The price of health care is rising at a quick rate because of the many challenges facing healthcare such as malpractice cost to doctor turnover, healthcare facilities or hospitals needs to take full advantage of their resources and make decisions to continue to be profitable and because of these challenges this is why it is important to improve patient satisfaction. “When”, we improve patient satisfaction we increase productivity. The hospital administration, doctors, and staff spend more time addressing complaints and non-compliant patients, which can damagingly influences the hospital or health clinic productivity. Satisfied patients are easier to care for and less time is spent dealing with complaints, and patient are more compliant with there healthcare. “Focusing”, on making the patient happy decreases the length of patient’s visits and time in the clinic and can cut the cost of treatment and increase patient capacity.
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Hospitals and facilities around the world are focusing their attention on patient satisfaction. To examine patient satisfaction hospital look towards patient satisfaction surveys to help the hospital administration by including the patient viewpoint to generate a philosophy where services are believed to be an important strategy for the hospital or healthcare facility. “Although”, patient surveys has been successful there is still work that needs to be done. Patient surveys are used as a way to measure quality of care and patient safety.
Evaluate and Explain Inconsistency
When evaluating and explaining the inconsistency between customer satisfaction and profitability and why it tends to exist in healthcare organizations, according to an article by Kerfoot, K. (2016. Para 1-7). Hospital Consumer Assessment of Healthcare Providers and Systems scores are based on patient satisfaction by using surveys, which have a direct effect on hospital revenue. “When”, a patient is discharged from the hospital a patient may be asked to complete a survey relevant to their hospital visit and based on the scores the hospital or clinic will either cost or increase profit up to 1.5% to 2% of Medicare payments. This averages about $500,000 to $850,000 a year for each hospital. “Although”, risky Patient satisfaction survey can be rewarding and increase hospital profits.
Several healthcare executives that was surveyed expressed that patient experience and satisfaction was one of the 3 major concerns due to the loss or gain of funding. The link between HCAHPS scores and hospital profitability established through data based on 3,025 critical-care hospital around the world. The higher the HCAHPS score increases profit at a margin of .93, and the lower scoring hospitals for patient satisfaction displayed a lower profit margin of -4.59.
“Because”, of the Affordable Care act more Americans are purchasing health insurance and making patient satisfaction of the utmost importance. The more people that are insured means more people seeking health care cause’s hospital to compete for the patient business. Health care is like a business, it determines how much to patients is worth, because if the patient is unhappy with the service you provide that will not stay loyal to your hospital.
The link concerning profitability and HCAHPS scores is Quality of care which as the greatest influence of patient satisfaction. Hospital staff that work with patients, and their happiness with their job have an impact on the quality of care. Patients believe that hospitals should reduce by 2% for nurses that report displeasure with their occupation seeing a profit rate of 37% and hospitals that score above a 9 see a profit of 80%. “When”, hospital invest in their staff they will see a greater return in the long run. Technology can produce optimistic work setting that provides structure that support members of the hospital by encouraging a balance between life and work. Combining staff and technology can decrease burnout and provider fatigue by decreasing overtime and other factors.
Statistical Procedures or Refute Inconsistency
“When”, applying the statistical procedures discussed in class to support or refute the inconsistencies, there are 4 tests that involve certain expectations be met. The first test is the t-Test which is normally used in literature and used to link two groups with a continuous variable and can be paired or unpaired and A P <0.05 proposes data indicating a difference amongst the two groups one being male and other group female. Chi-Squared of Association test the association of categorical variables and A P<0.05 points out the association among the two variables.
Pearson’s Correlation assess association between two continuous variables and takes on the values between -1 and 1. A positive value increases both variables but if the value is negative, when one variable increases one decrease. Linear relation value is zero and if the value is 0.5 to 0.6 indicate a sensible correlation, 0.6 to 0.7 propose a good correlation and a correlation of 0.7 to 0.8 is an excellent correlation, a correlation above 0.8 magnitude is rare. “Lastly”, linear regression is used when the variable outcome is continuous and there are two types simple linear regression analyze data for the outcome variable alongside a predictor variable and estimates a regression coefficient, which proposes how much the variable outcome increases or change the predictor variable. Multiple linear regression is used to compute coefficients. Material Research Essential. (2014).
