Improved Reimbursements via Patient Experience & Value-Based Care

Improved Reimbursements via Patient Experience & Value-Based Care

At the intersection of patient experience and value-based care, one signpost points toward improved reimbursements.

Elizabeth Hanes, RN, BSN
Health & Medical Writer

Today’s healthcare consumer expects a customer-service oriented experience that extends well beyond simply receiving adequate medical interventions. And healthcare systems have been working to improve the overall patient experience because it (as measured by HCAHPS surveys) can affect their reimbursements in the value-based purchasing model. Yet even though the concept of “patient experience” is a complex one that can involve many disparate features, organizations can always look to the human factor to point the way toward an exceptional patient experience.

One patient, two vastly different experiences

As recounted in a Medcity News story, Charlotte Yeh was an emergency department physician who found herself admitted to an emergency room after being struck by a car. She describes a very poor patient experience that includes this “callous” comment by a resident doctor: “There’s no medical reason to admit you,” he said, “but if you can’t walk, we’ll just have to.”

Yeh goes on to provide additional details about a hospitalization gone wrong – and how the rehab hospital she was discharged to subsequently got the patient experience very right: “I saw staff treating every patient with dignity and respect, and listening to what mattered to them.”

The value of a high-quality patient experience on reimbursements

CNOs and other healthcare executives can find it challenging to create an excellent patient experience because—as any nurse knows—what “matters” to one patient may not matter to another. Certainly, as noted by Yeh above, communication might matter a lot to many patients, especially those in critical care situations. Then again, other patients might highly value factors like pain control, comfortable furnishings or even inpatient menu options.

Perhaps key to creating a great patient experience lies in understanding your patient population’s preferences. Because regardless of how challenging it might be to pinpoint what constitutes a good patient experience, nurse executives today realize they must find the magic formula to high experience scores in order to maximize the rewards to be found in a value-based purchasing model.

One sure way to improve patient experience ratings

Healthcare is a service delivered by human beings to other human beings, so it stands to reason that patients generally place a high value on the quality of these interactions. In fact, the American Nursing Association (ANA) directly correlates nurse staffing with HCAHPS scores for various measures including communication, responsiveness of staff and overall experience rating.

Achieving high-quality personal interactions requires adequate staffing for nurses and allied health professionals, but you probably realize staffing levels tell only part of the story. An organization can be fully staffed on paper yet still lack personnel in key areas at peak times due to ineffective scheduling. When natural census fluctuations occur in your facility, how do you allocate personnel to avoid having a suddenly high-census unit become understaffed while another unit sends nurses home due to low census?

It’s an important question for any CNO, because patients on an understaffed unit may not receive the level of personal attention they believe they deserve, leading them to report low patient experience scores. One way to mitigate this possibility is to implement a nimble scheduling solution that allows you to seamlessly transfer staff between units and help ensure an excellent patient experience regardless of census.

You may find that comfortable furnishings and free beverages may go a long way toward enhancing the patient experience and increasing an organization’s patient-reported scores, but one sure way to create an exceptional experience is to make sure patients get enough valuable one-on-one time with nurses and other staff members. When you implement responsive scheduling solutions, you can help ensure patients always feel they are receiving a high degree of personal service and an excellent patient experience.

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