Date of Conferral



Doctor of Business Administration (D.B.A.)


Business Administration


Gene Fusch


Recent changes in the Centers for Medicare and Medicaid Services (CMS) reimbursement programs resulted in $1 billion in payments to hospitals based on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. Approximately 50% of the 3,000 hospitals currently receiving Medicare supplements may receive increases in reimbursement payments while 50% will receive decreases in payments. This case study explored how one hospital team in North Texas achieved high HCAHPS scores. The primary provider theory, Deming's model of plan-do-study-act (PDSA), and disruptive innovation theory framed the study. The data collection process included administrator interviews (n = 7), hospital document analysis (n = 13), and observations of staff conducting care (n = 8). Through method triangulation, themes emerged on the constructs required to achieve high HCAHPS scores. Themes included caregiver-patient interactions, hospital services, hospital environment, hospital technology, and hospital governance. Although this was a single case study, other healthcare leaders may explore the findings to determine how the information contained within might transfer to other healthcare organizations. Improved patient outcomes resulting from education, communication, and technology in the continuum of care might enhance the patient experience and patients' overall health and wellness.