Patient Experience: Why Will Executive Bonuses Will Be Lower Than Expected?

Sometimes I find it helpful to make a point with all of the subtlety of the first scene in a James Bond movie.  But, today I think we shall slide into it a little more adroitly.   

The other day my youngest son asked me if water was free when I was a boy.  I told him we used to have to rub two sticks together to make water—that slowed him down.  Some days it feels like the world is not what it never was.  Then my wife handed me a serving of Activia Yogurt, the one attested to by Jamie Lee Curtis, explain that it is supposed to be good for people over fifty.  Next they would be handing me a walker and taking away my driver’s license.

One of my favorite trade magazines for staying abreast of current thought leadership is HealthLeaders.  I do find however that there is usually an article in the magazine that seems to be begging for a different perspective; mine.

This week’s issue was no different.  One article ‘The Rise of the Chief Strategy Officer’ showed a chart of CEO’s top priorities for the next three years.  And you guessed it, their top priority is patient experience and satisfaction—I’m assuming their goal is to raise it, for to lower it would be nonsensical, but the priority was sorely lacking a verb.  Forty-nine percent of the CEOs selected this goal.  The survey results did not show their second choice, but if one extrapolates from other surveys, those listing patient experience as their second choice would be around forty percent.

Another article, sponsored by Conifer Health addressed building loyalty.  The top area of concern to improve community interaction is HCAHPs surveys and patient satisfaction surveys—we do like our surveys.  I guess that if ones only tool is a hammer everything it encounters had better be a nail. It reported that the main challenge in having a positive relationship with every patient is building patient loyalty—29%.  And, their main areas of focus, in order of rank, to improve patient experience are in-visit, outreach, feedback—there is our survey friend, access, and pre-visit.

I’ll tie this altogether in a moment, but first, the final article that caught my eye was Reassessing Executive Compensation in which one CEO said “There is a heavy emphasis on patient experience…for executive compensation.”  A chart listed KPIs for skill sets required of a CEO.  All of the skills, as you might expect, had to do with the business of healthcare; costs, alignment, optimization.

So, here’s what that leaves us.  Patient experience is a top priority. Improving patient experience ties directly to executive compensation. And the top activity to try to improve patient experience is—say it with me—surveys.

Permit me to make a bold prediction—hospital CEO incentive payments will be lower than what they might have been.  Here is why:

  • Less than one hospital in four even has a system-wide definition of the term “patient experience.”
  • If you can’t define it, how can you possibly expect to raise it?  By raising the scores someone else’s definition—CMS?
  • Patient experience is tied to what happens inside the hospital (clinical satisfaction) and what happens outside the hospital (customer satisfaction through access)
  • Nobody is measuring customer satisfaction, it is not even included in the discussion? Is that because it isn’t surveyed, or because it is deemed irrelevant?
  • Hospital executives cannot list the most frequented patient touchpoints
  • Hospital executives do not know which touchpoints have the greatest impact on customer satisfaction.


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