Is the emphasis on patient satisfaction scores driving up the cost of care?

Patient satisfaction scores now affect a provider's reimbursements.

Since 2013, the Centers for Medicare and Medicaid Services (CMS) has withheld 1 percent of total hospital reimbursement, and used those funds to reward the facilities with the highest performance-measure scores. Patient satisfactions reports make up a third of that score, financially incentivizing providers to ensure their charges are content with the care they received.  

However, the health care industry has long had split opinions on the effectiveness of this strategy. Consumers and industry critics argued it would help patients better understand their treatments and cost of care, while many physicians resented what they saw as a another federal imposition into their practice.

According to the results of a survey performed by Emergency Physicians Monthly, 48 percent of providers said they altered medical treatment because of the potential for a negative report on a patient satisfaction survey, with 10 percent of those admitting they provided medically unnecessary care. 

A separate South Carolina Medical Association survey found that more than half of responding physicians had ordered tests they considered unnecessary or inappropriate based on fears of negative patient satisfaction scores. 

"Doctors may order requested tests or treatments to satisfy patients rather than out of medical necessity, which may expose patients to risks without benefits," Joshua Fenton, an associate professor of Community Medicine at UC Davis told Healthcare Daily. "A better approach is to explain carefully why a test or treatment isn't needed, but that takes time, which is in short supply during primary-care visit."

The cost of these unnecessary tests can quickly accumulate, leaving care facilities faced with issues of bad debt when patients are not able to afford the up-front costs of the tests. Facilities that have encountered problems with accounts receivable management are encourages to outsource medical billing management to increase cash flow and see a more manageable claims load per employee.