Patient Experience or Patient Satisfaction – Is there a difference?

For many years, healthcare systems have invested a significant amount of money and resources surveying patients to identify areas of opportunity within their organization to improve overall patient satisfaction.

With the implementation the Affordable Care Act (ACA), patient experience began to take center stage. The Agency for Healthcare Research and Quality (AHRQ) developed and implemented the Consumer Assessment of Healthcare Providers and Systems (CAHPS) program. The program and its family of surveys were designed to advance our scientific understanding of a patient’s experience.

Often used interchangeably throughout healthcare, patient experience and patient satisfaction are not the same thing. While the differences may be minute, understanding those differences is key when striving to deliver patient-centered care.


AHRQ defines patient experience as, “the range of interactions that patients have with the health care system, including their care from health plans, and from doctors, nurses, and staff in hospitals, physician practices, and other health care facilities. As an integral component of health care quality, patient experience includes several aspects of health care delivery that patients value highly when they seek and receive care, such as getting timely appointments, easy access to information, and good communication with health care providers.”

The Beryl Institute, a healthcare organization dedicated to improving the patient experience, states that patient experience is “the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care.”

CAHPS surveys are a critical tool used to measure and assess a patient’s experience. These surveys are an objective measure of care quality, as perceived by patients. They are designed to help health care organizations use data to identify strengths and weaknesses, determine where they need to improve, and track quality improvement progress over time.

CAHPS surveys ask questions like the following:

  • How often did clerks and receptionists treat you with courtesy and respect?
  • How often did you get an appointment as soon as you needed?
  • How often did this provider listened carefully to you?

Patients respond utilizing a response scale of Never, Sometimes Usually, or Always, reporting on their experience as objectively as possible.

Some CAHPS surveys have transitioned to a new response scale. That response scale is “Yes, definitely”, “Yes, somewhat” or “No”. To accommodate this change, the same questions are used, simply worded differently as shown below.

  • Did the staff from this provider’s office treat you with courtesy and respect?
  • Was the most recent visit as soon as you needed?
  • Did this provider listen carefully to you?

Overall performance on a CAHPS survey is calculated as a “Top Box” score. This is defined as the percent of questions that received the best possible or most desired response, which is typically “Always” or ‘Yes, definitely”.


AHRQ describes patient satisfaction as understanding “whether a patient’s expectations about a health encounter were met. Two people who receive the exact same care, but who have different expectations for how that care is supposed to be delivered, can give different satisfaction ratings because of their different expectations.”

In other words, patient satisfaction is a subjective healthcare measure. Two patients can receive the exact same care but because their expectations differ, the level of satisfaction will also be different.

Some examples of patient satisfaction survey questions include:

  • How would you rate the friendliness and helpfulness of the staff?
  • How would you rate getting an appointment as soon as you needed?
  • How would you rate how well the provider listened carefully to you?

Patient satisfaction surveys typically utilize a Likert response scale allowing individuals to express how much they agree or disagree with a statement. It is normally a 5-point scale with “5” being the best and “1” being the worst (i.e., Excellent, Very Good, Good, Fair or Poor). Overall satisfaction is usually calculated by averaging the numeric value of the Likert scale across responses, for example 4.37 out of 5.00.


The Centers for Medicare & Medicaid Services (CMS) has made patient experience a core component when determining reimbursement levels, STAR ratings, Quality Bonuses, and public reporting. CAHPS surveys have become critical tools for healthcare professionals interested in assessing the patient-centeredness of the care they deliver. They assist in identifying areas for improvement and determining whether objective quality measures have been met.

“CAHPS surveys do not ask patients how satisfied they were with their care; rather, they ask patients to report on the aspects of their experiences that are important to them and for which they are the best, and sometimes the only source of information,” the agency wrote on its website.

Subjective feedback can be just as valuable. Healthcare organizations use patient satisfaction to seek and understand what is most important to their patients across varied socio-economic and geographic variables. This data can be difficult to garner from the more objective CAHPS type surveys.

Public reporting and STAR ratings provide patients more transparency and informed choices in their healthcare decisions. Healthcare organizations benefit by recognizing the interdependence of customer service expectations (measured through patient satisfaction) and process excellence (measured through patient experience).

To learn how your organization can gather continuous, year-round survey feedback, speak with an expert today.