Research Finds Link Between Patient Experience of Care Measures and Readmissions
Press Ganey Associates, Inc., a recognized leader in health care performance improvement, has released a new research study indicating hospitals that perform better on patient experience of care measures have lower patient readmission rates. The study is the first in the Performance Insights series, which will examine various aspects of the patient experience and identify current barriers to improvement and opportunities for advancement.
National trends suggest that hospitals struggle to identify and address the factors that influence readmissions. The Press Ganey study, however, reveals a strong association between lower rates of excess readmissions for certain conditions and higher performance on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) value-based purchasing metrics.
“Readmissions and HCAHPS are multifaceted, and performance on these metrics is sensitive to myriad factors – clinical practice, processes, systems, patient factors, cultural factors and community resources chief among them,” said Nell Buhlman, VP Product Strategy. “To effectively combat patient readmissions, hospitals can benefit from a foundational strategy that starts first and foremost with the patient – and efforts that are aimed at improving HCAHPS scores are an excellent initial step.”
Beginning October 1, the Centers for Medicare & Medicaid Services (CMS) put into effect a policy that reduces Medicare payment for hospitals with higher than expected readmission rates. Hospitals with excess risk-adjusted readmissions for heart attack, heart failure and pneumonia patients will lose as much as 1 percent of their total Medicare diagnosis related group payments. This penalty will increase to 2 percent in 2013 and to 3 percent in 2014. For this reason, reducing readmissions has become a top priority for hospitals and other stakeholders.
The Press Ganey study found that as hospital performance on HCAHPS increases, readmission penalties decrease. This pattern was most noticeable at the ends of the performance distribution: Very low overall HCAHPS performance (scores of 0-20) was associated with much-higher-than-average readmission penalties, and very high HCAHPS performance (80-100) was associated with much-lower-than-average readmission penalties. There was no relationship between clinical VBP scores and readmission penalties at either the individual facility level or the group level.
Press Ganey analyzed hospitals’ readmission penalty data in the context of their scores for CMS’s Hospital Inpatient VBP to determine if there was a relationship in performance on the two pay-for-performance programs. The VBP program establishes scores for both the HCAHPS survey results and process of care measures. The analysis utilized Press Ganey’s proprietary data base of more than 10,000 health care organizations nationwide, as well as data from CMS.
The study also suggests a number of potential improvement strategies around the patient experience as related to the discharge process, a key issue in avoiding readmissions.
About Press Ganey Associates, Inc.
Recognized as a leader in performance improvement for more than 25 years, Press Ganey partners with more than 10,000 health care organizations worldwide to create and sustain high performing organizations, and, ultimately, improve the overall health care experience. The company offers a comprehensive portfolio of solutions to help clients operate efficiently, improve quality, increase market share and optimize reimbursement. Press Ganey works with clients from across the continuum of care – hospitals, medical practices, home care agencies and other providers – including 50 percent of all U.S. hospitals. For more information, visit www.pressganey.com.