Summary: Quality measurements for health care providers, hospitals, surgical centers and so on are a hot topic. Everybody’s got a favorite source (Yelp? healthgrades.com? AHRQ? Leapfrog? Consumer Reports? U.S. News and World Report? Your Facebook friends?) but the bottom line seems to be this: There’s a cacophony of competing sources of measurement, none of them particularly strong. So we were interested to see this recent study revealing the outcome of the latest government effort to resolve the problem, as described by Alexandra Robbins in The Atlantic.
“When Department of Health and Human Services administrators decided to base 30 percent of hospitals’ Medicare reimbursement on patient satisfaction survey scores, they likely figured that transparency and accountability would improve healthcare. The Centers for Medicare and Medicaid Services (CMS) officials wrote, rather reasonably, ‘Delivery of high-quality, patient-centered care requires us to carefully consider the patient’s experience in the hospital inpatient setting.’ They probably had no idea that their methods could end up indirectly harming patients.
“Beginning in October 2012, the Affordable Care Act implemented a policy withholding 1 percent of total Medicare reimbursements—approximately $850 million—from hospitals (that percentage will double in 2017). Each year, only hospitals with high patient-satisfaction scores and a measure of certain basic care standards will earn that money back, and the top performers will receive bonus money from the pool.Patient-satisfaction surveys have their place. But the potential cost of the subjective scores are leading hospitals to steer focus away from patient health, messing with the highest stakes possible: people’s lives.” Alexandra Robbins, The Problem With Satisfied Patients, The Atlantic.