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P A T I E N T - C E N T E R E D C A R EExcellence in Patient Satisfaction Within a

Patient-Centered CultureBarbara Cliff, RN, PhD, FACHE, President/CEO, W indber M edical Center

M any healthca re leaders are anticipating th e G enters for Medicare & MedicaidServices' (GMS) value-based purchasing (VBP) program, in which paymentsare based partially on patie nt satisfaction. To qualify for incentive payou ts, hospi-tal executives need to look intently at ways to boost HGAHPS (Hospital GonsumerAssessment of H ealthcare P roviders an d Systems) scores. A patient-centered culturecan help facilitate improvements in HGAHPS scores.VBP ANO HCA HPSHospital VBP links a portion of hospitals' Inpatient Prospective Payment Systempay m ent from GMS to performa nce on a set of quality measures. The H ospital VBPprog ram was established by the Affordable Gare Act of 2 0 1 0 . Many final rules issuedin 2011 ou tline th e param eters of the prog ram for fiscal years 2013 and 2014 (GMS2012). GMS (2012) clarifies:

The total performance score for hospital V B P in FY 2 0 1 3 will have tw o components: theclinical process domain, which accounts for 7 0 % of the total performance score; andthe patient experience domain, which accounts for 3 0 % of the total performance score.The HCAHPS survey is the basis for the patient experience domain.The HGAHPS survey was the first na tion al, stand ardized , p ublicly reported survey

of patien ts' perspectives of hos pital care. The survey is designed to prod uce dataabout patients' views about care that allow objective, meaningful comparisons ofhospitals in areas of importance to consumers. Additionally, public reporting of theresults incentivizes hospitals to improve quality of care and enhances accountabilityin healthcare by increasing transparency (GMS 2010).

In summ ary, VBP provides financial incentives for hosp itals tha t m eet certainquality performance standards including m easures that focus on patient percep-tion s of care. Tha t such m easures are included further solidifies th e eco no m ic signifi-cance of providing ex cellent care. These incentives are anticipated to com pel m orehealthcare leaders to ch am pion the imp ortance of providing patient-centered care.P A T I E N T S A T I S F A C T I O N I N A P A T I E N T C E N T E R E D C U L T U R EUnder V B P , it will be more important for hospitals to pay attention to patient satisfac-


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JOURNAL OF HEALTHCARE MANAGEMENT 57:3 MAY/JUNE 2012

hospitals ho w well they are meeting patients' needs and can call attention to opportunities for improvement (Frampton etal. 2008 ).

Planetree Designated Patient-Centered Hospitals represent the highest levelof achievement inpatient-centered care based onevidence and standards, and thePlanetree Designation Program is the only known program to formally recognizeexcellence inpatient-centered care across the continuum of care (Planetree 2012).Demonstrating the positive association between patient-centered care and patientsatisfaction, Planetree Designated Patient-Centered Hospitals consistently exceednational HCAHPS performance benchm arks for patient satisfaction (see Exhibit 1).These hospitals as a group perform better than th e CMS nation al average in all tenof the publicly reported HCAHPS categories, most significantly inoverall rating andquestions about willingness to recommend (Frampton and Channel 2009).C A S E I N P O I N T A T W I N D B E R M E D I C A L C E N T E RWindber Medical Center (WMC), a 54-bed hospital in westem Pennsylvania, is a Plane-tree Designated Patient-Centered. Hospital. We are the only P lanetree hospital in Pennsyl-vania and o ne of only 13 hospitals in the country to have achieved Planetree Designationstatus. We have demonstrated a strong assodation between patient-centered care andexcellence in patient satisfaction. Our HCAHPS scores corisisteny exceed nat ional, state,>E X H I B I T 1HCAHPS Comparison ot US Planetree Designated Hospi ta l Average and CMS Nat ional Average;Repo rting T ime Pe r iod : 04 / 01 / 20 10 - 0 3 / 31 / 2011

90

85

80

75

70

65

60

55

50

45

8E8 180

I78

7572

67 168I I ^60 I I 59

68

601

8279

76 I

I7 067 nI II II I Designated Hospital Average CMS National Average


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PATIENT-CENTERED CARE

and regional averages. In fact, W M C w a s the recipient of the H ealthGrades Ou tstand-ing P atient Experience Award for 2 0 1 1 , placing us within the to p 10 percent of hospitalsnationw ide for exemplary service to patients (H ealthGrades 2012).T H E F I N A N C I A L B E N E F I T O F P A T I E N T S A T I S F A C T I O NImprovements in patient satisfaction can also contribute to positive financial results(Hall 2008). Increased patient loyalty is associated with revenue gains and enhancedreputation is associated with increased patient volumes and profits, reduction inma lpractice claims, and greater efficiency (Hall 200 8). In additio n, "hospitals withhigh performa nce scores in pa tient care are more profitable" (Press Ganey 2011).US hospitals within the to p 25 percent of HCAHPS scores are, on average, the mostprofitable and have the be st clinical ou tcom es (Press Ganey 2011), suggesting that agreat patient experience coupled with superior clinical outcomes can result in stron-ger financial performa nce as well.F U T U R E S I G N I F I C A N C EExcellence in pa tient satisfaction with in a patient-centered culture can result inimproved outcom es. Healthcare leaders need to recognize the im portance of exemplarycare that is truly patient centered and should listen to the voice of the patient. Institu-tions that endeavo r to seek and respond to consu mer expectations and preferences willbe distinctly poised to reap th e benefits of pa tient satisfaction, improved quality of care,and greater reimbu rsement (Frampton and Chan nel 2009). With the pending launchof V B P , the benefits of patient-centered care bea r unprecedented significance.R E F E R E N C E SCenters for Medicare & Medicaid Services (CMS). 2012. "HCAHPS Executive Insight." PublishedJanuary 2012. www.hcahpsonline.org/executive_insight .. 2010. "HCAHPS Fact Sheet." Published July 2010. www.hcahpsonline.org/files/HCAHPS

Fact Sheet 2010.pdf.Co mm on we alth Fund. 2012. "Why No t the Best?" Accessed March 9, 2012. ww w.wh ynotthebest .org.Fram pton, S., and P. Cha rmel (eds.) . 2009 . Putting Patients First: Best Practices in Patient-CenteredCare, 2nd ed. San Francisco: Jossey-Bass.Frampton, S., S. Guastello, C. Brady, M. Hale, S. Horowitz, S. Bennett Smith, and S. Stone. 2008.Patient-Centered Care Improvement Cuide. Derby, CT: Planetree. www.patient-centeredcare.org.Hall, M. F. 20 08 . "Looking to Imp rove Financial Results? Start by Listening to Pa tients." HealthcareFinancial Management 62 (10) : 76-80.

HealthGrades. 2012. "Quality Awards and Ratings." Accessed February 18. www.healthgrades.com.Planetree. 2012. "What Is Planetree Designation?" Accessed February 18. http://planetree.org/?pageJ d = 8 9 .Press Ganey. 2011. "Press G a n e /s 2011 Pulse Report Provides Broad Look at Key Trend s in H ealthCare." Publ ished Novem ber 14. ww w.pressganey.com /pressroom/pressroom _2011/ l l - l l -14/Good_Pat ient_Care_Equals_Good_Business_%E2%80% 93_New_Repor t_Shows_Higher-Performing_Hospitals_Eam_More_Profi ts .aspx.


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