Healthcare Reform Threatens Patient Satisfaction at Safety-Net Hospitals

An article written in American Medical News journal reported that the Association of American Medical Colleges believes the decline of quality patient care in “safety-net” hospitals will continue as the Supreme Court Decision on the Affordable Care Act moves along. A study from the Archives of Internal Medicine indicates that safety-net hospitals, those known to treat high numbers of low-income and Medicaid patients, struggle to produce the same level of patient satisfaction as non-safety-net hospitals.

The Congressional Budget Office estimates that the Affordable Care Act (ACA) will newly insure approximately 30 million patients within the next decade. The Association of American Medical Colleges stated that this predicted influx of insured hospital patients will create a strain on the healthcare system, especially the safety-net hospitals. Safety-net hospitals currently depend on federal subsidies under the Disproportionate Share Hospital Program, but under the ACA this funding will be cut by about half over the next 10 years. 

The ACA plan includes a “pay-per-performance” funding incentive to hospitals displaying quality improvements; to qualify for funding, hospitals are assessed on several percentage factors, 30 percent being patient satisfaction. Beth Feldpush, vice president of policy and advocacy at the National Association of Public Hospitals and Health Systems, stated that 30 percent is too much weight to place on patient satisfaction and fears that the incentive program puts safety-net hospitals at a disadvantage for qualifying for funding. According to the Archives of Internal Medicine study, safety-net hospitals already see a patient satisfaction rate 6 percentage points lower than non-safety-net hospitals.

Based on the predicted patient increase and funding cuts from the healthcare reform, the strain on safety-net hospitals is only expected to worsen, leaving few resources to improve the current rate of patient satisfaction.

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