Recall that pay-for-performance programs seek to improve health care quality while lowering costs. In 2006, the Centers for Medicare and Medicaid Services (CMS) implemented a national survey instrument known as the Hospital Consumer Assessment of Healthcare Providers and Services (HCAHPS) to allow patient care experiences to be analyzed at a national level, to increase incentives for hospitals to improve care, and to enhance accountability by increasing transparency of patient care quality.

Research has shown that it is important to adjust the HCAHPS survey scores based on the type of procedure performed and presence of certain services, such as inpatient psychiatric care.

Why might patients who experience longer hospital stays tend to give lower scores on the HCAHPS survey? What factors play a crucial role in patient satisfaction? What further research might be necessary to improve the HCAHPS survey?