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From Satisfaction to Surgery: Patient Experience Lessons from Hospital Refunds

By Kathy, Senior Marketing Strategist

Person sitting at a desk using smartphone with "Refund" arrow & money sign displayed on screenGeisinger Health System (GHS) made the news a year ago with a ground breaking commitment to patient experience. GHS was the first hospital group to offer money-back refunds on their care...and with no questions asked. The retail world provides patient experience lessons.

The program is for “patients whose experiences and expectations were not met with kindness and compassion.” Plus, it goes beyond questions of wait times or convenient parking. Geisinger “promises to refund copays for spine and bariatric surgery if customers are unhappy with outcomes,” according to US News.

“A copay is the fixed fee that patients pay up front to doctors or hospitals for medical care,” US News reports. “Geisinger's decision to refund its share of the copay is the latest, and perhaps most radical, innovation of a system recognized for reinventing medical care.

“It represents a major rethinking of Geisinger's approach, elevating the patient's experience from one measure of hospital performance among many to the value that matters most. And, as it did when it introduced a 90-day warranty for surgery patients almost a decade ago, Geisinger took its cues from major retailers like Starbucks, FedEx and Amazon.”

The GHS ProvenExperience App...

A free smartphone app for Geisinger ProvenExperience patients helps assess the quality of service. And, if not satisfied, they can use the app to ask for a refund…processed within three to five days. The app asks for feedback. “I’m [happy] or [unhappy] with my experience.” Geisinger also "wants to know what happened so we can make it right.”

Financial refunds and guarantees are largely unknown in healthcare delivery. Starbucks, Amazon and other retail giants illustrate the importance of customer service to business success and growth.

As one example, not long ago consumers were wary about making purchases online. Virtual retailers—many without a brick-and-mortar storefront—sharply reduced buyer apprehension using a heavy dose of excellence in customer service. Merchandise is delivered overnight, and returns and exchanges were quick, convenient and hassle free.

An increasing percentage of patients are informed and empowered consumers. Many believe their time is just as valuable as the doctor’s time. And they are more than ready for healthcare to take a service lesson (or two) from the retail world.

Patient experience lessons learned from retail…

It the roll-out year, the Geisinger program has stood up to its refund promise with payouts totaling more than $400,000 to patients. The issues can range from staff communications to bedside manners to subjective surgical satisfaction. Some of the lessons learned include:

Identifying issues for improvement. Some concerns are typical of any facility, such as noise levels, caregiver communications or wait times. Patient financials are clarified.

Refunds issued even when “the system” was working properly. In some instances, the hospital accepted responsibility when they failed to communicate and educate the patient about the billing cycle. Issues about how the revenue system works are now being improved.

Most refund requests were legitimate concerns. News reports about the system’s first year show “valid, authentic grievances.” Yet it may be appropriate to add some caveats to the program. Time constraints may be appropriate for events several years old.

Patients rarely demanded a full refund. Patient refunds are by way of a sliding scale. But it seems that patients wanted to express their dissatisfaction to help remedy a problem.

Continuous improvement. The root concerns that resulted in a refund are investigated by patient advocates and other staff members. The intent is to remedy the causes of the problem and improve the system and patient experience.

Geisinger Health System is a physician-lead provider with headquarters in Danville, PA. It is the first in the industry to provide money-back options. We’re waiting to hear about other hospitals that are willing to install a similar patient satisfaction refund program. Please let us know how you think this system would work for you.

Kathy Gaughran

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