Tying Patient Satisfaction to Medicare Reimbursement is Problematic - page 3

by TheCommuter 19,510 Views | 62 Comments Senior Moderator

Patient satisfaction surveys have been receiving an amplified amount of attention at hospitals and other types of healthcare facilities, especially since the results of these reviews now have a significant effect on Medicare... Read More


  1. 5
    I have been saying the same thing for a few years now. I too have witnessed numerous times where the nurse who provides the most competent care but does not coddle the patient gets the most complaints. I have seen patient's and their families praise nurses and doctors who give inferior care just because they smile and give repeated scripted responses. Eventually insurance companies will implement this protocol so they too may cut payments. This in turn is going to drive up healthcare cost.
    batmik, Jessy_RN, Sugarcoma, and 2 others like this.
  2. 5
    Quote from ParkerBeanCurdRN,BSN
    I too think it is a ploy to decrease reimbursement. I am interested in knowing how this will affect staffing ratios. If administrators see a correlation between staffing ratios and patient satisfaction, then maybe adequate staffing will become priority. Let’s see…losing money because of poor patient satisfaction or decreasing the bottom line to add staff to make patients happy. Hmmmm. Let’s be honest, hospitals are becoming Hilton Resorts. While I think it is nice to have a comfortable ambience, it sets expectations higher than what I feel can be delivered unless staffing changes are made.

    What do you suppose will happen to the smaller hospitals that do not have the capital to renovate or pay fair salaries?
    They won't change the staffing- they will just can the "low performers" and get new ones, since nurses are a dime a dozen....
    Sammie7, Friskee, Jessy_RN, and 2 others like this.
  3. 0
    Quote from TheCommuter
    I think a handful of the small hospitals that lack deep pockets/capital will fold up, go under, and close their doors for good as the result of continual monetary losses.
    This just happened recently where I live.
  4. 16
    I see this more as a "Oh we know people hate the ER times, hate being sick and are demanding as hell" so therefore how can we save some money...Thats right lets ask them stupid questions and then say you have to score the best on all of them to get paid for it.

    I wish I could pay less when my food takes too long to get to me
    Or the waitress is rude
    Or when the lines are long to get checked out at the grocery store
    or fill in the blank here.
    Sammie7, dudette10, Friskee, and 13 others like this.
  5. 3
    Quote from Tina, RN
    What made me finally leave my per diem job (and acute care) for good? Last year, I received my first ever write up. The reason: A patient's family told my nurse manager that they felt I "wasn't in the room enough". I got a phone call from my manager, telling me about the family's complaints. Apparently, they were also angry that I wouldn't give the patient a tylenol. 1) He had no orders for tylenol, and I had documented that I tried repeatedly to contact the doctor. 2) The patient was extremely ill and in liver failure!! My nurse manager actually told me that it wouldn't have been a big deal to "slip him a tylenol" to keep them happy. I could not believe what I was hearing! Customer satisfaction at its finest!
    This has happened in other areas, too. We were basically told by management that it doesn't matter if a patient is somnolent, if they are due for their pain medicine or Xanax or whatever, you are to give it. Why? Because it's for "patient satisfaction." Screw your professional nursing judgement.
    Sammie7, Jessy_RN, and Tina, RN like this.
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    Thank you for the wonderful article and all of the thoughtful comments. All of the above has weighed on me quite heavily already and I'm only in my second of four semesters of school. It seems as though many of us are stuck between a rock and hard place. The hospital is promoting "customer service" as in a hotel atmosphere, professors are promoting "therapeutic communication & safety," third party payers are demanding “safety & efficiency,” and patients are demanding everything. It seems as though it all boils down to the almighty dollar. What a sad situation when it comes to dealing with human lives - humans that could our mother, father, brother, sister, etc.

    How can we as nurses be compassionate and effective nurses when we are constantly watching our backs because we're worried about being written up and we’re run ragged? How can we be genuine and give of ourselves when we are told to give scripted replies? How can we ensure patient safety when we are short-staffed over over-loaded with patients?

    I have never been a political person, but I feel so strongly about all of this, I am wondering, "How can I make a difference? Who can I talk to? How can I learn more? How can I be involved in the process?"

    I listened to an exasperated nurse explain to my clinical instructor that she was frustrated with patient stay limitations imposed by the XYZ insurance company. When I heard this, I thought "Who at the insurance company is making these decisions? Who are they? How much are they paid? What are their credentials? What's the bottom line of that company? How much do the top dogs make who probably have MBAs and no medical background?" I then said, "I know what I’ll do when I graduate! I need to go undercover at XYZ and find out what the heck is going on!!"

    Well, I must get back to the crushing textbook on my lap and turn my thoughts inward to the next hurdle lurking on Tuesday morning.
    ceccia, Jessy_RN, jrwest, and 3 others like this.
  7. 0
    Every CMS measure has open comment before it becomes Rule. Anyone can comment, yet I would bet not one had posted a response on the CMS web site. AT insurance companies it is a medical director who is a physician making decisions.
  8. 1
    Great article, and I agree with you 100%. Too many times have I witnessed a client be given superb hospitality during the stay. We setch sodas, magazines, anything to try to keep the score high. We even goes far to say "Thank you for choosing _________, we hope that you will give us all 5's" Though, at discharge you find you now have an angry pt because they have been prescribed torodal rather than dilauded. Guess what we're getting on the cards.
    Second note, our healthcare system has now set itself up for pt satisfaction that we will have to start saying "Welcome to the Hilton". It's a beast in the making. Thank you to the government.
    roasted likes this.
  9. 0
    What is a CMS measure?
  10. 0
    Quote from ImKosher
    Second note, our healthcare system has now set itself up for pt satisfaction that we will have to start saying "Welcome to the Hilton". It's a beast in the making. Thank you to the government.

    too late - it's already started.

    What I'd like to know is why are hospitals sooo stupid that they actually think they will get glowing scores even if we serve the pt trays on silver platters with a personal waiter?? This is a no win situation,and I can't wait to see the aftermath when hospitals will not be getting paid for any services. What , are they going to can everyone that has to do with pt care and perception? They won't be canning the docs; they'll be canning the nurses. Heck, they probably won't even can the ancilliary staff. Seriously, after a few months/years of not getting paid( because medicare will eek out of having to pay) how long do we think hospitals will hang around for this???

    More food for thought..


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