As the Wall Street Journal reports, a recently instituted Obamacare pay-for-performance measure will tie hospital payments to consumer satisfaction by measuring responses to a questionnaire that surveys how well hospitals are serving their patients. Part of the reimbursement cuts for hospitals that take on Medicare patients — a rate cut of one percent this fiscal year, increasing to two percent by 2017 — will be redistributed to the high-performing hospitals that meet certain procedural benchmarks and score well on a the questionnaire:
Nearly $1 billion in payments to hospitals over the next year will be based in part on patient satisfaction, determined by a 27-question government survey administered to patients. Hospitals with high scores will get a bonus payment. Those with low ones will lose money. [...]
The new payment rate combines hospitals’ patient-satisfaction scores with a measure of whether hospitals follow a dozen procedural metrics for treating such things as heart ailments and pneumonia. For example, hospitals can get marked down if they don’t immediately give patients medication during a heart attack. [...]
Survey questions include: “How often did doctors treat you with courtesy and respect?” and “How often were your room and bathroom kept clean?” It asks patients to rate their stay on a scale of zero to 10.
High-performing hospitals will be rewarded with a Medicare “bonus” while low-performing hospitals have to live with the reimbursement rate cut. Since hospitals are far more in control of the procedural Obamacare metrics than the patient-satisfaction ones, providers are making sure they do everything they can to give patients personal attention and a satisfactory hospital visit.
As the Journal also points out, this Obamacare pay-for-performance theory of cost-cutting sets up a stark contrast with the preferences of the Republican presidential ticket. Instead of working within the existing network of Medicare and health care providers to incentivize higher performance while reducing health spending, Romney/Ryan would repeal Obamacare and further privatize the program, shifting the cost of care onto seniors’ premiums instead of asking for more from the providers that actually deliver medical services.