About 10 years ago, Danita Cohen, chief experience officer of University Medical Center of Southern Nevada in Las Vegas, approached CEO Mason Van Houweling with a proposal: Create a patient experience training program tailored to the hospital’s own patients and families.
Mr. Van Houweling backed the proposal, leading to the creation of ICARE at UMC, a program now mandatory for the organization’s roughly 4,500 employees that teaches staff to introduce themselves, explain why they are in a patient’s room and ask before leaving whether there is anything else they can do.
UMC’s patient experience scores have improved over that period. Data the hospital shared with Becker’s shows that its scores improved across seven patient experience measures including hospital ratings, patients’ willingness to recommend the hospital and communication with nurses and physicians, from late 2016 through early 2026, while trend lines for more than 1,700 hospitals in Press Ganey’s comparison database were flat or declining.
It also illustrates the role CEOs can play in sustaining patient experience efforts at a time when financial pressures are forcing hospitals to scrutinize spending across their organizations. Health systems are heading into 2027 facing substantial Medicaid funding reductions under HR 1, while patient experience departments are already feeling the effects of tighter budgets.
In an August column for Becker’s, Rick Evans, strategic adviser at New York City-based NewYork-Presbyterian, warned that hospitals facing tighter budgets are disproportionately cutting the already small teams responsible for monitoring patient feedback and improving patient experience. He said some organizations justify eliminating those positions by arguing that patient experience is everyone’s responsibility, but have later seen patient ratings decline and had to rebuild their programs.
The pressure to reduce spending comes as patients continue to place a high value on their healthcare experiences. In The Beryl Institute’s September 2026 PX Pulse survey of 1,000 U.S. adults, 93% said a good patient experience is extremely or very important, a share that has held steady since 2019.
Health system CEOs who spoke with Becker’s cautioned against treating patient experience as an easy place to cut.
“Treating PX as an optional ‘soft’ administrative cost rather than a core strategic and operational driver is a high-risk misstep that can damage a health system’s financial health, operational efficiency, and reputation,” Saad Ehtisham, DHA, president and CEO of Morristown, N.J.-based Atlantic Health, told Becker’s. “Cutting PX programs rarely saves money in the net financial picture. Instead, it shifts costs into areas with far greater negative impact.”
John Fernandez, president and CEO of Providence, R.I.-based Brown University Health, said any cuts to those programs should come only after operations improve.
“If cutting patient experience program budgets, they should be doing so because they improved operations enough to no longer need a program,” he told Becker’s. “For example, if the organization uses tech to eliminate scheduling problems and/or pre-authorizations, then there is less need for a program.”
It starts with the CEO
As hospitals weigh competing financial priorities, executives said keeping patient experience from slipping down the agenda starts with the CEO.
“In my opinion, the tone is set by the office of the CEO,” Dr. Ehtisham said. “If the CEO doesn’t believe consumer experience is a core growth strategy, it’s not going to be important to the rest of the organization.”
At Atlantic Health, consumer experience is one of five pillars in the system’s strategic plan through 2028. Dr. Ehtisham said he raises the topic monthly and in nearly every interaction with his leaders.
“What are we doing to reduce friction with consumers? What are we doing to improve access?” he said. “It becomes a known fact that this is important to me, so it becomes important to the rest of the organization.”
At UMC, Ms. Cohen said Mr. Van Houweling closes orientations for new employees and physicians by talking about patient experience, after reviewing the organization’s financial and strategic priorities.
“He ends by telling new hires, new physicians and new employees: If we just get the patient experience right and create an experience they wouldn’t be able to get anywhere else, then the rest falls into place,” Ms. Cohen said.
Jennifer Jasmine Arfaa, PhD, senior vice president and chief patient experience officer of Valhalla, N.Y.-based WMCHealth, has been an inaugural chief experience officer at three organizations, most recently joining WMCHealth in May. Before accepting a role, she looks for evidence that the CEO is committed to making patient experience part of the organization’s culture and will provide the support needed to build the function.
Once in the role, she said, one of the most useful things a CEO can do is spend an uninterrupted day with patient advocates and the employees who review patient feedback, reading survey comments, complaint logs and grievance letters, both positive and negative, and then setting priorities with the experience leader.
