Hospital Refunds Patients’ Money When Complaints Are Filed

Just a few days before Karen Hull was about to embark on a major surgery in January, she received an unwelcomed phone call from the hospital.

Geisinger Health System in Danville, Pa. requested that the 46-year-old dental hygienist from Bloomsburg, Pa. make a "good faith payment" first. Incensed at the request before her lumbar spine surgery occurred, Hull sought a refund for a deposit she had made.

"I wasn't going to skip out on my surgery," she said.

While hospitals have been sluggishly improving its services such as ramping up food options and bedside manners and reducing wait times, developing a system for feedback from its patients and responding to it quickly has been scant and not a priority.

Geisinger has embarked on a new strategy to attract and retain more patients, a rare approach taken by the health care industry which has followed a strict, adversarial attitude when consumers complain about medical care, the length of stay and bills. To close that gap, the hospital system's chief executive David Feinberg decided last fall to "do the right thing by our patients" and make the process less vexing, especially if a physician or nurse acts in an untoward manner with consumers.

He implemented a new program that is the first in the U.S. to give refunds to patients who complain without asking any questions, limiting it only to what they shelled out for a copay or a deductible. The area which Geisinger serves includes a population that is multi-generational and serves 45 counties in central and northeast Pennsylvania as well as southern New Jersey and loath to moving to another location, which means improving customer service is even more vital.

"There is no judge or jury," he said. "If you ask for it, you get it. We are happy to refund the money back with no questions asked."

Hull received the $150 that she requested and did not seek a larger reimbursement, because did not want to appear "hoggish" since she generally had good experiences with Geisinger. "I was treated very well with my last surgery," she said. The refund amount was "fair" to Hull.

Geisinger has a long history of responding to patient issues, and people who needed additional care after a surgery were not charged additional payments, said Feinberg, who was the former CEO of the UCLA Hospital System.

This novel approach was launched because patients "want more than money back," and their real intent is to have someone from the hospital listen to their issue and address it," he said.

"We are committed to fixing it for the next person," Feinberg said.

The hospital spent $95,000 from the start of last October to May 10 this year on 200 refunds from major issues such as incorrectly filling out a prescription and leaving the patient without any pain medication for more than a day to lesser issues. The refunds ranged from less than $20 to several thousand dollars. Patient satisfaction plays a larger role now since the federal government utilizes this factor when it comes to hospitals seeking reimbursements.

The feedback from patients range from serious criticisms to less urgent ones. One 58-year old patient who had undergone back surgery could not fill out a prescription twice, because the form for the painkiller was not accurately filled out by the physician. This patient's out-of-pocket cost of $1,260 was waived because the patient did not have pain medication for 26 hours after the surgery occurred.

Another patient was told to go to the ER for a test before surgery. After sitting there for ten hours, the patient was told by the ER doctor that a particular test was not even conducted there. The $200 co-pay for the ER visit was waived.

The hospital responds to all grievances. One 38-year old patient complained of numbness of the arm after blood was drawn last October, and the remaining $14.74 out-of-pocket fee was waived.

No patients have abused this new program so far, and instead the lines of communication have opened up. Patients who did not think their treatment met up with their expectations can leave a comment through the free mobile app. This feedback has proved to be invaluable for the staff, he said.

"We want to get it right with our patients, and it's been successful," said Feinberg. "Most people have only asked for superficial payments."

Creating a better relationship with patients that is more cooperative is the long-term goal of the hospital.

"If you don't think we did a good job, we didn't do a good job," he said.

Feinberg's end game is to be a "disruptor" in the health care industry, which has historically been slow to change and adapt.

"We want to refine health care and keep taking things to the next level," he said. "We want to make sure we always explain what is going on next in your care."