Should Patients Get a Money-Back Guarantee?

Agnes Shanley


April 26, 2017

In This Article

Should Health Systems Adopt a Money-Back Guarantee?

At least one health organization, Geisinger Health System, is taking the lead in launching a money-back guarantee for unhappy patients in the form of rebates. Patient complaints that are backed by the guarantee are not necessarily tied directly to patient care. Rather, they are more service-oriented.

Are these rebates a good idea for healthcare? Will other health clinics and doctors follow Geisinger's lead?

If people once considered physicians to be God-like,[1] many healthcare professionals now wonder whether daily practice has swung too far in the opposite, "service delivery" direction. As efforts intensify to measure the value and the quality of healthcare, and tie physician reimbursement to quantifiable results, the business of medicine is adopting more of the practices used by the retail, hospitality, and food service industries (among others) to assess performance and gauge improvement.

In a recent Medscape commentary, Should Dissatisfied Patients Get Their Money Back?,[2] ethicist Art Caplan, PhD, explored this topic, asking whether patient rebates are a good idea. He cited Geisinger Health System's recent decision to offer money-back guarantees when patients are not happy with a healthcare provider's service.

Such rebates would not be connected to the quality of care that patients had received, but rather to such amenities as office wait times and level of communication with staff members. Although Caplan applauded efforts to measure patient satisfaction, he also asked whether programs such as Geisinger's divert patients to focus more on the frosting (eg, service amenities) than on the cake (ie, whether they received good medical care).

Caplan's commentary generated a torrent of critical comments from practicing physicians and other healthcare providers. One family doctor says that such practices are ushering in an era of "Neverland medicine." "If we allow be the norm, it will surely put an end to medicine as we know it," he writes, asking: "Do we want our profession to be a 30-minute infomercial, or one based on science and founded on the principles of caring, but also on reality?"


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