Medicare reduced payments to 1,451 hospitals based on poor patient satisfaction scores and quality measures, while 1,231 hospitals will see their payments increase due to positive scores. 
The payment adjustments were made through the Hospital Value-Based Purchasing program, which provides incentives to hospitals to provide quality care to patients. The program is one of the Affordable Care Act’s many cost containment measures. For many hospitals, the payment changes are so small, they will likely not even notice. According to Kaiser Health News, nearly half of the hospitals will lose or gain less than a fifth of one percent what Medicare would have otherwise paid. The Gallup Indian Medical Center in New Mexico will receive the biggest reduction (1.14%), and Arkansas Heart Hospital in Little Rock will see the biggest increase (0.88%). Medicare calculates a hospital’s quality score using a few different measures. This year, 45% of a hospital’s score is based on how well it followed clinical standards of care, and 30% is based on patient satisfaction questionnaires. The remaining 25% is based on the number of Medicare patient who died in the hospital or within a month after discharge. Medicare compares each hospital’s scores to other hospitals. It also considers how each hospital has improved its scores over the two year period that Medicare has been tracking the data. Medicare is planning on adding new measures next year and increasing the size of the penalties. Many hospitals are taking steps to ensure quality and patient satisfaction. For example, some have reduced nighttime noise, an item on the patient questionnaire, by replacing squeaky wheels on food carts and limiting cell phone use outside of rooms. Another area where hospitals can improve patient satisfaction is by ensuring they have adequate staffing. A survey of hospitalists found that:
The payment adjustments were made through the Hospital Value-Based Purchasing program, which provides incentives to hospitals to provide quality care to patients. The program is one of the Affordable Care Act’s many cost containment measures. For many hospitals, the payment changes are so small, they will likely not even notice. According to Kaiser Health News, nearly half of the hospitals will lose or gain less than a fifth of one percent what Medicare would have otherwise paid. The Gallup Indian Medical Center in New Mexico will receive the biggest reduction (1.14%), and Arkansas Heart Hospital in Little Rock will see the biggest increase (0.88%). Medicare calculates a hospital’s quality score using a few different measures. This year, 45% of a hospital’s score is based on how well it followed clinical standards of care, and 30% is based on patient satisfaction questionnaires. The remaining 25% is based on the number of Medicare patient who died in the hospital or within a month after discharge. Medicare compares each hospital’s scores to other hospitals. It also considers how each hospital has improved its scores over the two year period that Medicare has been tracking the data. Medicare is planning on adding new measures next year and increasing the size of the penalties. Many hospitals are taking steps to ensure quality and patient satisfaction. For example, some have reduced nighttime noise, an item on the patient questionnaire, by replacing squeaky wheels on food carts and limiting cell phone use outside of rooms. Another area where hospitals can improve patient satisfaction is by ensuring they have adequate staffing. A survey of hospitalists found that:
- 22% believe high workloads cause admissions and discharges to be delayed until the next shift.
- 25% believe high workloads demand too much time making it hard to fully discuss treatment options or answer questions from patients and their families.
- 22% believe they order more unnecessary tests and procedures because they do not have enough time to complete an adequate assessment of the patient.
- 19% believe high workloads actually worsen patient satisfaction.
With hospital reimbursement increasingly being tied to patient satisfaction and quality outcomes, it is more important than ever to ensure your staff’s workloads are manageable. Organizations that use locum tenens physicians and NPs to supplement their existing staff can accomplish that.
