Physicians receive a report summarizing survey results and comparing them to peers. While experts agree that surveys are a good source of information about quality of care, most express serious reservations about using survey results to reimburse physicians. David Radosevich, PhD, director of implementation and analysis at the Health Outcomes Institute in Bloomington, Minn., explained that most surveys are developed under tightly controlled conditions that are unlike most physician practices. Another concern stems from evidence that sicker patients are generally harder to satisfy and may be a liability to physicians whose pay is being influenced by survey results. Patients 75 and older and groups of patients under 16 show increasing levels of dissatisfaction, according to researchers.
Medicaid patients are more interested in transportation issues than private pay patients.
One solution is to adjust patient survey results to reflect the patient's age or illness so that physicians treating individuals who are harder to please won't be unfairly penalized. But not everyone feels the adjustments are necessary. And beyond While researchers hash out the merits of using satisfaction data to pay physicians, HMOs are planning to use surveys in other new ways. One possible direction is to use patient surveys to judge how well primary care physicians are coordinating care. Surveys may ask patients if they know who is responsible for coordinating their care and if subspecialists they see have the information they need to provide care.