Healthcare Glossary→NPS / Patient Satisfaction
Quality Programs

NPS and Patient Satisfaction

Patient satisfaction metrics — including Net Promoter Score (NPS) and formal survey instruments like HCAHPS — quantify the patient experience and directly influence reputation, referrals, and in hospital settings, Medicare VBP payment adjustments.

Net Promoter Score in Healthcare

Net Promoter Score (NPS) was developed by Fred Reichheld at Bain & Company in 2003. It is based on a single question: "How likely are you to recommend [practice/hospital] to a friend or family member?" on a 0–10 scale. Responses are categorised as: Promoters (9–10), Passives (7–8), and Detractors (0–6). NPS = % Promoters − % Detractors. NPS ranges from −100 to +100.

Healthcare NPS Benchmarks

  • Below 0: Poor — more detractors than promoters. Indicates systemic patient experience problems.
  • 0–30: Average for healthcare. Many hospital systems fall in this range.
  • 30–50: Good — better than average for healthcare
  • 50–70: Excellent — top-quartile healthcare NPS
  • > 70: World-class — rare in healthcare, typically associated with specialty practices and concierge medicine

Healthcare consistently underperforms other industries in NPS. Technology companies (Apple: ~72), hospitality (Ritz-Carlton: ~65), and financial services leaders typically outperform healthcare. This gap reflects the inherent difficulty of creating positive experience during illness and care encounters, as well as genuine service quality variation.

Patient Satisfaction vs Patient Experience

An important distinction: "patient satisfaction" measures whether expectations were met; "patient experience" measures whether specific care events occurred (was pain well-controlled? did nurses explain medications?). HCAHPS primarily measures patient experience (did the doctor communicate clearly?) rather than satisfaction (was the visit pleasant?). This distinction matters because experience-based questions are more actionable for clinical improvement and less subject to expectation bias.

Financial Impact of Patient Satisfaction

Patient satisfaction drives referrals, retention, and Google review ratings — which increasingly influence patient choice of provider. Studies show that patients who rate their experience 5/5 stars are 5× more likely to return and 4× more likely to refer others. For hospitals, HCAHPS scores determine 25% of the Hospital VBP Total Performance Score, directly linking patient experience to Medicare payment adjustments.