Geisinger's money-back guarantee is about more than refunds

When Geisinger Health System President and CEO David Feinberg, MD, mentioned the idea of offering a money-back guarantee on healthcare, other health system leaders said, "Don't do it." They reminded him that healthcare is different than other industries, and patients are happy so long as they have a good relationship with their physician.

The discouragement did not deter him. After considering the direction the industry is headed and the level of care the Danville, Pa-based system wants to provide, Dr. Feinberg decided to go for it in late 2015.

ProvenExperience may be Geisinger's most radical innovation. Under the program, launched in November, patients who receive care at a Geisinger facility can use a smartphone app to tell the system about their experience and then request a refund if they are unhappy with the care they received. Although the program applies to all Geisinger patients, the app has only been piloted for bariatric and spine surgery patients since those procedures have high copays.

For example, if a spine surgery patient paid a $1,000 copay and wasn't pleased with how office staff treated them, they can use the app to select from a sliding scale how much of their copay they want refunded. They can choose from $1 to $1,000.

If a patient requests a refund, they get it within three to five days, even if Geisinger did everything perfectly. "We're saying it's up to you as the patient to tell us if we did it right," says Dr. Feinberg.

A program offering refunds to patients with no questions asked seems ripe for abuse, but Dr. Feinberg says that is not the case. He says everyone who has requested a refund so far has been remarkable fair, and he expects that to continue.

"Patients really don't want money back. They want us to recognize we did something wrong and make it right," says Dr. Feinberg. He said companies such as Starbucks have used a similar concept for years, and most people don't try to game the system. "You could drink three-fourths of your coffee at Starbucks and they would still give you a refund, but people don't ask for one."

The program is an evolution of Geisinger's ProvenCare portfolio, which was deemed "surgery with a warranty" by The New York Times. Under ProvenCare, if certain surgery patients were readmitted within 90 days with preventable complications, the system took responsibility and treated them at no extra charge.

The outcomes with ProvenCare were "spectacular," says Dr. Feinberg. Based on those results, system leaders began discussing how they could apply the same concept to take patient engagement and satisfaction to the next level. Those discussions led to the creation of ProvenExperience.

The new program is a win-win for patients, as it offers them the chance to provide feedback on the care they receive and benefit from changes Geisinger makes to its practices based on said feedback.

Although only certain patients are involved in the app pilot for the ProvenExperience program, the goal is to roll the app out to all of the health system's patients in the future.  

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