Becker's Hospital Review

25 Executive Briefing Sponsored by: CFOs: The New 'Executive Champions' of Patient Satisfaction N o hospital or health system is immune from margin pressure. From policy decisions made in Washington, D.C., to tense payer negotiations and competition with other health entities at the local, regional and national level, hospital CFOs face many economic determinants that cannot easily be controlled with financial investment. Fortunately, a patient's experience with a hospital or care team is very much within an organization's management. To ensure financial viability in this tenuous healthcare landscape, hospital CFOs must become acquainted with what was once an unfamiliar core competency: patient satisfaction. Patient satisfaction fell outside of CFO job descriptions in the past, but no hospital today will survive when its financial stewards and strategists are out of touch with patients. Why the change? CFOs' concern for the patient stems from their interest in ensuring financial stability. This year, the U.S. government will withhold $1.7 billion in Medicare payments from hospitals with poor performance on the HCAHPS survey, which measures patients' experiences in hospitals. With nonprofit hospitals currently reporting an average of 3.4 percent operating margins, few organizations can afford reimbursement cuts. "While [patient satisfaction] scores were critical before, value-based care has put a bright spotlight on them now," said Gerald Maccioli, MD, MBA, chief quality officer and medical director of clinical research and scientific intelligence for Envision Physician Services. The rise of consumerism and transition to quality-based reimbursements also underscores the importance of patient satisfaction. Many Americans are now covered by high- deductible health plans, and consumer behavior changes when facing potentially thousands of dollars in deductibles. MACRA, or the Medicare Access and CHIP Reauthorization Act, marks a new era in provider reimbursement that incorporates patient satisfaction to determine Medicare payments made to physicians. Patients also have an increasing number of outlets through which they can share, rate or grade their experience with a hospital. These forums supplement industry websites that detail hospitals' patient safety rates, surgeon performance and outcomes, health outcomes and other key metrics. Hospitals and health systems today are vulnerable to more public scrutiny than ever before, and a single negative experience can change the perception of an organization for many. These reasons all underscore the burgeoning role of healthcare CFOs in the patient experience. CFOs make decisions on everything from capital spending to incentive alignments. They oversee the dollars that, if properly allocated, can influence patients' consideration for their healthcare organization and empower care teams to deliver high-quality, compassionate and personalized care. Dr. Maccioli says the CFO should act as the "executive champion" for patient satisfaction. This article explores the new relationships CFOs must cement to do just that. Data-driven CFOs must integrate another layer of information into decision-making Finance is a data-driven field. CFOs are accustomed to managing the business through data and analytics — powerful empirical information that justifies where and why dollars are allocated. At the same time, CFOs' relationship with data will become even more sophisticated as they incorporate patient experience into their financial strategies. Patient satisfaction surveys and other tools provide the qualitative feedback and information vital to making wise long-term investments. For example, a decision that may yield immediate cost savings may yield detrimental effects on patients in the long run. U.S. News & World Report published a list in 2015 detailing the most common pieces of feedback from patient letters or surveys. Many respondents cited sleep deprivation, noisy nurses' stations and messy rooms as core reasons they were dissatisfied with their care, and only a small percentage of feedback involved the clinical care they received. Their input highlighted shortcomings that hospitals could remedy through adjustments to daily operations. CFOs possess analytical minds that enable them to understand the patient experience through concrete data instead of abstract discussions or anecdotes. The same rings true for their departments. Financial teams are more inclined to buy into the vision of a leader who makes large-scale decisions based on data rather than instincts or personal experiences. This reason alone is cause for hospitals to implement survey methods and mechanisms that enable patients and families to provide immediate feedback about their experience before they leave the hospital. For example, some hospitals and health systems share questionnaires on tablets with patients and families, thereby increasing the likelihood and quality of feedback when it is still top of mind. In addition to powerful survey feedback, CFOs have a wealth of internal benchmarks that relate to the patient experience — albeit less obviously.

• Cover