The ROI of Patient Experience

The Cleveland Clinic is known for prioritizing patient experience, particularly around relationship-centered communication. Experts explain how this philosophy makes not just moral but financial sense.

Hospitals and providers are more aware than ever that communication and empathy can make all the difference in how a person feels about a hospital stay or medical encounter.

But with competing priorities such as patient safety, quality, and other elements that visibly impact the bottom line, the 'why' for investing in patient experience can be a tough sell. Experts from the Cleveland Clinic note the following ways doing the right thing translates to dollars.

Payers Are Keeping Score

The Centers for Medicare & Medicaid Services began tying Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores to hospital reimbursement in 2012.

While the penalties for sub-par performances have increased slowly, the dollars now are substantial. As of this year, HCAHPS scores determine up to 2% of a hospital or health system's Medicare payments.

"The risk for not giving patients a good experience financially now becomes very high, so hospitals or practices that don't stand behind the fact that we need to take care of our patients both behaviorally and clinically stand to lose a significant amount of money," says Lori Kondas, MBA, senior director for the office of patient experience at the Cleveland Clinic.

There are several other ways patient experience indirectly, but cumulatively influences the bottom line, adds Joshua Miller, DO, the Cleveland Clinic's vice president for regional family health center operations.

The industry's shift toward value-based care is only one.

"We'll sit down with our doctors and say, 'We really care about this.' We'll talk about narrow networks, how [payers] will drop physicians and things of that nature potentially on scores, so we need to start paying attention to it now or we're going to pay later because of it, either from a malpractice suit or other financial consequence," Miller says.

Consumerism Is King

Meanwhile, the healthcare industry must also accept being in the midst of the age of consumerism, adds Kondas.

"It really is patient experience overall that drives people toward where they choose. With that increasing amount of transparency, patients can see what others think about you," she says.

"It's sort of like TripAdvisor. You can go anywhere and learn about a healthcare system—and not just about what the quality of care was, but how [consumers] were treated."

Empathy Boosts Efficiency

"The evidence suggests that you can actually save time by making a single empathic statement," says Chief Experience Officer Adrienne Boissy, MD, MA.

"The rationale behind that is that if someone is coming to me emotionally charged and I ignore those cues and continue on my own agenda, those cues will either continue to surface and escalate," she says. "Or the patient will stop talking because you've demonstrated that you're not willing to 'see' the emotional human in front of you."

Addressing the cue the first time takes less time, she says.

A patient who is angry about a long wait before an appointment, for example, is more likely to be distracted by that frustration and less engaged in talking over medical concerns with the provider, potentially snowballing into poor adherence, which may in turn contribute to a preventable hospitalization, to name just one plausible scenario, notes Miller.

Since 2011, Cleveland Clinic caregivers have learned how to handle these situations with a course in relationship-centered communication. "We tell the doctors it's almost like an MBA for communication," Miller says. "It's to give them more tools in their tool belt," he adds.

In 2016, Boissy and colleagues compiled this curriculum into a book entitled, Communication the Cleveland the Cleveland Clinic Way.

"My hope is that these communication skills remain central to how we train leadership," Boissy says.

Ignoring Experience Can Cost You

What's more, organizations engaged in patient experience—hiring not just for clinical skill but also behavior—see lower rates of costly turnover, says Kondas.

And patients who feel heard are less likely to sue, research has shown.

Ultimately, the business case boils down to this: "If you want patients to come to your hospital, you better make them happy," Kondas says.