Healthcare Financial News

How do patients feel about the care they receive in U.S. hospitals? A new study by Boston researchers supported by the Commonwealth Fund shows that while patients are generally satisfied with their care, satisfaction levels are not as high as they could be and rise significantly when hospitals have more nurses at the bedside. The study, published in the October 30 New England Journal of Medicine (read abstract), reveals that patients frequently feel hospitals fall short in addressing basic quality issues--controlling pain, communicating about medications, and coordinating discharge planning.

In the first analysis of its kind, Harvard School of Public Health researchers examined patient experience information collected by the federal government through its Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. They examined patient views on communication with doctors, communication with nurses, nursing services, communication about medications, pain control, room conditions, and discharge information. The HCAHPS analysis is based on data from 2,400 hospitals, and illustrates how patients perceive care at U.S. hospitals.

While two-thirds of patients gave their hospital care a high rating, very few hospitals received the highest rating from 90 percent or more of their patients. The performance of for-profit hospitals was worse than that of private and nonprofit hospitals in all areas, but differences between teaching and non-teaching hospitals were small and insignificant.

The U.S. Department of Health & Human Services Office of Inspector General (OIG) has found that the Centers for Medicare & Medicaid Services (CMS) has taken limited actions to ensure adequate implementation of the Health Insurance Portability and Accountability Act of 1996 Security Rule. The HIPAA Security Rule requires an entity such as a health plan or healthcare provider that transmits any health information in electronic form to ensure the integrity and confidentiality of the information, protect against any reasonably anticipated threats or risks to the security or integrity of the information, and protect against unauthorized uses or disclosures of the information.

CMS had no effective mechanism to ensure that covered entities were complying with the HIPAA Security Rule or that electronic protected health information was being adequately protected. The OIG noted that CMS had an effective process for receiving, categorizing, tracking, and resolving complaints.

CMS did not agree with OIG’s findings because it believed that its complaint-driven enforcement process has furthered the goal of voluntary compliance. However, CMS agreed with OIG’s recommendation to establish specific policies and procedures for conducting compliance reviews of covered entities. OIG maintains that adding these reviews to its oversight process will enhance CMS's ability to determine whether the HIPAA Security Rule is being properly implemented.