“CEOs have to have a real understanding of and focus on those opportunities, and not always be fed all the good,” she said.
Built into the culture
For these leaders, making patient experience part of the organization’s culture, rather than a standalone initiative, is another way to keep it from getting lost amid competing priorities.
Mr. Fernandez said the commitment starts before an employee’s first day.
“I like to hire for kindness, because it’s a lot easier to hire for it than teach it,” he said.
When Becker’s spoke with Mr. Fernandez in February, he described a focus on “wow care” in 2026, an approach centered on creating positive, memorable experiences for patients through everyday employee interactions. Rather than treating it as a temporary initiative, he said the system is embedding those expectations into its culture, bringing together operations, quality and patient access.
Brown University Health has given employees a short list of everyday behaviors, including “make time for joy,” “lend a hand” and “see the whole person,” which Mr. Fernandez keeps posted on his office wall. His favorite is “own the next step.”
Because the behaviors are built into daily routines rather than run as a separate program, he said, they do not have to compete for funding. That matters as Brown University Health navigates its own financial challenges. This fall, the system cut 10 senior leadership roles, offered buyouts to about 200 employees and projected a $64 million gap against its operating margin goal for fiscal 2027.
“In every meeting, you have to live it, not make it an initiative,” Mr. Fernandez said. “Otherwise, it can easily be cut, or with so many other priorities, this one could get lost.”
“Wow Care is not a department. It’s a strategy.”
Connecting experience to the bottom line
Leaders said the business case for patient experience work rests on access, referrals and reimbursement.
Mr. Fernandez noted that a health system cannot claim a strong patient experience if patients struggle to get an appointment and receive treatment, because satisfaction surveys reach only the patients who made it through the door.
“Good patient experience, or the Wow that we use, is just good to do for patients and good to do for our bottom line,” he said. “In healthcare, the best referral mechanism is word of mouth.”
Dr. Ehtisham views consumer experience as a growth strategy rather than a satisfaction measure. Atlantic Health is working toward measuring consumer loyalty and trust, and results from acute care, ambulatory clinics and other surveyed areas go into a balanced scorecard the board reviews monthly.
“I’ve been saying for a long time that our competition is not the other health systems in the area,” Dr. Ehtisham said. “Our competition is the consumer’s perception of where care is more personalized and where they have better access, with the same capabilities.”
Dr. Arfaa pointed to the most direct financial link: HCAHPS scores. In Medicare’s Hospital Value-Based Purchasing Program, CMS reduces participating hospitals’ base operating Medicare payments by 2% and redistributes the money as incentive payments based on performance. HCAHPS results determine the patient experience-related domain, which accounts for 25% of a hospital’s total performance score. Those scores also shape reputation, since patients can compare hospitals’ ratings on CMS’ Care Compare website, including measures such as cleanliness.
“If a hospital has one star for cleanliness, people might think twice: ‘If they’re not clean, is their operating room not clean?'” Dr. Arfaa said.
Accountability at every level
Beyond making patient experience part of the culture, some health systems hold employees accountable for it through performance goals and compensation.
At Brown University Health, patient experience is written into leaders’ goals. Mr. Fernandez said an executive overseeing outpatient services, for example, should have a goal to increase patient access, an improvement that benefits both patients and the organization.
Newport Beach, Calif.-based Hoag takes the idea down to every employee. Patient experience has been one of four organizational pillars tied to employees’ annual bonuses for more than 25 years, said Robert Braithwaite, Hoag’s president and CEO. Every department builds an annual plan from the organization’s strategic goals, with dashboards tracking daily results. Departments that fall short must submit remediation plans every six months for senior leadership to review, and employees receive live quarterly briefings on organizational goals.
Board members and Hoag’s founders occasionally join executives on rounds to talk about why patient experience has been a founding principle of the organization since 1952.
Mr. Braithwaite also recognizes individual employees. Each month, he presents $5,000 awards to two or three employees for exceptional patient experience, in front of their peers. The presentations are recorded and shared throughout the organization.
“That’s a game changer for a housekeeper or a transporter,” he said.
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