Patients’ Happiness and Medicare Reimbursement

There are many reasons a patient may be happy or unhappy with his or her hospital stay.  The most obvious reason is whether the health issue necessitating that stay has been resolved.  But there are many other reasons that patients might or might not be happy, from whether the sink in their room was too small to the lack of current and interesting magazines at hand.  The New York Times explains how these seemingly small issues can have a big effect on hospitals:

Winning praise from patients has become a pressing — and often elusive — obsession for NYU and for hospitals nationwide. In the coming months, Medicare will start taking patient satisfaction into account when reimbursing hospitals. Disgruntled patients will mean reduced revenue, a frightening prospect for hospitals already facing empty beds because of the recession and pressure from insurers to hold down costs.

Medicare’s new rule, mandated in the Affordable Care Act, pits hospitals against one another in a competition to best satisfy patients; those with the best scores will receive more money.

But some hospitals are worried that assessments from patients like Ms. Schwartz can be influenced not just by the quality of their care, but also by amenities like single rooms, renovated units and tasty food. And hospitals in cities and certain regions, like the Northeast and California, tend to get lower ratings, raising concerns that their revenues will be reduced simply because patients in those places are more disposed to grumble about things that a polite Midwesterner or Southerner would forgive.

“Hospitals are going be punished financially by the federal government for things they can’t control,” said Dr. James Merlino, chief experience officer at the Cleveland Clinic.

Surprisingly, some of the nation’s most prestigious hospitals, including Cedars-Sinai Medical Center in Los Angeles and the University of Chicago Medical Center, get lower marks from patients on most areas of patient experiences, according to the government’s Hospital Compare Web site.

So do many of New York City’s elite institutions, including NewYork-Presbyterian Hospital, the Mount Sinai Medical Center and Beth Israel Medical Center. Some hospitals, like NYU, get bad patient reviews even as they score average or superior in measures of clinical care from the government and accreditation groups.

“People in New York have very high expectations about what it means to be taken care of,” said Dr. Katherine Hochman, an NYU physician. “When they don’t get their food on time and have to spend eight hours in the emergency department, well, that’s just not their image of what a world-class institution is.”