Patient Perceptions: Best & Worst Rated Hospitals

CMS's pending shift to a value-based purchasing model means healthcare providers will have to beat national averages in specific care areas to earn back the portion of Medicare funding that CMS will start holding back beginning in October 2012.

While just 1 percent of hospital revenue is initially on the line, care quality is already slated to have extended impact on revenues over time, putting clinical outcomes and patient ratings (currently weighted in determining the re-distribution of withheld funds at 70 percent and 30 percent, respectively) at its proper place in the national spotlight.

An NPR Health article recently highlighted patient experience trends, proposing that the " Unhappiest Hospital Patients are in New York City, Chicago and Florida." NPR's findings piqued the interest of several staff members in the Billian's HealthDATA (BHD) office, prompting additional digging into hospital patient satisfaction data. 

Researchers looked at patients' overall hospital ratings in HCAHPS surveys, isolating the 25 top-rated and 25 worst-rated hospitals among a universe of about 3,000 hospitals that had survey participation rates of 25 percent or greater for the July 2009  through June 2010 reporting period. Unlike the NPR study (which focused on three more specific aspects of HCAHPS surveys - 1: how well doctors/nurses communicated, 2: whether pain was always handled well and 3: whether rooms were clean/quiet), BHD findings didn't show any geographic clustering, but did reveal other commonalities shared among best-rated facilities.

What Best Rated Hospitals Have In Common
Ninety percent of the 25 best-rated hospitals were for profit facilities and over 75 percent had 35 beds or fewer, with average admissions well below the 25 worst-rated hospitals' average.

Surprisingly, neither clinical outcomes nor profitability of the hospital seemed to factor into positive or negative ratings.  Only two of the top 25 facilities beat national averages for mortality or readmission rates for pneumonia, heart attack or heart failure.  Just seven of the bottom facilities scored below national averages. Worst-rated facilities also reported net patient revenue averages double that of their top 25 counterparts (not surprising considering the smaller stature of the latter group).

Reading Between the Lines
Undoubtedly, positive marks are more likely to come when rating neighbors in close-knit communities, but it's also probably safe to suggest that smaller facilities offer more opportunities for unadulterated patient interaction that may foster a higher level of comfort in patients. So, how on earth do larger hospitals in densely-populated metro areas or the chaotic halls of teaching hospitals mimic the more intimate settings patients seem so fond of? 

The recent blog, " Bringing Disney Magic - and Business Philosophies - to Healthcare," explores the epic success of Disney - a brand that successfully caters to hoards of people daily - and suggests ways that the Disney-way-of-doing-business has a place in healthcare, particularly their oath of "Quality Service."  Like healthcare, Disney isn't cheap, but "the attention to detail and the commitment to going above and beyond for guests at Disney are unparalleled," to quote Kim Wacker, Marketing Specialist at Jackson Healthcare and former Disney professional. "If people know that you truly care and want to help them and do not have a selfish motive, they will become customers - or patients - for life," she explains.

In other words: Do whatever it takes to make sure the patient feels like something more than "billable."  This pressure to increase patient comfort levels, while working with tighter budgets, while likely grappling with major IT projects and adjusting to new workflows is no small feat for today's healthcare professional. 

What initiatives - large or small - have had a positive impact on patient satisfaction? Share your thoughts via the patient perceptions discussion going on right now at