The ridiculousness of basing reimbursement on customer satisfaction

  1. 53
    If hospital reimbursement is going to be tied to customer satisfaction surveys, I think EVERYTHING should be tied to customer satisfaction surveys. There was some ridiculousness at the Kroger grocery store tonight. I'd only give them a 4 out of 5. Thus, my groceries should be free. Oh, and I'm unhappy with one of my grades. So my tuition should be free. There's also been a number of times that lately that I turn the tv on, and there's not an episode of Law & Order on any of the stations. That makes me unhappy, thus nobody at DirecTV should get a raise and I should get my service for free. And the groceries I used from the previous visit gave me a bit of heartburn. Thus THOSE groceries should also be free. And my cat just gave me a funny look. Now I know my internet service has nothing to do with that, but I'm going to complain to them anyway, and thus my internet should be free.
    uRNmyway, Cranberrygirl, Aurora77, and 50 others like this.

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  2. 25 Comments...

  3. 10
    "Reimbursement" as in, money to hospitals, or as in, what you personally earn?

    If you walk into your annual review with a buncha bad feedback from patients, it will affect your raise. That's just how it is.

    And it's a damn shame that patients often can't tell when they're getting excellent nursing care, because that might require the patient to take some responsibility, experience some discomfort, actively participate, cough and deep breathe even though it hurts.
    tokidoki7, KaroSnowQueen, kcmylorn, and 7 others like this.
  4. 5
    It doesn't even need to be bad feedback from MY patients. If my floor doesn't get a high enough score, that kills a whole segment of all of our raises on the floor. Even if I'm the sugary sweet nurse that lets the patients do whatever they want and that they all love.
    opossum, lrobinson5, OCNRN63, and 2 others like this.
  5. 16
    Not to mention, there are some people that you just cannot please. Around here, our patient satisfaction surveys range from the care they received to if their meals were acceptable. So, my care that I give can be cut down because they got vanilla pudding instead of chocolate pudding or because their family didn't get a meal tray (which we don't provide to family members anymore) and had to pay for a meal in the cafeteria. I understand customer service and all that, but this is a littl,e over the top, IMO.
    Aurora77, IowaKaren, tokidoki7, and 13 others like this.
  6. 6
    Raises? You guys can get raises based on your, or your units preformance? Wow, I thought such things where a thing of the past.
    KaroSnowQueen, opossum, gaylarn4, and 3 others like this.
  7. 7
    Cutting staff to save money and improving customer satisfaction simply don't go together. We've had the no raise/no happy customer talk on our floor. All while we barely have enough staff to wipe butts, much less make hot chocolate and fluff pillows.
  8. 6
    At Kroger's ... you pay upfront, or you make the choice to go down the street to the next grocery store. Kroger's doesn't have to wait for "reimbursement" dependent on whether or not you burn the meal that you attempted to cook with the groceries you bought.

    Remember, the reimbursement tied to patient surveys is from Medicare, not all payor sources. Although private insurers typically follow the standards set by CMS for Medicare, which derive from quasi-governmental agency JCAHO.

    But, ya know, we like to pretend we have free market health care in this country ...
    Not_A_Hat_Person, tokidoki7, wooh, and 3 others like this.
  9. 13
    The OP is referring to HCAHPS (HCAHPS - Facts Page) which is going to determine payment rates to hospitals.

    I agree with the principle of not paying the same amount for crappy service that you pay for great service, but there should be a way to determine how much of the 'rating' is due to unrealistic expectations. For instance, a lot of patients think they will have no post-op pain... sometimes because that's what the doctor told them when she was convincing them to have the surgery. It's also a fact that the survey is completed by family members rather than the patient... and they don't even know what was going on outside of their visiting time.

    Unfortunately, it seems that one of the most effective ways to deal with HCAHPS is by trying to influence patient recall though repetitive and consistent information that (we hope) they will remember when it comes time to fill out the survey. That is why everyone is scripting... "our goal is to manage your pain effectively" or some such thing on an hourly basis. Hmm - maybe we can insert speakers into the mattress & play subliminal messages whenever they are asleep? Just a thought.
    Aurora77, Not_A_Hat_Person, esrun00, and 10 others like this.
  10. 8
    Quote from wooh
    If hospital reimbursement is going to be tied to customer satisfaction surveys, I think EVERYTHING should be tied to customer satisfaction surveys. There was some ridiculousness at the Kroger grocery store tonight. I'd only give them a 4 out of 5. Thus, my groceries should be free. Oh, and I'm unhappy with one of my grades. So my tuition should be free. There's also been a number of times that lately that I turn the tv on, and there's not an episode of Law & Order on any of the stations. That makes me unhappy, thus nobody at DirecTV should get a raise and I should get my service for free. And the groceries I used from the previous visit gave me a bit of heartburn. Thus THOSE groceries should also be free. And my cat just gave me a funny look. Now I know my internet service has nothing to do with that, but I'm going to complain to them anyway, and thus my internet should be free.
    It's the Walmart business model for hospitals. You buy a product, don't like it, then you don't have to pay for it. Ever see a Walmart customer return a half eaten birthday cake? Every expectation is worth consideration. Every customer request has merit. Anything to make the customer happy. If the customer is not happy you give them a ten dollar gift card to ease their pain.
    Last edit by TheCommuter on Jan 24, '12 : Reason: quotation blocks
    KaroSnowQueen, opossum, wooh, and 5 others like this.
  11. 5
    The only problem with that is there are very disgruntled patients who, despite you and other staff members doing their job extraordinarily well, will give poor surveys. They just want to watch the world burn. Often people don't understand that certain aspects of their care that they didn't like was best for them, and they go home ****** off. I heard once of a guy who had some fingers chopped off (carpenter), and as he was unconscious, and no family there, the surgeon decided to reattach them in his best interest. He was furious because his insurance couldn't cover it. But hey, he can still work!


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