This blog post was written by our guest blogger Michele Treinin, Healthcare Analyst at Research & Marketing Strategies (RMS) in Syracuse, NY.

Starting Oct. 1, HCAHPS® scores will begin to influence how much hospitals are compensated under the Patient Protection and Affordable Care Act. Safety Net Hospitals (SNHs) are at a risk of receiving even less compensation based on the scores they receive. A recent study begins to conjure up reasons why scores are lower and also what needs to be done to prevent failure within these hospitals.

CMS CAHPS Survey Vendor

Safety Net Hospitals (SNHs) are facilities that “care for vulnerable and typically poor populations. These patients, on average, are sicker and tend to have lower levels of trust in the health care system.” Of the 3,096 hospitals that the sample consisted of, SNHs accounted for 769 (25 percent) of them. The population that SNHs serve tends to be uninsured and unable to pay or have Medicaid, which pays very little to doctors and hospitals. With that being said, these hospitals lack significant funding and work with what they have, which often means older facilities that are more rundown and look unclean. They also lack the sufficient nursing staff to handle the amount of patients served, which also leads to unsatisfactory scores.

The authors defined two reasons that may lead to the reason why SNHs score lower than their counterparts:

1) Patients in SNHs have very different expectations of care and the hospital environment; and

2) SNHs are not doing a very good job focusing on patient issues.

Both of these reasons are problems to be dealt with but, due to healthcare reform, SNHs may be losing more money if they don’t improve their overall care. In an open federal forum, SNHs argued that they were at a disadvantage and applied for an adjustment stating that many of their patients were sicker compared to non-SNHs, which led to less-favorable responses. They also argued that language barriers, poverty and cultural issues needed to be taken into consideration; they were not granted the adjustment. Officials at the Centers for Medicare and Medicaid Services (CMS) argued that some patients who were treated under the similar conditions responded positively using the adage if some hospitals can do it, all can.

Everyone deserves the highest form of patient-centered care and this means SNHs need to improve. It may not be that simple though; as reimbursement lessens on these already cash-strapped facilities, the future may look bleak: either adapt or die. These facilities may not make it if they continue to operate with less than favorable scores.

If your hospital is looking to improve HCAHPS® scores, Research & Marketing Strategies is your full-service market research and consulting firm that provides personal services to hospitals large and small. We are an approved CAHPS® survey vendor to help with all of your healthcare needs. If you would like any information, please contact our CAHPS® Business Development Director, Sandy Baker at 315-635-9802 or email her at

To read the original link, which was the basis of this article click here.