Price vs. Quality of Services
MACPAC. (2018. Para 1-24) suggested that several research studies has been done to see if managed care delivery systems improved outcomes there is no evidence that managed care increases or decreases access to quality care for the patient. The enrollee’s access to care is the responsibility of the Medicaid managed care organization which is vital to improving the delivery of quality of care. “For”, each person enrolled in a plan under managed care the state pays a fee at a fixed rate for each member per month to cover services that each enrollee receive. The payer pays the doctors for Medicaid services that the patient needed and contained within the plan under Medicaid.
Doctors are required to keep their patients healthy to preserve cost within the payment rate by providing preventive care to minimize costly hospital and emergency room visits. Some people believe that under the capitated payment system MCOs are paid per patient and not on the amount of treatment, is given an incentive to decrease the cost of treatment. Capitation rates can also impact incentives and if set to low can cause incentives to limit services through the use of the doctor, preauthorization polices and place restrictions on benefits. “With”, the decrease in rate prompt policies to pay less for care and can cut the number of physicians willing to provide care “therefore”, delaying access to care.
Managed care plans can create their own network qualifications, terms of contract and compensation rate set by the state. M CO patients are normally limited to a network of doctors and must deliver satisfactory care. In urban and rural areas across the United States size, range of network will impact the types, availability, and quality of care accessible to patients which can vary largely by state.
The provision of benefits under various delivery systems can present many challenges in management of care because contracts amongst the state and managed care organization recognize which state plan will be the obligation of the MCO, some benefits are the sole responsibility of Medicaid and have been provided through managed care such as long term care and transportation is fixed from the capitated benefit package to continue access to care and because MCOs can offer services including the services accessible under the state plan can be improved for their patients. Contracts must be specific, Medicaid managed care must meet certain criteria that don’t apply to Medicaid, federal and regulatory laws such as standards of access to quality care and conditions of annual quality review, that applies to the MCO’s.
In studying in the relationship concerning managed care, access and quality Medicaid managed care offers payees better quality access, but the scope and level of improvements are specific to the state and variable. A Medicaid managed study conducted in Texas determined patients’ satisfaction reveals that Managed care organizations are meeting their patients’ needs as well as satisfaction scores exceeding national standards on a number of key areas such as readmissions. Another survey of the state Medicaid program indicated that over two-thirds of states conveyed that Medicaid payees experienced some access to care problems because of problems by a patient with other insurance, but at the same time access to care was improved due to managed care fee-for-service.
Managed care on the quality of care can be difficult to evaluate. Quality is a subjective theory and is assessed using both process measures and results. Data published by NCOA from CAHPS survey measures the views of the enrollee’s health insurance plan, physicians, total health, and the ability to access care. Enrollees in the managed care programs rate their health coverage at a higher rate as opposed to private insurance patient with a poorer rating compared to Medicare patients.
High Patient Satisfaction Results
“According”, to Healthcare Financial Management Association, (2018, Para 1-16) when using high patient satisfaction to my advantage negotiating a new managed care contract for the hospital requires planning, establishing a relationship and cooperation amongst all parties involved. Negotiating requires preparation, so that the hospital can establish a payer-provider partnership. The main objective of managed care negotiation is to obtain reasonable compensation for care, the effect patients will have on our workflow and products being offered.
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A payer profile should be established before sitting down at the negotiating table. To create a payer profile we must reach out to the contracting partners to collect key information about the goals being negotiated and products or equipment they plan to endorse. Information can also be obtained from data collected inside the organization by researching how much income the payer will bring to the hospital or clinic, how it is a breakdown within the different department in the hospital. We should also analyze denials and reach out to the organization staff via a survey or communication about any problems to collect information.
“Lastly”, if all parties involve maintain communication with a positive approach and payer and health care professional can agree they all win. With the knowledge, expertise and method doctors used to deliver health care for the patients, the patient will be placed at the top of the health care process.
