title: Patient Hospital Experience Improved Modestly, But No Evidence Medicare Incentives Promoted Meaningful Gains.
abstract: The Centers for Medicare and Medicaid Services (CMS) has played a leading role in efforts to improve patients' experiences with hospital care. Yet little is known about how much patient experience has changed over the past decade, and even less is known about the impact of CMS's most recent strategy: tying payments to performance under the Value-Based Purchasing (VBP) program. We examined trends in multiple measures of patient satisfaction in the period 2008-14. We found that patient experience has improved modestly at US hospitals-both those participating in the VBP program and others-with the majority of improvement concentrated in the period before the program was implemented. While certain subsets of hospitals improved more than others, we found no evidence that the program has had a beneficial effect. As policy makers continue to promote value-based payment as a way to improve patient experience, it will be critical to ensure that payment is structured in ways that actually drive improvement.
authors.affiliation: Irene Papanicolas (i.n.papanicolas@lse.ac.uk) is an assistant professor of health economics in the Department of Social Policy at the London School of Economics, in London, England. At the time of this writing, she was a 2015-16 Harkness Fellow in the Department of Health Policy and Management at the Harvard T. H. Chan School of Public Health, in Boston, Massachusetts.
authors.forename: Irene
authors.initials: I
authors.lastname: Papanicolas
authors.affiliation: José F. Figueroa is a physician in the Department of Medicine at Brigham and Women's Hospital and an instructor of medicine at Harvard Medical School, both in Boston.
authors.forename: José F
authors.initials: JF
authors.lastname: Figueroa
authors.affiliation: E. John Orav is an associate professor of biostatistics at the Harvard T. H. Chan School of Public Health.
authors.forename: E John
authors.initials: EJ
authors.lastname: Orav
authors.affiliation: Ashish K. Jha is the K. T. Li Professor of International Health at the Harvard T. H. Chan School of Public Health and director of the Harvard Global Health Institute, in Cambridge, Massachusetts.
authors.forename: Ashish K
authors.initials: AK
authors.lastname: Jha
mesh_terms: D005102:Health Expenditures; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D006278:Medicare / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D011445:Prospective Payment System; D012052:Reimbursement, Incentive / Q000191:economics; D011795:Surveys and Questionnaires; D014481:United States; D062505:Value-Based Purchasing / Q000706:statistics & numerical data*
keywords: Health Reform; Hospitals; Quality Of Care