1. Only “patient-reported outcomes” utilized in P4P payment algorithms methodology are related to patient satisfaction measures. Usually only a very small percentage (10-15%) of overall P4P payment algorithm for physician and hospital P4P programs.

2. Few other things on patient satisfaction – it is very important to note that patient satisfaction measures has not been proven in the medical literature to be linked to improvement in quality measures, there is a movement to adopt standardized reporting instruments (CAHPS instruments), and ultimately too to discern value of this measure to consumers given that patient satisfaction scores suffer from dramatic ceiling effect (e.g., really a difference between a doc with a 89% rating and a doc with a 92% rating).

3. Patient satisfaction vendor market for hospitals is very mature and dominated by a few large firms including Press Ganey, NRC Picker, PRC, and a handful of other vendors. Pretty much the same for health plans although a few notable exceptions here recently including the Zagat/Wellpoint deal. Market for physicians is much smaller just because their isn’t a requirement by CMS to report patient satisfaction scores (in order to avoid a payment hit) and most physicians simply don’t want to pay a few hundred dollars out of pocket.

4. Less familiar with market for patient-reported clinical outcomes. Pretty diverse range of applications though including in drug development and health plan programs. Usually most of these instruments are created by academic researchers, vetted through medical literature, and then applied in various situations. Good example is the SF-36/SF-12 that was created by John Ware and a few other researchers. SF-12 is probably the most widely used instrument for patient-reported health outcomes today. For example, Medicare (for managed care enrollees) , VA, and NCQA use this instrument to collect information on an annual basis. Go to QualityMetric (John Ware’s company) to see an example of a company in this space although I am willing to bet that others like Medstat (Thomson) also offer these services too.