Our current establishment of a firm concept of what managed care is also comes with the recognition of flaws within the system. Clearly there are areas in healthcare that need serious reform. This proposal will focus on reorganizing the review process of managed care to include patient feedback and review. The managed care organization should act to implement a system for patient review in order to highlight areas of weakness in the care that patients were given.
Currently, a review system is already in place for analyzing patient treatment after the services have been delivered, which is called Retrospective Utilization Review. This type of review assesses the appropriateness of the care given, but could be improved by adding patient satisfaction surveys to the tools it uses for assessment. While there are already patient review mechanisms placed in some areas of managed care, such as The Consumer Assessment of Health Plans Survey in the Medicaid managed care program, patient review and input not only needs to be further implemented, but the way the surveys are accessed needs to be improved in order to actually lead to improvements in care. They need to be seen not as a threat to physicians and providers as a way to expose certain people who are not doing their job, but instead they need to be formative, guiding change (Lleffe, Wilcock). They can emphasis certain problems, such as the dignity of elderly patients and problems with discharge, so that corrective actions can be taken.
Patient satisfaction surveys can improve cost, access, and quality. Cost can be improved because for one, patient satisfaction leads to a specific organization being made a person’s first choice, and also, by bringing to light problems that, if fixed, would reduce costs. For example, here is a statement from a patient survey response, “Seeing more than one doctor meant the right hand did not know what the left was doing, only my persistent asking got a response and eventually got me a discharge at 7:30 at night” (Lleffe, Wilcock). Clearly this statement shows that because of lack of communication between the physicians the patient had to stay longer than necessary in the hospital, increasing the cost of their stay. This is just one example of ways feedback can improve cost, and this statement also shows how they can improve the quality of care. In general, by having patient feedback you have a collaborative way to measure what types of problems a certain organization has and then find ways to improve upon them. In addition, incentives, possibly through bonuses, can provide rewards to employees of hospitals who are excelling in patient satisfaction. Patient feedback surveys allow for the satisfaction to be measured and reward to be distributed. With a financial reward as an incentive, employees would be more likely to try to improve the patient care, therefore improving quality. And finally, there are ways that patient feedback can improve access. For example, an article discussing the effect of patient feedback at Seton Health St. Mary’s in Troy, NY talked about their experience with patient satisfaction surveys and results(Williams). In one case, after the physicians started doing post-discharge phone calls, there was an immediate impact on the hospitals scores. The hospital recognized this substantial impact, and implemented a program for post-discharge phone calls, therefore improving the access of the patient because it is another source of interaction available to them to improve their health that they might not have otherwise had due to things such as lack of transportation.
The implementation of a patient feedback system is more important than competing topics because if this program can be successfully utilized and the feedback is used it will bring all providers up to a satisfactory level of performance. By doing so, we can provide better access to patients, because as we learned, healthcare is not fully accessible if that care is not adequate. Some people may not feel that this topic is as important as other areas of reform because in a healthcare system whose cost is escalading at such a rate that it will be at 20% of the Gross Domestic Product(GDP) by 2015, ways to contain these costs tend to be at the central focus of healthcare reform. However, with patient review we are able to make sure that the patient’s health is not compromised in order to improve these costs, and after all, saving or improving the quality of the life of the patient will always be the most important thing.
References
"Client Satisfaction Evaluations." World Health Organization. 2000. Web. 27 Mar. 2011.
"Kaiser Commission on Medicaid and the Uninsured." Medicaid and Managed Care:Key Data, Trends, and Issues (2010). Kaiser Family Foundation, Feb. 2010. Web. 27 Mar. 2011.
Lliffe, Steve, Jane Wilcock, Jill Manthorpe, Jo Moriarty, Michelle Cornes, Roger Clough, and Les Bright. "Can Clinicians Benefit from Patient Satisfaction Surveys? Evaluating the NSF for Older People, 2005-2006 -- Lliffe Et Al. 101 (12): 598." JRSM. The Royal Society of Medicine Press, 2008. Web. 27 Mar. 2011.
Shi, Leiyu, and Douglas A. Singh. "Managed Care and Integrated Organizations." Delivering Health Care in America: a Systems Approach. Sudbury, MA: Jones and Bartlett, 2008. 334-71. Print.
Williams, David E. "Hospitals, Physicians Paying More Attention to Patient Feedback." MedCity News. 10 Mar. 2011. Web. 24 Mar. 2011.
