Will new levels of accountability for patient satisfaction be a sufficient driver of change in the US Healthcare system?


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We’ve already taken a number of close looks at the payers and how healthcare reform coming out of the current administration is forcing the powerful hand of change, but let’s take a fresh look at providers and especially, hospitals.

Having had the personal misfortune of being a patient in a hospital a month ago for my very first time, I wanted to share some observations about the experience.

While I came into the hospital via the emergency room and because I was transported by ambulance I was wisked into the triage process rather than being left for an unpredictably long amount of time in the waiting room, being brought in was where the positive patient experience ended and the mismanagement and bureaucracy began.

The admitting nurse took my name and insurance information while another took my vitals.The grilling continued with duplicative information being provided to a series of interrogators for close to 20 minutes prior to them strapping on my ID wristband and parking me in the hallway on a gurney where they left me for the next six hours.

I am not sure if this was a steller example of best of breed healthcare, but I’ll suggest it likely fell short in terms of the overall experience I received from the hospital. Never before had I felt like such a number and dehumanized by an overtaxed process run by doctors and administrators who have found more loopholes in the payer process to shake a stick at, all in the spirit of ensuring maximum financial compensation for minimal services rendered.

While I was “parked” in the hallway, nobody paid much attention to my repeated efforts to secure a room – even one with a roommate. The spot in the hallway they left me was in a busy area where my IV stand was bumped into more than once by doctors with other patients pulling on the needle delivering pain killers and other drugs into my uncomfortable body.

When I was finally discharged the doctor and nurses were kind and attentive in filling in their forms and computer records and sent me on my way.

There was no interest in ensuring comfort or even timely attention to the reason I was at the hospital to begin with. Not to be purposely alliterative, but marvelous modern medical management it was not.

While my personal hospital experience is limited, that first and only experience left me feeling cold and somewhat mishandled.

That said, had I come into the hospital as part of a Medicare program, there has been recent regulatory change mandating my satisfaction as a patient before the hospital receives 100% of their payment from the payer system. In short, if I don’t give a rave review, the hospital doesn’t get paid.

In my opinion putting that level of scruitiny toward the patient experience brings a new attention to care and how it’s delivered – at least to those in the program. I’m imagining a day when all insured patients, whether through government programs like Medicare or otherwise can take on more power in the process and allow us to bring a voice into the accounting. The level of medical care would skyrocket since their payment hinges on my satisfaction. Until that day, I’m afraid we’ll remain mistreated numbers with colorful wristbands parked in hospital hallways being ignored by overworked doctors who charge the payer system inflated rates for minimal services rendered.

In this patient’s opinion, that day can’t come soon enough.

There are notable exceptions to the rule, however most of the significant ones are in hospitals that operate nontraditionally and are generally for profit businesses as opposed to the more typical not-for-profits we see in our communities. Generally, the for profits are specialty providers such as Procure, the cancer treatment center, for example where they launched their treatment centers following not only the charter of providing the world’s best medical care, but doing so in a setting that would both rival the great hotels and administered by patient advocates and front office staff that are warm and attentive. A vast contrast to what I experienced locally.

It’s a shame to suggest this, but profit is a major catalyst for change and either threatening to block specific payments or resort to a for-profit destination hospital half way across the country leaving local hospitals with empty beds may be the drivers for the change the system needs to one and for all improve.

It’s all about profit and accountability, I believe. At least in my experience.

Republished with author's permission from original post.

Marc Mandel
Marc Mandel is a Regional Sales Director at Allegiance, Inc.


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