods and nonmedical language also help healthcare providers improve communication by empowering patients and putting them at ease.
  • Listening well — The best insights on improving patient satisfaction often come directly from patients. Data from a range of sources can enable hospital leaders to review actual patient feedback rather than rely solely on overall patient satisfaction scores. Online reviews, social media comments, pulse surveys, and other feedback mechanisms can provide a comprehensive understanding of patients’ experiences and identify areas for improvement.

Creating an environment conducive to success

Lay the groundwork for an environment that supports your healthcare professionals in their efforts to provide high-quality patient care by:

  • Upgrading outdated systems — Slow, outdated systems delay treatment and cause frustration among patients and providers. Even small updates to appointment scheduling platforms, waiting room systems and signage, and nurse call buttons can increase providers’ efficiency and positively impact patient satisfaction.
  • Caring for the caregivers — Healthcare professionals who feel valued at work and find meaning in their profession create better experiences for their patients than those experiencing frustration and burnout. Healthcare leaders must ensure their staff members have access to the professional, psychological, and financial support they need.
  • Setting expectations — Healthcare facilities should regularly update their website, patient portal, and printed materials to ensure that important information is always readily available. Including an FAQ section within these materials that addresses prescription refills, after-hours care, and appointment scheduling helps minimize patient frustration and allows healthcare providers to focus their energy on treatment.
  • Ensuring cleanliness — No one wants to receive care in an environment that doesn’t feel sanitary and safe. By implementing exhaustive cleanliness practices that reach every corner of the building, including waiting rooms, bathrooms, and physicians’ offices, healthcare organizations better protect their patients and provide a high-quality care environment.

Improve your patient satisfaction scores

More than ever, a hospital’s success is contingent on its ability to prioritize patient experience. HCAHPS scores tie directly to hospital reimbursement, influencing healthcare leaders to create environments that foster safe, comfortable patient care. For many, that means working directly with their staff to improve clinician engagement to achieve better health outcomes.


Patient Experience: Fundamentals and New Frontiers

Gain actionable information to strengthen your patient experience and improve your HCAHPS scores. Download our research brief for insights on implementing tactics for more effective listening, asking patients tough questions, deploying patient-centered technology, and more.

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