The importance of pleasing patients

Over the past several years there have been many discussions in physician practices and hospital corridors that fee-for-service physician reimbursement has become outdated and runs counter to the goals of lower cost and better outcomes for patients. Industry insiders agree that changes need to be made to physician reimbursement models by rewarding physicians for "quality" patient interactions and better clinical outcomes instead of for the number of patients they see and how productive they are.

But making that type of change can be difficult.

Meryl Luallin, a San-Diego-based consultant/partner with SullivanLuallin says the time is ripe for medical practices to prepare for the coming changes. "[The U.S. Centers for Medicare and Medicaid Services] is now focusing on the Affordable Care Act (ACA) Triple Aim [which] … is better clinical outcomes with lower costs, with more engaged, happy patients," says Luallin. "And so, with all this focus, there's measurement going on constantly, where doctors and their organizations are monitoring patient outcomes, and also measuring clinical outcomes, as well as cost measures. But they are also monitoring patient satisfaction."

Related: Six Ways to Improve Patient Satisfaction Scores

The term "quality" encompasses a number of government programs and private-payer quality initiatives. And with the elimination of the Sustainable Growth Rate Formula in the first part of 2015 through the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), the government has communicated its intent to replace the defunct formula with a new hybrid program called the Merit-Based Incentive Payment System (MIPS). While full implementation of MIPS won't affect physician practices until 2019, other quality initiatives like the Clinician & Group-Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS), one type of patient satisfaction survey, will be factored into small-group Medicare reimbursement formulas starting in 2017, for those participating in Physician Quality Reporting System (PQRS).

These patient satisfaction surveys ask patients about their subjective experiences at their doctors' offices, and rather than judge clinical competence, they ask patients questions concerning access to care, physician communication, and staff effectiveness. Luallin says that even if physicians score well, they must achieve higher than a 95 percent on the CG-CAHPS or they rank only at the 50^th percentile when compared to their peers. And with a score of 88 percent, a provider is ranked at the 10^th percentile, says Luallin, which means a reduction in bonus money from Medicare.

 

Internal server error