At the Helm

Want to please patients? Maybe you should start a specialty hospital.


"Patient experience" is like motherhood and apple pie. It’s impossible to argue about its importance, and virtually all health care providers will tell you that making sure that patients have a positive experience is one of their top priorities.

Not all hospitals are doing equally well at fulfilling that aspiration, though. And it turns out that there is a group of hospitals that seem to have a decided advantage when it comes to providing an excellent patient experience: specialty hospitals. An Advisory Board analysis of recent Hospital Compare data suggests that specialty hospitals dominate the rankings when it comes to patient satisfaction.

 Download: The top 5% of hospitals for patient satisfaction

The data we analyzed comes from the HCAHPS survey, which is administered to hospital patients around the country. The survey asks about nine dimensions of care: communication with doctors, communication with nurses, responsiveness of hospital staff, pain management, communication about medicines, discharge information, cleanliness of the hospital environment, quietness of the hospital environment, and transition of care.

When we tallied the scores, more than four out of five of the top-scoring hospitals were specialty facilities—surgical hospitals, orthopedics hospitals, or heart hospitals. And of the remainder, nearly all were small hospitals that were nominally general-purpose but in practice provided the same kind of focused care that the specialty hospitals did.

Why patient experience really matters now

Beyond the obvious reasons why health systems want patients to have a great experience when visiting their institutions, there are two big reasons why “patient experience” matters more than ever today—and why the 95% of hospitals not at the top of the patient satisfaction rankings should be paying attention to the facilities with the best scores.

Hear our Chief Research Officer discuss the patient satisfaction rankings on NPR

First of all, since patients are increasingly making their own decisions as to which providers they choose, whether as part of health care exchange network plans or at the point of accessing care, brand and reputation will be ever more important. So the word-of-mouth endorsements from excellent patient experiences are valuable in themselves, and also as a platform for marketing efforts.

What’s more, patient satisfaction, as measured through the HCAHPS survey, has also become a major component of value-based payment incentives. In Medicare’s Value-Based Payment program, patient satisfaction comprised 30% of the overall score for fiscal 2015; for 2016 and 2017, it will comprise 25%.

Speculating on the secrets of specialty success

But what’s behind this survey data?

It’s impossible to know for sure, but I’d bet that a big part of the advantage that specialty hospitals hold here is that they can provide a predictable and therefore tightly managed experience for patients. Our service line research has consistently found that for procedures like joint replacement, highly structured hospital-based "center of excellence" programs produce more satisfied patients and better clinical outcomes than more loosely managed offerings.

Of course, it’s much easier for a hospital to have a high overall patient satisfaction score when its mix of patients includes just scheduled cardiac, orthopedics, or spine surgeries, and not the less predictable, more difficult-to-manage medical cases.

Still, many of the specialty hospitals atop the patient satisfaction rankings promote their scores to the public, reinforcing the value of their brand and presumably supporting their market presence. While a general acute-care hospital can’t replicate the specialty hospital’s advantages entirely, health systems should consider how this finding could impact their growth strategies.

At very least, it’s one more piece of evidence in favor of the "center of excellence" approach to providing surgical care, and should reinforce the importance of health systems’ efforts to develop and strengthen cardiovascular and orthopedic centers of excellence. To take it a step further, though, systems might consider the value of standalone, specialized facilities as they pursue expansion strategies, particularly those targeted at attracting the increasingly retail-savvy health care consumer.

More on why focusing on patient experience matters

Why you should focus on cost growth, not cost cutting

Outdated approaches to managing patient experience could be costing you millions. See how investing in patient experience improvements can save you millions instead.

Download the infographic


Get patient satisfaction data in real time

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