Ethical issues involved when presenting results is giving a false report, bribery, rewards, violating the rules and ignoring the facts or lying. Lying is defined as being dishonest. Additional issues included when presenting results are setting limitations on negotiation before you start talk, taking an offer back that has already been set at a later date and failure to put the contract in writing. Nursing Link. (2018).
Qualitative and Quantitative
Qualitative data can be used to help hospital improve market share because it is used as a plan by the hospitals to help patients see the bigger picture and help marketers gather numerous amounts of information about the patients. Qualitative research focus on the primary reason, opinions, and why patients act a certain way.
“When”, studying the qualitative data you will understand what influences patients to take action and getting to the basic core of what makes a patient tick. Marketers might look at numbers to see why patients may not return to the hospital or clinic though numbers but don’t say why, another qualitative approach is videoing a method used to record a patient thought as they continue to deliver correct, clear and actionable reasons for their choices. This kind of videoing captures things that analytical data cannot.
“Finally”, qualitative research can be looked at as a study that focus on the role of the patient. Analytical numbers are used in controlling technical mishaps, uncovering avenues and other areas where primary numbers make difference. Marketing persona is based on personal information collected from those numbers such as a patient’s gender or location. Patel, N. (2018, Para 1-14).
“According”, to an article by New Perspective. (2015, Para 1-6). Quantitative data can be used to help hospital improve market share to improve patient satisfaction, health specialists work life, ways to avoid patient illness and hospital safety. Quantitative research focuses on statistical, mathematical or numerical results and can help hospitals increase services and influence actions.
Studies are conducted to help hospitals recognize their patients who needs care are in pain or feeling discomfort. “Though”, patient surveys physicians can find more information about their patient and to see if they are happy with their care. Studies are conducted by surveys such as patient satisfaction surveys, marketing research, and Pain assessment surveys this information allows healthcare workers find out what patients needs and how they will improve, as well as learn patient demographic to structure their services.
Doctors can learn more about a patient diseases by conducting research to get essential data for qualitative research. Viewpoints uses both quantitative and qualitative research to study data that is aimed at helping the hospital improve its decision making information. Hospital administration may seek input from the patient bout the appearance of the office, improving the hospital is a good way to obtain patient/staff satisfaction. “Lastly”, interviewing the hospital staff can be used to learn common practices in regard to educating and supplying the patient with the information needed, this is used to obtain more resources that will be shared with patients and then quantitatively tested.
I believe that patient surveys and using the outcome of the results will add value and allow patients to help improve quality care. Implementation of surveys depend of the project and applications for conducting the project. “In”, the health-care setting surveys are use as tools that are tailored to improve quality care. I often hear patients and hospital staff say that surveys are a waste of time because the outcome will not result in a quality improvement plan. Some hospitals have been known to use surveys incorrectly to attain financial gains.
It is vital for hospital employees to establish partnerships with patients, with the goal to build trust and instill an attitude to benefit both parties. The sharing of information and being clear with the investor can help influence when negotiating is needed. Teamwork and benchmarking is essential for best practices. “When”, conducting surveys information should be obtained from more than one source to get a better outcome and not used to make changes or policy decisions.
Healthcare Management Financial Association. (2018). Successfully Negotiating Managed Care Contracts Retrieved from http://www.hfma.org/Content.aspx?id=16658
Kerfoot, K. (2016). Patient Satisfaction and the Bottom Line Retrieved from http://www.apihealthcare.com/blog/healthcare-trends/patient-satisfaction-and-the-bottom-line
MACPAC. (2018). Managed care’s effect on outcomes Retrieved from https://www.macpac.gov/subtopic/managed-cares-effect-on-outcomes/
- New Perspective. (2015). How Quantitative Research Helps Improve Healthcare Facilities Retrieved from https://www.new-perspectives.net/quantitative-research-improves-healthcare-facilities/
- Nurse Link (2018). Ethics in Managed Care Contracting Retrieved from http://nursinglink.monster.com/training/articles/328-ethics-in-managed-care-contracting
Patel, N. (2018).How to Use Qualitative Research to Expand on Your Marketing Personas Retrieved from https://neilpatel.com/blog/qualitative-research-marketing-personas/
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