Including Patient Satisfaction in the Quality Equation

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Posted By: Roberta Mullin August 12, 2014

patient satisfaction

Twitter Chatting about Patient Satisfaction

By Joy Rios, Managing Partner at Practice Transformation
Twitter: @askjoyrios

A couple weeks ago, I had the pleasure of hosting my first Twitter chat under the hashtag #kareochat.* The topic focused on quality measures – a timely subject, as quality measures are an instrumental component of the Physician Quality Reporting System (PQRS), the Value Based Payment Modifier, and the EHR Incentive Programs. Since I’ve been wading these waters for quite some time, it’s no wonder that the way that CMS assesses the quality of healthcare has been on my mind lately. One question that enlivened the online conversation was: To what extent should patient satisfaction be part of the quality calculation?

This answer struck me as particularly insightful:

When it comes to quality, we mainly focus is on what’s tangible – we measure outcomes of tests or labs, processes that have been implemented, or environments enhanced. But what if we could significantly improve quality by adding some focus on softer skills – something as straightforward as improving the communication between doctors and patients?

Turns out CMS has been having a similar conversation and is adjusting their quality program requirements to address this very idea. Their solution is to include patient satisfaction in measuring quality by accepting Consumer Assessment of Healthcare Providers for Clinicians and Groups (CG CAHPS) surveys. How? Well, these guys asked the same question:

In case you haven’t been reading the fine print, there are several ways to include patient satisfaction surveys for both PQRS and Meaningful Use. So far, the survey option only applies to groups of 25 eligible professionals or more, but they still exist. To sum it up:

  • Groups of 100+ who are reporting PQRS via the GPRO Web Interface are required to submit the 12 patient satisfaction surveys included in CG CAHPS.
  • Groups of 25-99 have the option to do the same.
  • Groups of 25+ who report via EHR or Registry can also meet the PQRS incentive criteria by submitting the surveys along with just 6 quality measures.

What this could mean for you is that soon, even smaller groups may be able to report fewer clinical quality measures and add in to the mix a host of soft skill measures, including (but not limited to):

  • Provider communication
  • Shared decision making
  • Health promotion & education
  • Courteous & helpful office staff
  • Between visit communication

By this new definition, quality could encompass far more than just clinical actions.

Seeing how CMS has a track record of testing out new rules on larger practices and then phasing them in to smaller ones, it may be prudent for providers and groups to start preparing for this unfolding focus on patient satisfaction.

One option for providers is to jump right in and follow the instructions outlined here to implement the complete 12 surveys included in the CG CAHPS program.

Another option is to start small. They could work with Adopt One Challenge to improve a single patient-centered communication skill each year.

It’s a good point – patient satisfaction with the quality of care they receive is possibly more important than the provider’s input, since they’re the ones who have to live with the consequences.

*If you feel like joining the conversation, the #kareochat takes place on Twitter every Thursday from 9 – 10 am PST.