The effect of patient quality measurements and HCAHPS patient satisfaction on hospital reimbursements

IF 1.5 Q3 MANAGEMENT Human systems management Pub Date : 2022-10-20 DOI:10.3233/hsm-220042

Hui-chuan Chen, Tommy Cates, Monty Taylor

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Abstract

BACKGROUND: The Centers of Medicare & Medicaid Services (CMS) links hospital reimbursements to quality metrics. Likewise, the Hospital Value-Based Purchasing (VBP) program offers financial incentives to acute-care hospitals based on performance improvements on several quality measures included in the national Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. A research gap exists with regard to assessing the effectiveness of VBP incentives on improving the patient’s quality of care. OBJECTIVE: This study is to determine whether hospitals which reported better patient quality metrics and lower frequency of pressure sores received higher reimbursements. METHODS: The data were retrieved from the CMS Care Compare website utilizing matched data from 2297 US hospitals. Information on HCAHPS, the VBP Program in Patient Safety Index, and Reimbursements was obtained for this study. Partial Least Square (PLS) was utilized thru SmartPLS 3.0 to test the hypotheses. RESULTS: The results did not reveal any financial penalties when hospitals reported lower patient quality outcomes and increased numbers of pressure sores. However, lower patient quality measures were associated with lower patient satisfaction. Controversially, lower patient satisfaction scores were associated with higher reimbursement rates overall. CONCLUSIONS: The main contribution of this study reveals that the effectiveness of value-based reimbursements and the concept of continuous improvement is constrained due to the lack of unified measurement objectives across US healthcare institutions.

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患者质量测量和HCAHPS患者满意度对医院报销的影响

背景：医疗保险和医疗补助服务中心（CMS）将医院报销与质量指标联系起来。同样，基于医院价值的采购（VBP）计划根据国家医院医疗保健提供者和系统消费者评估（HCAHPS）调查中包含的几个质量指标的绩效改进，为急性护理医院提供经济激励。在评估VBP激励措施对提高患者护理质量的有效性方面存在研究空白。目的：本研究旨在确定报告患者质量指标更好、压疮发生率较低的医院是否获得了更高的报销。方法：利用2297家美国医院的匹配数据，从CMS Care Compare网站检索数据。本研究获得了关于HCAHPS、VBP项目患者安全指数和报销的信息。通过SmartPLS 3.0使用偏最小二乘（PLS）来检验假设。结果：当医院报告患者质量下降和压疮数量增加时，结果没有显示任何经济处罚。然而，患者质量指标越低，患者满意度越低。有争议的是，患者满意度得分越低，总体报销率越高。结论：本研究的主要贡献表明，由于美国医疗机构缺乏统一的衡量目标，基于价值的报销和持续改进概念的有效性受到限制。

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来源期刊

Human systems management MANAGEMENT-

CiteScore

3.50

自引率

30.40%

发文量

期刊介绍： Human Systems Management (HSM) is an interdisciplinary, international, refereed journal, offering applicable, scientific insight into reinventing business, civil-society and government organizations, through the sustainable development of high-technology processes and structures. Adhering to the highest civic, ethical and moral ideals, the journal promotes the emerging anthropocentric-sociocentric paradigm of societal human systems, rather than the pervasively mechanistic and organismic or medieval corporatism views of humankind’s recent past. Intentionality and scope Their management autonomy, capability, culture, mastery, processes, purposefulness, skills, structure and technology often determine which human organizations truly are societal systems, while others are not. HSM seeks to help transform human organizations into true societal systems, free of bureaucratic ills, along two essential, inseparable, yet complementary aspects of modern management: a) the management of societal human systems: the mastery, science and technology of management, including self management, striving for strategic, business and functional effectiveness, efficiency and productivity, through high quality and high technology, i.e., the capabilities and competences that only truly societal human systems create and use, and b) the societal human systems management: the enabling of human beings to form creative teams, communities and societies through autonomy, mastery and purposefulness, on both a personal and a collegial level, while catalyzing people’s creative, inventive and innovative potential, as people participate in corporate-, business- and functional-level decisions. Appreciably large is the gulf between the innovative ideas that world-class societal human systems create and use, and what some conventional business journals offer. The latter often pertain to already refuted practices, while outmoded business-school curricula reinforce this problematic situation.