Now medical care comes with a money-back guarantee.
That’s the promise made Tuesday by Dr. David Feinberg, president and CEO of Geisinger Health System, who unveiled a commitment to refund part or all of the hospital’s copay for spine and bariatric surgery to patients who are dissatisfied with their care.
A copay is the fixed fee that patients pay up front to doctors or hospitals for medical care. Geisinger’s decision to refund its share of the copay to dissatisfied patients is billed as the latest, and perhaps most radical, innovation of a system recognized for continually 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.
“When you go into a Starbucks and you don’t like the coffee, I’ve never heard a barista say, ‘No, we made it the right way, you have to drink it,” he said. “They just take care of you. This is about patient care, people taking care of people. We want to get it right every time with every patient.”
That doesn’t mean that the quality of medical care will suffer. Rather, the patient’s well-being will be viewed in a broader context, as a critical part of the patient’s overall experience, Feinberg told U.S. News.
“People with high deductibles and high copays feel as if they really are paying for health care,” he says. “When it’s your money, I want to treat you not only as a patient but as a valued customer.”
The program began as an experiment involving spine and bariatric surgery at two of the system’s 12 hospitals, Geisinger Medical Center in Danville, Pennsylvania, and Geisinger Wyoming Valley Medical Center in Wilkes-Barre.
Using a new patient app, ProvenExperience, developed by Geisinger and available online for free via iTunes, patients are encouraged to offer feedback about the care they received, positive or negative. Those with concerns can click through to a slider and request partial or full refund of the copay for their surgery, $2,000 for bariatric surgery or $1,000 for spinal procedures.
“You get a check within three to five days,” he says. The amount is left up to the patient, a decision that Feinberg says is based on the “honor system.”
In coming months, Geisinger leaders plan to develop other ways for patients to express their views about patient care, whether by phone, on paper or online. “First and foremost, we want to know, when we’ve done something wrong, if there’s anything we can do to correct it,” Feinberg says. “We’re going to make sure it doesn’t happen again.”
Geisinger has long been in the forefront of hospital efforts to improve the quality of care, boost outcomes and lower costs. ProvenExperience reflects a convergence of those efforts and a parallel push to inject “a little more compassion” into health care, says Feinberg, who introduced the program during a speech at the 2015 Press Ganey Executive Leadership Conference in Orlando.
What may be the program’s most important dimension is the information it will yield to those who are trying to re-engineer care to better serve patients’ needs, says Dr. Donald Berwick, president emeritus and senior fellow at the Institute of Healthcare Improvement. “This will be a whole new way to understand the experience and outcomes of patients,” he said.
Not surprisingly, perhaps, the initiative began with an email to Feinberg written by a disgruntled patient. The patient, Joseph Tomsho, 46, a communications worker, was distressed to discover his spine surgery cost more than he had anticipated, because he hadn’t factored in a new $1,000 copay.
When Feinberg looked into it, he found that Geisinger had fulfilled its obligation to explain the change of benefits. “To me, it was a case where we had done everything the right way, and we were happy to prove it to the patient.”
Feinberg decided to offer Tomsho a refund, and he decided to offer refunds more broadly as a way to demonstrate Geisinger’s commitment to patient satisfaction. This led to a discussion with Tomsho’s neurologist, Dr. Jonathan Slotkin, director of spinal surgery at the Geisinger Health System Neuroscience Institute — who, coincidentally, is also medical director of Geisinger in Motion, the institute responsible for producing mobile apps.
Feinberg asked Slotkin to offer Tomsho his refund. Within eight weeks, Slotkin and his team also created the ProvenExperience app.
“I’m humbled by it,” says Tomsho of the change his letter has provoked.
Feinberg says he has encountered any number of naysayers, including fellow members of a CEO roundtable. But he also considered Kodak’s failure to recognize the potential of digital photography and the railroads that dismissed the possibility that people might travel by air.
“Maybe it is revolutionary for our industry,” he says. “It isn’t for Nordstrom’s.”
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Unsatisfied With Your Surgery? Get Your Money Back originally appeared on usnews.com
