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The patient experience is playing a growing role in medical practice reimbursement, physician certification, and payment incentives.
Physicians and practice managers face pressure to increase performance and reduce costs in just about every area, and with the myriad of performance-based incentive programs, licensing and certification requirements, and reporting obligations, it’s no wonder many are overwhelmed and confused.
There is much to deliver on, and expectations are high. One of those
deliverables is patient experience, which focuses on the patient’s perception of care received. Because of its impact on patient health outcomes and financial efficiencies, patient experience is now viewed as a marker of quality patient care and is being measured through CAHPS surveys.
Here are six ways focusing on improving the patient experience might benefit your practice:
1. Maximize PQRS incentive.Reporting of CAHPS surveys may be used to meet one of the nine mandatory measures, and one of the three mandatory National Quality Strategy domains, under the PQRS program. Financially speaking, that’s one-third of the way toward meeting your Medicare Part B Physician Fee Schedule incentive. This is an easy way to fulfil PQRS requirements and avoid the 2 percent decrease in payment for unsatisfactory reporting in 2016.
2. Maximize Physician Value-Based Payment Modifier (VBPM) dollars. Reporting of CAHPS surveys counts towards at least 16.7 percent of the VBPM dollars, providing physicians and practices with a good opportunity to improve performance, and reimbursements.
3. Maximize shared-savings dollars. CAHPS surveys are used to measure the patient and caregiver experience in Medicare's pioneer and shared-savings program accountable care organizations (ACOs). This makes up 25 percent of the overall quality score used to determine an ACO’s share of cost-savings (or losses for those in the two-sided shared-savings model).
4. Meet the new Maintenance of Certification requirement. ABIM now requires all board certified physicians to participate in the completion of CAHPS surveys by the end of 2018, and every five years thereafter.
5. Gain Patient-Centered Medical Home certification. Measuring CAHPS domains will earn points towards Level 1, 2, or 3 of medical home certification under the National Committee for Quality Assurance.
6. Improve your reputation. Medicare's Physician Compare website now includes quality of care ratings for group practices.
Many of the CAHPS survey questions require factual responses about the patient’s contact with the office, such as how quickly patients are able to schedule an appointment, or how long they wait. These questions require straightforward responses, and practices can improve performance by examining their current processes and making efficiency improvements.
Other survey responses inquire about the cognitive aspects of the physician-patient interaction, and identify how patients feel throughout the encounter.
• How often did this provider explain things in a way that was easy to understand?
• How often did this provider listen carefully to you?
• How often did this provider show respect for what you had to say?
• How would you rate this provider?
Most physicians believe they will perform well on these questions, however, research suggests that this is often not the case.
A 2011 study found that patients do not express their health concerns, expectations, or opinions in up to 75 percent of physician visits, principally because they are not asked. A report from leaders at Elmhurst Memorial Healthcare, Hackensack University Medical Center, Piedmont Healthcare, Griffin Hospital, and Sharp Healthcare noted that more than 50 percent of patients leave their appointment not understanding what they were told, how to take their medication, or in fact, why they need to take their medication at all.
Good interpersonal skills and the ability to create a good patient experience is not something that just “comes naturally” to all doctors. Just like any other evidence-based clinical competency, it requires teaching, practice, and evaluation.
In my next post, I will provide you with simple techniques to help ensure you are doing all you can to improve the patient experience at your practice.
Sue Larsen is president and director of education of Astute Doctor Education, Inc, a provider of online education and resources specializing in physician interpersonal skills. Larsen has over 10 years experience in medical education, and understands how to turn clinical evidence into practical, technique-based learning events. E-mail her here.