THE ECONOMIC IMPACT OF HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (HCAHPS) SCORES FOR HOSPITALS PROVIDING INPATIENT PSYCHIATRIC SERVICES
Abstract
Background – Psychiatric inpatient services generally generate losses for the hospitals that offer them. Due to quality based purchasing programs implemented through the Patient Protection and Affordable Care Act (PPACA), hospital reimbursements are based in part on scores from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey.
Objective – This study examines the relationship between the presence of psychiatric inpatient services and hospital performance on the HCAHPS Survey. If a negative relationship exists, the new quality based purchasing program will amplify hospital losses on this service line and lead to a continued reductions in the number of psychiatric care beds at acute care hospitals.
Method – Five statistical tests are used to evaluate the relationship between inpatient psychiatric services and hospital performance on the HCAHPS Survey and subsequent reimbursement.
Results – Independent t-test results indicate that the presence of inpatient psychiatric services results in lower mean scores on key HCAHPS Survey questions. Spearman’s correlation tests indicate that the number of inpatient psychiatric beds has a negative relationship with mean scores on key HCAHPS Survey questions. Finally, a Chi-square test found a negative relationship between the presence of inpatient psychiatric services and the amount of reimbursement received by hospitals from the Centers for Medicare and Medicaid Services (CMS). The result of each test is statistically significant at the 99% level.
Conclusions – This study concludes that the presence of psychiatric inpatient services is correlated with lower HCAHPS scores and reimbursement through CMS. The government should consider an HCAHPS adjustment factor for hospitals providing inpatient psychiatric services in order to create incentives for hospitals to continue providing psychiatric inpatient services.
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