Issue link: https://beckershealthcare.uberflip.com/i/759108
70 THOUGHT LEADERSHIP Geisinger CEO Dr. David Feinberg Talks 1 Year of Patient Refunds By Brooke Murphy G eisinger Health System in Danville, Pa., implemented a satisfaction-guar- anteed patient refund program in November 2015 under the mantle of President and CEO David Feinberg, MD. Aer one year of refunds, Dr. Feinberg says the health system could have actually returned less money to patients compared to years prior. Under the ProvenExperience initiative, pa- tients can request refunds if they are dissatis- fied with their hospital experience. Refunds work on a sliding scale, meaning patients can seek refunds as little as $1 to more than $2,000. As of August, Geisinger had returned more than $400,000 to dissatisfied patients through the ProvenExperience initiative. Compared to the size of Geisinger's sprawling system — which includes 12 hospital campuses, two re- search centers and more than 30,000 employ- ees — $400,000 is less money than some might expect. Dr. Feinberg spoke with Becker's Hospital Re- view about lessons learned and insight gained through Geisinger's satisfaction-guaranteed refund program. Target areas for improvement e ProvenExperience program grew out of a desire to evolve Geisinger's patient engage- ment practices, Dr. Feinberg says. Patients' specific, detailed complaints guided Geising- er's subsequent work to improve patient expe- rience across its continuum of care. Dr. Feinberg listed some of the most com- mon patient complaints filed in the program, including long wait times in the emergency room, poor communication with their care- giver and environmental complaints, like noise level. Geisinger also received a stream of complaints regarding financial interactions. As consumers emerge as a critical payer group, patient finan- cial interactions have presented a significant problem for some organizations. Sometimes even providing patients with all the correct fi- nancial information still isn't enough to guar- antee understanding and satisfaction. Dr. Feinberg described several instances where Geisinger staff explained all relevant finan- cial and insurance information to patients via email, and patients still complained when an unexpected bill arrived in the mail. Each pa- tient was issued a refund because even though the system didn't err, Dr. Feinberg believes it still failed to connect with and properly ed- ucate the patient. is revealed pain points in Geisinger's revenue cycle and bill design, which the system is working to address. Dr. Feinberg believes the ProvenExperience program gave Geisinger a much more intimate knowledge of their patients which the system used to institute effective, long-term change. e refunds are effectively a tool that helps Geisinger continue advancing the standard of quality patient care. "When the complaints be- gin to go down, we know we've found a solu- tion," Dr. Feinberg says. Patients just want to be heard Prior to launching the program, some industry peers voiced concern. ey said patients with illegitimate complaints would take advantage of Geisinger, demanding refunds as a way to re- duce their out-of-pocket expenses. e health system found patients largely re- ported valid, authentic grievances. But Dr. Feinberg admits the administration has con- sidered implementing some caveats aer en- countering some "suspicious" cases. "A man called and wanted a refund for his son's spine surgery from 1993," says Dr. Feinberg. "We gave him the refund, but we decided to put some time constraints on the program." Geisinger Health System also received some complaints from patients post-cosmetic sur- gery that elicited skepticism among program administrators. e health system has not de- cided whether it will discontinue the refund program in its cosmetic practice. Dr. Feinberg wasn't necessarily surprised by patients' overwhelming goodwill and honesty. But he was surprised to find patients rarely, if ever, requested a refund in full. e program gave patients a meaningful way to express and validate their dissatisfaction, rather than an opportunity to save money. "People just want be heard. We're in this indus- try to take care of people and treat them with compassion. Patients recognize and honor that commitment," Dr. Feinberg says. n 7 Thoughts on Leadership With One of Yale-New Haven's Youngest Administrators By Mackenzie Bean A t 28-years-old, Stephanie Beauton already has quite a list of accomplishments to her name. She serves as an off-shift executive administrator at Yale-New Haven (Conn.) Hospital, holds a master's degree in health adminis- tration and is finishing up a health and human services doctorate with a concentration in community health and education. She also serves as an adjunct faculty mem- ber at Naugatuck Valley Community College in Waterbury, Conn., and co-founded a nonprofit organiza- tion called Fitizen, which she sits on the board of directors for. Ms. Beauton was raised in a small town in Connecticut. While her mom and dad didn't go to college, they always encouraged her to work hard and open up her mind to learning. Starting at age 18, she participated in as many healthcare-related intern- ships as possible — including one at New Haven, Conn.-based St. Rapha- el's Hospital, which was acquired by Yale-New Haven in 2012 — and even- tually earned a bachelor's degree in political science and public health from Southern Connecticut State University in New Haven. She received the 2013 Alumni Com- munity Service Award from South- ern Connecticut State University, sits on the board for Get Healthy CT and acts as a liaison for the New Haven Chapter of the Crisis Intervention Stress Management Committee. Ms. Beauton shared her thoughts on leadership and her role at Yale-New Haven with Becker's Hospital Review. Note: Responses have been lightly edited for length and clarity.