The Perception Of Quality And The Reimbursement Of Services

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How hospitals provide care has become as important as the care provided. This paper will establish the connection between the perception of quality and the reimbursement of services. Next, the impact of intradepartmental communication on patient care will be examined. Finally, this paper will attempt to demonstrate that the lessons from successful interim communications between departments can translate into an improved perception of quality during patient encounters.
Patients’ perception of quality and the impact on reimbursements CMS is one of the largest payers for medical service in United States. Up to 55% of all care provided is covered under the umbrella of Medicare or Medicaid (American Hospital Association, 2009). Operating
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This represents a substantial portion of a hospital’s operating margin which has forced a re-examination of the meaning of quality in health care. According to Ly et al. (2011), “lower margins are associated with lower quality of care.” Therefore, hospitals may be paid less due to subjective patient survey responses which may, in effect, lower quality further. Lower quality will then drive lower scores in a negative feedback loop. The health care industry can no longer measure quality based purely by patient outcomes. Under CMS regulations, quality is a product of both patient outcomes as well as the patient’s perception of how the services are provided, among other measures (Centers for Medicare and Medicaid Services, 2015). Therefore, the patient’s perception of quality can no longer be ignored. The patient’s perception of quality is influenced by the individual contacts made during a health care encounter. According to Johnson Thornton et al. (2011), “… this study suggests that [social concordance] is positively associated with patient satisfaction with care.” Extending this reasoning beyond the physician-patient dyad, all health care employees who contact the patient in the system must be able to effectively communicate to a patient the nature and impact of their contact. Failure to do may harm the interpersonal perceptions formed by a patient during an encounter.
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