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Move the Needle Up: How Great Patient Experiences Can Earn Big Payer Bonuses

These days, the Center for Medicare and Medicaid Services (CMS) is implementing the Physician Quality and Reporting System (PQRS) and the dreaded Value-Based Modifier (VBM). While many healthcare organizations are focusing on the dollar bonuses provided by CMS for a variety of clinical outcome measures, too often overlooked is the 30 percent weighting on patient satisfaction. There is little to no expense associated with improving the patient experience. It's simply a matter of knowing which questions on a patient satisfaction survey are most likely to result in the key outcomes of "high overall satisfaction" and "likelihood of recommending the provider."

A regression analysis of patient satisfaction data in the MGMA-SullivanLuallin Group database indicates that there are seven items that are MOST predictive of the key "outcomes" as noted previously. These survey items are:

  • Signage and directions easy to follow
  • Helpfulness of the receptionist/office staff
  • Willingness to listen carefully to you
  • Waiting time in the exam room
  • Knowledge of important information about your medical history
  • Helpfulness of the people who assisted with billing/insurance
  • Answering your questions in a way that was easy to understand

Strategies for ensuring high scores on the above questions are found in an easy-to-recall acronym: C.L.E.A.R.

  • Connect
  • Listen
  • Explain
  • Ask
  • Reconnect

Each of the elements of the acronym translates into a series of service "protocols" that will ensure high scores on the seven survey items listed above.

Make certain that signage is clear, visible and legible; that schedulers ask, "Do you know where we're located?"; that receptionists greet patients with a smile and acknowledge others in line; and that physicians are prepared with knowledge of patient's history.

Ensure that providers and others give good eye contact when asking questions and that they respond empathetically to patients' presenting problems.

Make sure that receptionists inform patients of wait times; that medical assistants explain what will happen next; that everyone uses non-technical language and explains things clearly; and that physicians use 3-D models and handouts.

Ensure that medical assistants inquire, "Is there anything else I can do to make you comfortable while you wait?"; that billing staff ask, "Is there anything else I can help you with?"; and that care providers ask, "What other questions do you have for me?"

Have medical assistants frequently reconnect with patients waiting in exam room; and have everyone offer a parting comment to reconnect with departing patients and others.

Using these simple strategies will boost scores in the areas that count most toward maxing CMS bonuses.