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To Lure Patients, Pennsylvania Hospital Refunds Unhappy Customers


People nowadays have a lot more choice in what hospitals to go to. Jess Jiang, from our Planet Money podcast, has the story of one health system that's trying a novel way to lure in new business.

JESS JIANG, BYLINE: Two years ago Joe Tomsho was painting the ceiling of his bedroom. He was on a ladder.

JOE TOMSHO: All of a sudden my arms started getting, like, numb and real painful.

JIANG: He went to the ER, saw doctor after doctor, but months later the pain was still bad.

TOMSHO: Physical therapy helped some, but it still stayed there and didn't go away.

JIANG: After a year, Joe and his doctors decided the solution was spinal surgery. He says he looked on his insurance's website to check the cost - $500. He figured, OK, I'll do this. He went to Geisinger Medical Center near his home in Pennsylvania, and the surgery went well. But a couple months later...

TOMSHO: The bill came through. And there was my deductible, and there was another co-pay of $1,000 on there. And it's like, what's this extra $1,000 on here for?

JIANG: His portion of the bill was three times what he expected. A lot of patients can relate to this. Fighting back is exhausting and feels like a waste of time. But Joe had another option, something really powerful - an email address of the CEO of Geisinger. So one day he sat down and wrote a long rambling e-mail.

TOMSHO: I was nervous when I sent it. I've never done something like this before and I guess I was that angry that it's like, I'm doing it. Sick and tired of all the B.S.

DAVID FEINBERG: I felt bad for him and he had put a lot of thought into it. And he wasn't asking for money.

JIANG: This is Dr. David Feinberg, the CEO of Geisinger Health System, with over a dozen different hospitals. He read Joe's e-mail, checked up with Joe's medical team and he found out technically Geisinger did everything right. But Dr. Feinberg says something still felt wrong.

FEINBERG: I mean, it's like going to Starbucks and you get the latte and you don't like it. And the barista sips it and says, no we made it right. The temperature's right. The foam is right. You have to drink it. And that's what we were doing. That's just not a way to care for somebody. So I - that's what I was trying to get at.

JIANG: In the end, Geisinger decided to waive that $1,000. Joe felt vindicated.

TOMSHO: I was happy because it's like, yeah I went up against big business and the little guy came out ahead for a change.

JIANG: Joe's case changed how Geisinger handles patients. Their aim now is to treat them like normal customers. When they're unhappy, give them a refund. After six months, they've given back almost $100,000.

JIANG: Do you know how many complaints are denied?

FEINBERG: Zero. This is - there's no evaluation on the complaint.

JIANG: So really no questions asked?

FEINBERG: Well, we ask your name and address to send you the money.

LEAH BINDER: They're a little crazy to be doing it. But it works for them

JIANG: Leah Binder runs Leapfrog, a non-profit that focuses on hospital quality. She says offering refunds is smart business. It keeps people coming back just like at a regular store.

BINDER: So what Geisinger seems to have done is said, well, you know what? Why don't we play by the same rules everyone else plays by? And so let's offer what any retailer would offer.

JIANG: Dr. Feinberg says healthcare is getting more competitive. And as patient shop around more, hospitals will need new ways to stand out.

FEINBERG: I don't want to be the best in healthcare. I want us to be the best. To be good in healthcare patient satisfaction makes you, like, you know, we're as good as the DMV. It makes you kind of the cream of crap.

JIANG: Dr. Feinberg is aiming higher. Jess Jiang, NPR News. Transcript provided by NPR, Copyright NPR.

Jess Jiang is the producer for NPR's international podcast, Rough Translation. Previously, Jess was a producer for Planet Money. In 2014, she won an Emmy for the team's T-shirt project. She followed the start of the t-shirt's journey, from cotton farms in Mississippi to factories in Indonesia. But her biggest prize has been getting to drive a forklift, back hoe, and a 35-ton digger for a story. Jess got her start in public radio at Studio 360—though, if you search hard enough, you can uncover a podcast she made back in college.