HCAHPS STUDY IDENTIFIES ACTIONABLE, ANALYTICS-BASED

AREAS FOR MAXIMIZING REIMBURSEMENTS

THE ISSUE
Healthcare leaders are overwhelmed with data coming
from numerous sources. This data in and of itself is not of
great use and leaves several unanswered questions that
continue to plague leaders.

By:
Do HCAHPS scores drive readmissions? Or do readmissions drive Hannah Spell, Ph.D.,
HCAHPS scores? More importantly—what DRIVES HCAHPS and Director of Research and Analytics
Readmissions. Existing research demonstrates that the two are
correlated—but doesn’t determine much else. Without using
the right analytics to uncover insights and connections, health-
care leaders are missing an opportunity to leverage these data to
achieve overall organizational goals.
THE RESEARCH

SMD performed an analysis of four years of Centers for Medicare and Medicaid Services (CMS) data at
more than 3,000 healthcare facilities, which brought together multiple data points including HCAHPS
scores, clinical care processes, and readmissions, as well as controls for hospital demographics (loca-
tion and size). This study represents the most comprehensive analysis of CMS data using advanced,
cause-effect analytic techniques, and conclusively determines which factors most affect patient care
and satisfaction.

THE RESULTS

The five key drivers found to directly impact outcomes critical to hospital performance and reimburse-
ments, in order, are as follows:
1. Communication between nurses and patients
2. Pain management
3. Medication and discharge instructions
4. Quietness of the patient care area
5. Cleanliness of the patient care area

RESEARCH KEY TAKEAWAYS

• Evidence demonstrates that improving HCAHPS scores will improve Readmission Rates and Clinical
Care Process Compliance.
• Evidence demonstrates that improving Clinical Care Process Compliance will also improve Read-
mission Rates.
• Counter to some prevailing wisdom, physician communication with patients is not a key driver of
overall HCAHPS.

THE OPPORTUNITY

By focusing on those drivers, healthcare leaders can identify and address barriers to good performance
and significantly improve HCAHPS scores, clinical process compliance, and readmission rates.

RECOMMENDED ACTIONS

A great place to start is your employee opinion survey. Using cause-effect analytics, you can show
which specific attitudes have a direct impact on important business outcomes. Use this initial analysis
to get leadership by-in to the process of HR/talent management analytics.

The cause-effect analytic tool used in this research also allows healthcare leaders to directly link data
like employee surveys and competency ratings to HCAHPS scores, helping leaders assess the strengths
of their team, the attitudes, competencies, and personalities critical to driving HCAHPS scores and
where to invest in recruitment, training and development, and workflows.

SMD has developed survey items that gather the clinical employee perspective on the same factors
patients rate to deliver HCAHPS scores. By using these HCAHPS-focused employee items leaders will
know where they may have deficiencies that will directly impact patient ratings of those same aspects.
This allows healthcare leaders a proactive approach to directly impact patient-centered aspects of
their facilities.

To speak with someone about the survey items, please contact Holly Bossert at hbossert@smdhr.com.