Nursing Care, Inpatient Satisfaction, and Value-Based Purchasing

OBJECTIVE: The objective of this study was to investigate how domains of patient satisfaction in hospitals predict Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) global rating scores to support hospital administrators in dealing with reimbursement changes. BACKGROUND: Medicare's inpatient value-based purchasing program ties a portion of hospital payments to scores on the HCAHPS survey. METHODS: Logistical regression analysis of patient-level satisfaction domain scores from a standard, commercially available survey and HCAHPS top-box scores controlled for potential confounding variables. RESULTS: Each 1-point increase in the nursing domain score increased the odds of achieving an HCAHPS top-box score by 4.9%. Increases in other domain scores also affected top-box odds, although to a smaller extent. CONCLUSIONS: Hospital administrators wishing to maximize Medicare reimbursement will realize the greatest impact by improving patient satisfaction with nursing care.