Profitability vs. Patient Satisfaction

IN OUR FIRST ARTICLE we noted that in the greater healthcare arena, much has been said about patient satisfaction and its overall beneficial effects: including, but not limited to, better clinical outcomes, more patient referrals, increased market share, higher hospital occupancy, greater leverage when negotiating with managed care providers, lower frequency of malpractice claims, higher clinical staff morale, and increased philanthropic support. However, comparatively little has been written about the impact of patient satisfaction on the bottom line of outpatient dialysis clinics/nephrology practices.

Reader Response

CEO Feels Patient Satisfaction Boosts Profit

My position is that enhancing or maximizing patient satisfaction—while keeping optimal clinical outcomes as a dual priority—does increase profitability.

If a patient makes it to the center—or is consistent in their home treatments— the center can bill and be reimbursed. If the percentage of those billed treatments includes a nominal percentage of private pays to offset Medicaid or Medicare ‘losses’ per treatment, the center fares better.

If you can keep a patient on a modality longer, that consistency helps amortize costs involved with training and initially acclimate them to dialysis.

If a center uses home dialysis modalities such as daily nocturnal, NxStage or PD, the amount of staff time/cost goes down the longer that person is maintained successfully on that modality. Since home modalities have a higher average net margin, the aggressive pursuit of getting your patients home can be THE major factor in increasing net margins while affording your patients more family or work time; less exposure to in-center infections; less procedures on average; and much less travel and wait times involved with meeting a center-imposed hemo schedule.

Patient care and satisfaction certainly can be linked to increased margins and ‘efficiencies’ in billed treatments.

Good Luck Jack!

CEO/Renal Administrator, New York

Nephrologist Sees No Correlation Between Financial Outcomes and Patient Satisfaction

The question you have asked is whether patient satisfaction evaluation improves financial outcomes of outpatient dialysis and nephrology practices? My own study into this has suggested the following:

1. Patient satisfaction is only one component of quality measures, which one can use to identify issues that need improvement affecting patients well being. By using patient satisfaction surveys, one might be able to identify patients’ astuteness in detecting breaks within systems, processes and outcomes, which might not have been evident by other methods. Patient satisfaction forms essentially change the focus from direct provider interpretation of quality of services being offered to quality of services expected. There should be no correlation to financial outcomes since some measures that patients perceive in improving quality might not cost anything at all.

2. Medicare’s goal of Health 2010 has shown repeatedly that if one fixes the denominator of assessing quality with fixed payments or even incremental payments for better quality, one still cannot achieve the quality standards desired, because what patients perceive as quality is very different form what scientists perceive as quality.

Respectfully,

Director of Nephrology MD, MPH, New York

Speak Your Mind

For those of you who are new to this column, our format is to pose financial- themed questions each month, invite reader response, and provide substantive insight to those issues that impact the financial health of renal providers and renal professionals.

As I mentioned last month, ultimately, you, the reader, will set our agenda by letting me know what money issues matter to you most. You can expect this column to provide relevant, real-time perspective, addressing your concerns, and yes, even challenging you to do a few calculations of your own.

All topics are open for discussion—ranging from hot-button, broad-based issues such as Medicare reimbursement, to more personal challenges such as how much increased professional compensation to expect from your present employer during your annual review.

Send your topic suggestions to me at jahern@ahernconsulting.com, I look forward to hearing from you. Please note your comments will be addressed, but your name will not be mentioned in any column without your permission.

In order to allow sufficient time for our readers to research and respond to our questions we will allow each topic at least a two-month span of discussion and comment. This means that most, if not all, comments will be presented and those of you who wish to respond to the first round of reader comments may do so. RBT

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