Wednesday, March 5, 2014

Patient Satisfaction A Law in 2014 - Part 2

In my last blog post, I revealed that many are not aware of one part of the United States Federal Affordable Care Act that enforces patient satisfaction as a factor for physician payments; at least starting with Medicare and Medicaid. It's a "pay for performance" law, according to the Centers for Medicare and Medicaid Services (CMS), a federal governing body established under the The Patient Protection and Affordable Care Act (PPACA). Publicly, we all know it as Obamacare and the patient protection section was to be enforced beginning January 1, 2014.

To re-summarize: "Quality, pay for performance, and hospital value based purchasing (HVBP) are synonymous terms which are used to indicate that in the future, healthcare hospital reimbursements will be linked to patient outcomes."

As I explained, the one and only site I could find that the government is using to collect this data about hospital performance and patient satisfaction is where patients can "report and rate their hospital experiences." The site says it "is dedicated to improving the quality of healthcare in the United States (and) provides an opportunity for patients to express their opinions regarding their hospital stay."

My question was: Who funds and manages this site? So, I sent a little email (see last blog post) and this is the totally inadequate yet telling response I got:

Hello Ms. Crohn

We are a private organization.  Please e mail a link to your blog, for us to read.  We welcome your input and thoughts and suggestions.

Thank you


Hmmmm. They want to know more about me before they spill any beans? I'm afraid to do it. Seriously, if I give them my information is it going to raise a red flag over my family and me? Am I going to start running into glitches in my personal health care odyssey? I'm not answering them so I've hit a dead end here.

I spent some more time on their site and, at first, couldn't find New York (it was mistakenly alphabetized and came after the "O" states rather than the "M" states. Then I was happy to see some statistics. For example, my community hospital had a near 70 per cent satisfaction rate. Other local hospitals fared about the same except for Westchester Medical Center in Valhalla, New York that has always accepted low income and indigent patients. Their satisfaction rate was less than 50 per cent.

Interestingly, while that medical center is partly funded by taxpayer monies (its land, etc.), it recently announced that it would not accept ANY of the insurances under the Health Care Exchange. Take that, patients! You can't come to the this fully-equipped, state-of-the-art medical and trauma center in the tri-state New York area anymore unless you can pay for it yourself or have private insurance.

Well, I've hit a roadblock or a blockhead or both because the information is extremely difficult to find. I asked two of my doctors if they heard about this part of the law and while they both said they had, they also said they had no structure in place to comply. I'll try to talk to the president of one of the hospitals in coming weeks to get more clarity on this issue.

So, I must conclude that millions of taxpayer dollars have been used to fund a patient satisfaction component of the ACA but it ain't working even though it's been in a pilot phase for a few years. And I'll keep waiting for a doctor or hospital representative to ask me to fill out a patient satisfaction survey and I'll report on it when and if I ever do.

Disturbing, to say the least.


  1. FYI, at present, it's the hospitals that have $$ on the line for patient satisfaction, not doctors. Some hospitals that employ doctors may also choose to reward/penalize physicians in part based on their patient satisfaction scores. The government does not formally post individual doctor patient satisfaction scores, so anything that you see in this regard is informal information from private groups (like Ratehospitals or healthgrades or whatever). However, you can view hospital patient satisfaction scores for any facility in the country by looking at the government's website.

    1. Thank you for your contribution to the conversation. I wish we could continue the dialogue if I know who you were. Isn't the law requiring both hospitals and doctors who take Medicare as of 1/1/14?


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