Does patient experience have an impact on reimbursement?

The healthcare industry is one of the biggest and most competitive industries in the 21st century. With so many hospitals competing over patients, many businesses are increasingly worried about their bottom line. But as healthcare businesses try to improve their balance sheets, the answer may come from an expected source – improving patient experiences.

Introduction

The healthcare industry is one of the biggest parts of the US economy. It is also quickly becoming an increasingly competitive industry. With the average US citizen spending nearly $10,000 a year on healthcare, healthcare businesses are looking for ways to capitalize on this growing market.

While the healthcare industry has often focused on increasing the number of patients that it serves as a way of improving its financials, what often goes unnoticed is the fact that hospitals can instead increase reimbursements per patient.

This would be a mantra of quality versus quantity.

Through patient experience improvement, healthcare businesses can start increasing their patient reimbursements and also provide a greater quality of healthcare – benefitting the patient and the business, both.

What is Patient Experience?

Patient experience is the perspective of the patient as they complete their healthcare journey. It is the sum of all the ‘experience’ and all that they feel during this journey. It is influenced by all the numerous interactions that they have with a healthcare organization.

Healthcare can be very roughly and simply be split into two parts – the technical aspects and the customer service aspect. The technical aspect of healthcare is related to the actual treatment of patients during their healthcare journey. These aspects include things like surgery, treatment, diagnosis, and more. The customer service aspect of healthcare includes things like a patient’s comfort, the cost of treatment, convenience, and more.
While patient outcomes usually measure just the quality of the technical aspect of care being provided, patient experience considers both aspects as both are important for the patient.

At the end of the day, patients are your healthcare business’ customers and they want to be treated like customers. Treating patients like active customers means reaping the benefits like customer loyalty, evangelism, and more.

We see our customers as invited guests to a party, and we are the hosts. It’s our job every day to make every important aspect of the customer experience a little bit better.” – Jeff Bezos

Is it different from Patient Satisfaction?

It is hard to come to a definitive definition of patient experience, and it can often be interchanged with another term – patient satisfaction. While similar in definition, patient satisfaction measures how satisfied patients are with their healthcare journey. To expand that pithy statement a little more, patient satisfaction refers to how much of their expectations were matched with their experiences.

Patient satisfaction has been seen to be a great predictor of the overall quality of care being provided by a healthcare organization. It is for this reason that surveys like the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and the Press Ganey survey measure patient satisfaction to adjudicate the quality of a healthcare facility. 

How do they impact reimbursement?

When you go to a hotel, the only thing that you’re ostensibly paying for is the room to sleep in, at least according to the bill. So should hotels be only focusing on making sure that the rooms are of the best quality that they can be? Well, they do focus on that but hotels also try to ensure that every other part of the stay at the hotel is as pleasant as possible. A hotel that only focuses on keeping the best rooms will always lose out to a competitor which also focuses on the rest of the stay, even if their rooms are slightly worse in quality.

That’s the importance of patient experience.

But hospitals aren’t only competing for new patient acquisition through great patient experience, they’re also competing for third-party payer and government incentives. HCAHPS scores are tied to incentives under programs like Medicare and more from the Centers of Medical Services. In 2016, over $1.5 billion was available in incentives alone.

But for those healthcare facilities that fail to meet the standards set by the CMS, they not only do not receive the incentives but are also at the risk of facing financial penalties (in addition to increased risk of malpractice suits).

How to improve Patient Experience?

The underlying thought to methods of improving patient experience is by making healthcare more patient-centric. It is not just a one-size-fits-all approach that will work for healthcare businesses. Firstly, a culture of understanding the importance of patient experience must be brought into organizations from the top.

Afterward, more useful advice is to improve engagement with patients at each touchpoint of the healthcare journeys. Getting medical treatment can be anxiety-inducing, for patients, their caregivers, families, and friends, so providing comfort, information and advice are one of the best ways to improve the patient experience.

Optimizing patient journeys by reducing wait times, improving facility accessibility, information dissemination, and more can tremendously improve patients’ experiences. The use of tools like patient journey mapping is especially useful in this regard.

For a simple example, let’s take the case of Mr. John Doe, age 58. At this age, Mr. Doe should be getting a colonoscopy every 10 years to screen for colon cancer. Patient engagement would make Mr. Doe more willing to independently seek out medical advice to get screened, reassurance from treating medical officer can reduce anxieties, clean and comfortable waiting areas make wait times more bearable for him and his family. Finally, clear dissemination of information means that Mr. Doe is properly prepped before his colonoscopy exam, and the results are explained to him simply. Mr. Doe has now had an excellent experience at your facility and is more likely to come back to your organization in the future.

Conclusion

Patient-centered care is quickly becoming the ultimate goal for the healthcare industry today. Apart from the obvious benefits to the patients themselves, healthcare organizations also stand to gain immensely from providing improved patient experiences. Increased reimbursement is just the tip of the iceberg of benefits that businesses can get by focusing on patient experiences.

BraveLabs is your go-to expert to accelerate your business’ shift to making patient experiences a priority. Through patient journey management, medical content, and early engagement, BraveLabs helps businesses to improve patient experiences.