A federal proposal to base 30% of hospital "incentive" payments on patient experience scores is meeting with strong resistance, in part because of concerns that culturally, patients in some parts of the country are just harder to please.
"We have to look at the data, but there's a perception that some parts of the country do better than other parts," says Blair Childs, senior vice president for public affairs for Premier Healthcare Alliance, a performance improvement group with 2,400 hospitals. "It might be less a function of what the hospital does than the attitude of the population. For example, In New York City, they are grumpier than they are in Minneapolis."
For example, patients in New York, New Jersey, and Pennsylvania, one of nine survey regions in the country, are indeed less likely to answer "definitely yes" that they would recommend the hospital where they received care to friends and family than patients in the other eight regions, according to charts from 2010 Press Ganey surveys. Other possible answers are "probably yes," "probably no," and "definitely no."
The Press Ganey survey found that 73% of patients in New England states, from Connecticut and Massachusetts, Maine, New Hampshire, Rhode Island and Vermont, are likely to recommend, versus 64% in New York, New Jersey and Pennsylvania.
Patients in Great Plains states such as Iowa, Kansas, Minnesota and Nebraska are among the likeliest to recommend. They scored 72%, while south central region patients in Arkansas, Louisiana, Oklahoma and Texas score 71%. 19 states along the lower eastern seaboard, in the southeast, and in the west from California to Washington were 68% likely.
Press Ganey surveyed patients with that and other questions used in the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) questionnaire. Under the federal proposal for Hospital Inpatient Value-Based Purchasing incentive payments, patient experience scores will be used to determine 30% of reimbursement for discharges at more than 3,000 hospitals.
The Centers for Medicare & Medicaid released a 126-page document Jan. 7 detailing how it will make value-based purchasing incentives. There is a 60-day comment period which ends March 8. The nine-month measurement period to determine the scores begins July 1.