HCAHPS scores Closely Tied to Readmission Rates

Posted on March 28, 2013. Filed under: Admission & Discharge, Communication, HCAHPS, Patient Experience |

ImageWith Medicare payment penalties for excess readmissions now in effect, reducing readmissions has become a top priority for hospitals and other stakeholders. The Centers for Medicare and Medicaid Services (CMS) publicly reports risk-adjusted readmission rates for heart attack, heart failure and pneumonia. The data shows significant variation in performance across hospitals, indicating that some hospitals are more successful than others at addressing the causes of readmissions. A recent study by Press Ganey suggests that performance on readmission metrics is associated with performance on patient experience of care measures.

Press Ganey analyzed hospitals’ readmission penalty data in the context of their scores for CMS’ Hospital Inpatient Value-based Purchasing program (VBP) to determine if there was a relationship in performance on the two pay-for-performance programs. The VBP program establishes scores for both the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results and process of care measures. The study found a demonstrated negative association between hospitals’ HCAHPS VBP scores and readmission penalties; as hospital performance on HCAHPS increased, readmission penalties decreased. Very low HCAHPS performance (scores of 0–19 was associated with much-higher-than-average readmission penalties, and very high HCAHPS performance (80–100) was associated with much-lower-than-average readmission penalties.

These findings support previous research on the link between patient experience and clinical quality found that higher overall patient satisfaction and satisfaction with discharge planning were associated with lower 30-day risk-standardized readmission rates. This current study seems to suggest, HCAHPS scores, not clinical measures, were more closely linked to readmission rates.

To effectively combat patient readmissions, hospitals can benefit from a foundational strategy that starts first and foremost with the patient – and efforts that are aimed at improving HCAHPS scores are an excellent initial step. The majority of the HCAHPS survey questions address communications between caregivers and patients. Effective communications is fundamental to ensuring that patients become engaged in their care and, consequently, better equipped to follow discharge instructions and self-monitor after leaving the acute care setting.

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