Becker's Hospital Review

47 THOUGHT LEADERSHIP Children's Hospital of Philadelphia for pediat- rics. As a not-for-profit, Virtua is committed to the well-being of the community and provides innovative outreach programs that address social challenges affecting health, most nota- bly the "Eat Well" food access initiative, which includes the unparalleled Eat Well Mobile Gro- cery Store. A Magnet-recognized health system ranked by U.S. News and World Report, Virtua has received many awards for quality, safety, and its outstanding work environment. For more information, visit Virtua.org. To help Vir- tua make a difference, visit GiveToVirtua.org. About Cooper University Health Care Cooper University Health Care is a leading academic health system with more 8,500 em- ployees and more than 800 employed physi- cians. Cooper University Hospital is the only Level 1 Trauma Center in South Jersey and the busiest in the region. Annually, nearly two million patients are served at Cooper's 635-bed flagship hospital, outpatient surgery center, three urgent care centers, and more than 105 ambulatory offices throughout the community. e Cooper Health Sciences campus is home to Cooper University Hospital, MD Anderson Cancer Center at Cooper, Children's Regional Hospital at Cooper, and Cooper Medical School of Rowan University. Visit CooperHealth.org to learn more. n How Geisinger's refund program is faring amid patient experience crisis By Erica Carbajal I n the middle of a patient experience crisis, the logical assumption for a health system that gives patients the opportunity to request a refund is that those expenses will skyrocket. Geisinger has seen the opposite, with pa- tient refunds on the decline in recent years. In late 2015, the Danville, Pa.-based system rolled out the ProvenExperience program, which gives every patient the option to claim a full refund, no questions asked. The program works on a sliding scale, allowing patients to de- termine how much of their copay they'd like back if their service or experience expectations weren't met. "This is recognizing the consumer side of medicine, but even beyond that, that if you promised to provide a certain service and fail — and [patients] paid money for it — that's considered just good business and relationship practice to say, 'Well, we should give your money back,'" Greg Burke, MD, Geisinger's chief patient experience officer, told Becker's. "I think any small businessman would understand that principle, and that brings credibility to our work." ProvenExperience refunded $320,141 in financial year 2016. In 2020, Dr. Burke said Geisinger refunded about $84,000, and the program refunded $40,000 in 2021 — a surprising trend, given a national drop in patient experi- ence satisfaction measures throughout the pandemic. Findings from a Press Ganey survey in November 2021 found patients' overall rating of hospital care fell 4 per- centage points, and the likelihood of recommending their hospital fell 4.5 percentage points. "For those who aren't familiar with how patient experience data moves, this is a huge drop," Rick Evans, chief expe- rience officer and senior vice president of NewYork-Pres- byterian Hospital, wrote in a piece for Becker's after the findings were published. COVID-19 complicated hospitals' ability to uphold cer- tain expectations on the patient experience side, and that was no exception at Geisinger. The health system saw an increase in the number of complaints surrounding com- munication issues, access and hospitality as the pandemic progressed. Amid the rise in complaints, refunds still decreased, per- haps because commitment to the ProvenExperience pro- gram has created an acute awareness of the patient expe- rience that drives constant improvement. "Whenever you make a service guarantee, you're willing to take some risk onto yourself," Dr. Burke said. "I think that really requires … that we continue to improve our process- es and not ignore even the small pain points that patients are feeling that are diminishing their experience of health- care," Dr. Burke said. Experience issues tied to refunds are always paired with an action plan to prevent other patients from experienc- ing the same shortfalls. Once a communication or other failure is identified, both operational and frontline leaders develop a plan. "Part of learning is not just knowing what went wrong for a particular patient or family, but then finding ways to fix it," Dr. Burke said. "There [always has to be] an action plan associated with failure. That benefits the system and also benefits the patients, because then we're continually im- proving." ProvenExperience has helped shape a culture of account- ability at Geisinger, with the majority of refunds over the last few years having been proactively offered by the Geisinger team and taken care of on the back end, rath- er than a patient or their family having to formally request one. And for those requested by patients, the "vast, vast" majority have been honest. "Much like a very good hotel or restaurant would recog- nize [a failure], before the patient asks for a refund, we'll offer it," Dr. Burke said. n

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