March 29, 2008
Medicare releases hospital patient satisfaction data
Before choosing a hospital for an elective procedure, patients can now use the Centers for Medicare and Medicaid Services' Hospital Compare Web Site to see how former patients rated their experiences at various hospitals. Patients can compare hospitals based on how well patients felt the doctors and nurses listened to them, whether the patients felt respected by the hospital staff, and whether patients understood the instructions on what to do after leaving the hospital.
Patients can also use the Hospital Compare Web site to compare how many patients were treated for heart attacks, pneumonia, and various surgeries at nearby hospitals and see how much Medicare paid.
These are the federal government's latest steps to promote "value-driven health care."
"Everyone ought to have a motivation to get better quality and lower costs," said Michael Leavitt, secretary of the U.S. Department of Health and Human Services.
CMS launched the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey data Friday before a group of hundreds of journalists gathering in Washington D.C. for an annual conference.
Leavitt spoke of the need to transform the current "health care sector" into a "health care system" that is not based on volume but on value. While acknowledging that the quality measures are "still rather clunky," the Secretary said that they will become increasingly sophisticated, and by using them, the public can demand accountability.
That accountability, he continued, is crucial to improving quality and decreasing efficiencies, which can lead to lower costs. Controlling health care costs, he said, is critical to the United States' ability to be competitive in a global market.
"Health care is beginning to undermine the capacity of our country to be competitive," Leavitt said, referring to last week's projections that spending at the current rate could deplete the Medicare trust fund by 2019.
CMS says it has three broad goals with the HCAHPS data: 1) to provide meaningful and objective hospital comparisons on topics that are important to consumers; 2) to create incentives for hospitals to improve the quality of patient care; and 3) to enhance accountability through transparency.
Dr. Carolyn Clancy, director of the Agency for Healthcare Research and Quality (AHQR), called the site an "invaluable tool for picking the best hospital for your needs."
"Patient perspective on care is a critical part of quality," Clancy said, using the example of a patient who cannot follow hospital discharge instructions because they weren't explained in a clear way. That patient, she said, is likely to be readmitted to the hospital for an added, unnecessary expense.
About 20 percent of surveyed patients said they didn't receive written instructions at discharge. As for feeling respected, 84 percent of patients felt their physician treated them with respect but only 77 percent said nurses did.
Data from about 2,500 hospitals is currently available. CMS said its goal is to have at least 300 surveys completed per hospital and to add hospitals. Hospitals must collect and report their survey results if they want to receive annual 2 percent Medicare payment increases.
The surveys reflect the experiences of all hospital patients older than 18, but the cost and volume data is for Medicare patients only. Gerry Shea, of AFL-CIO's government affairs division and part of the Hospital Quality Alliance, said the future hope is to have similar measures for patients with commercial insurance. Leavitt said he hopes Medicare's leadership on transparency and quality permeates the entire health sector.
CMS and AHQR began developing the survey in 2002. The National Quality Forum, a private nonprofit dedicated to creating evidenced-based national standards to improve patient care, endorsed the survey in 2005. The survey asks patients 27 questions about aspects of their hospital experience, such as communication with staff, staff responsiveness, cleanliness, pain management, medication instructions and discharge information. The data is adjusted based on the type of survey (telephone or paper) and the patient's age and health status. This initial data launch is based on surveys taken between October 2006 and June 2007.
While it will hopefully be a useful resource to help patients make decisions about hospitalizations, Hospital Compare should be one of many factors taken into consideration, said Rich Umbdenstock, president and CEO of the American Hospital Association.
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