When one considers all of the things that make up a person’s experience with a hospital—I use person instead of patient because prospective patients, people who interact with the hospital online and on the phone have experiences—the impact, positive or negative, of any single HCAHP becomes de minimis.

For example, a hospital buys its data. The survey establishes that the nurse in radiology can be cranky.  The hospital then hires a coach. The nurse learns how to smile.  Problem solved.  What is the ROI on the data buying and coaching hiring?  I do not think there is an ROI, at least not a positive one.

Here is what the voices are telling me.

• ·       Ordinary people (people not employed by the hospital) do not know what HCAHPs are, nor can they define them

• ·       Nobody who does not work at your hospital knows your hospital’s score and they do not know how it compares to the scores of your competitors

• ·       That means people do not use your hospital’s HCAHPs in determining whether to buy healthcare from you—it is a non-factor in their purchase decision.

• ·       These same people do know how difficult it is to schedule an appointment, to understand their bill and to file a claim.

• ·       The hospital does not know the difficulty.  The hospital does not know how that difficult translates into a poor experience and into lost patients.  The hospital does not know because it does not ask and it does not measure.

• ·       Most hospital employees cannot tell you their hospital’s score, how it compared to last year and what is being done to improve the score.

• ·       Employees cannot tell you whether last year’s patient experience initiatives were successful and whether the initiatives raised or lowered the overall score.

• ·       Most hospital financial executives probably do not know what was spent on improving patient experience and what that expenditure cost for each tenth of a point it raised their score. (Some hospitals that spent money to raise their scores actually saw their scores drop.)

If HCAHPs scores are a non-factor for patients and prospective patients—the very people whose experience hospitals are trying to affect, then it is important to ask the question ‘why are we focused only on improving HCAHP-experiences?’  Shouldn’t hospital executives be asking themselves whether paying for a coach to change the temperament of the radiology nurse affected their HCAHP score enough to reduce the penalty?  That is, what did they get for what they spent?

CMS penalizes half the hospitals based on poor HCAHPs, readmissions, and a combination of other factors.  The total penalty will amount to a dollar figure per bed times the number of beds, let’s pick the number $4,000 per bed.  For a 300 bed hospital the penalty in this example is $12,000,000.  A substantial amount no matter who you are.

However, I discovered that the average person who contacts a hospital is worth $7,000 to that hospital that year.  How many people contact your hospital each day?  To keep the math simple, let us assume the answer is 10.  Ten people times 365 days times $7,000 of potential revenue per person is $25,550,000 that could be earned.

The elephant in the room that nobody is asking about is what kind of experience are those ten people having when they contact the hospital?  Was it satisfactory? Did they hire us to provide their healthcare?