Potential Patient Bias by Insurance Coverage on CG-CAHPS Surveys: Impact on Physician Reimbursement

Objectives: Investigate the relationship between payor type and patient experience scores. Design: Cross-sectional retrospective study. Setting: Academic orthopaedic outpatient clinic. Patients: All patients seen in our clinic were given a Press Ganey survey. 2,934 surveys were collected between January 1, 2016 and December 31, 2020. Intervention: Press Ganey patient satisfaction survey overall satisfaction with physician. Main outcome measurement: Physician overall rating by patients stratified according to payor type. Results and conclusions: Medicare patients reported the highest satisfaction scores (91.98 ± 0.06), followed by Worker’s Compensation (90.49 ± 0.12), other government coverage (89.91 ± 0.45), commercial insurance (89.36 ± 0.12), Medicaid (88.74 ± 0.30), and self-pay/uncompensated (88.26 ± 0.48). ANOVA analysis resulted in an F value of 270.2205 (p < 0.001). Tukey-Kramer demonstrated statistically significant difference between the means of all payor groups except Medicaid vs. self-pay/uncompensated. Our data indicates that patient experience scores are influenced by payor type. These biases may negatively impact physician reimbursement, even in the setting of high-quality care. Thus, orthopedic physicians should be mindful of payor type bias when selecting MIPS quality reporting metrics, and policymakers should consider adjusting reimbursement models according to payor-mix. Level of Evidence: Level III Keywords: Business, Insurance, Patient Bias, Reimbursement (J Ortho Business 2022; Volume 2, Issue 3:pages 1-4)