This paper examines the data on hospital quality performance published by the Centers for Medicare and Medicaid Services (CMS) to assess how successful the Affordable Care Act of 2010 has been in improving patient experience of care and total quality performance in its first four years. Beginning in fiscal year 2013, the law required hospital compensation to be linked to quality performance measures of clinical process of care and patients' satisfaction with their hospital experience. The paper describes the complex scoring system used to process survey responses measuring patients' perceptions of their hospital experience. It then examines the data published by for the fiscal years 2013 to 2016 to assess the effectiveness of the law in improving patient experience of care. The paper concludes that a majority of hospitals have not improved patient satisfaction over the four years. This was true for hospitals in all regions and of all sizes. Further, the historical data provide a poor predictor of the next year's performance.
Health care quality; Affordable Care Act; Value-based purchasing; quality improvement