From Protection to Performance: Why Hospital Security is a Strategic Lever for Quality and Value-Based Reimbursement
In the past, hospital security was often viewed as a necessary expense — a cost center designed to guard doors, manage visitor access, and respond to emergencies. But in today’s healthcare landscape, that perception is shifting. With rising concerns over workplace violence, behavioral health crises, and regulatory scrutiny, many hospitals are starting to recognize security for what it truly is: a frontline driver of safety, quality, and ultimately, financial performance. In fact, strategic security staffing protocols are increasingly tied to key quality metrics and value-based reimbursement models.
Security and Patient Experience: A Direct Line to HCAHPS
The presence of trained, professional security officers has a measurable impact on the hospital experience. Patients and families are more likely to feel safe and respected when security personnel are visible, responsive, and integrated with clinical workflows. This is especially important in high-stress areas such as emergency departments, behavioral health units, and urban hospitals with public safety challenges. These impressions are captured in HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores — a cornerstone metric used in the CMS Value-Based Purchasing (VBP) program. Even a small improvement in perceived safety or responsiveness can affect a hospital’s VBP score and reimbursement.
Workplace Violence and Staff Retention: A Quality Issue
Violence in healthcare settings is rising. According to the American Hospital Association, 44% of nurses reported experiencing physical violence, and 68% reported verbal abuse in 2022 alone. These incidents are more than HR concerns — they drive burnout, increase turnover, and reduce care quality. Hospitals with clear, proactive security staffing protocols report lower incident rates, faster response to escalating behavior, and improved retention among clinical staff. Lower turnover supports continuity of care, reduces medical errors, and boosts patient satisfaction — all factors that impact CMS Star Ratings, Leapfrog safety grades, and VBP scores.
Preventing Adverse Events: Protecting Quality and Compliance
Weak or under-resourced security programs can contribute to serious events such as patient elopements, unauthorized access, physical altercations, and noncompliance with visitor protocols. Each of these risks can lead to CMS penalties for hospital-acquired conditions (HACs), negative findings during accreditation surveys, reputational damage, and legal exposure. Robust protocols improve safety and protect against financial losses tied to quality shortfalls.
Security and Value-Based Care: Connecting the Dots
Hospitals in value-based models like ACOs, BPCI, and CMS VBP are graded on outcomes and experience. Security plays a pivotal role in improving ED throughput, supporting safe transitions of care, and reducing readmissions. Security becomes a clinical enabler — reducing waste, lowering risk, and enhancing patient-centered care. These gains align directly with CMS incentives and benchmarks.
Rethinking the ROI of Security
When evaluating ROI on hospital security investments, leaders must consider revenue protection via VBP payments, cost avoidance related to violence and lawsuits, and staff productivity. According to one analysis, hospitals can lose over $1 million annually in turnover costs due to workplace violence and safety issues. Proactive security staffing mitigates these losses while strengthening quality performance.
Final Thought: Security as a Strategic Asset
Hospital security is no longer a back-office function — it’s a strategic lever for patient experience, staff safety, regulatory compliance, and financial performance. As value-based care evolves, integrating security into quality and reimbursement strategies will help hospitals deliver safer, more efficient, and more profitable care.
Sources and Footnotes
Centers for Medicare & Medicaid Services (CMS). Hospital Value-Based Purchasing Program. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospital-Value-Based-Purchasing
American Hospital Association (AHA). “Hospitals in Crisis: Addressing Violence Against Health Care Workers.” 2023. https://www.aha.org
The Joint Commission. Sentinel Event Data Summary 2023. https://www.jointcommission.org/resources/patient-safety-topics/sentinel-event/
International Association for Healthcare Security and Safety (IAHSS). Security Design Guidelines for Healthcare Facilities. 2020. https://www.iahss.org
