Physician Organizations - More
About the Surveys
Other sections of this Report help consumers understand the role of health plans in assuring that patients receive good medical care. However, it is also important for consumers to know whether medical groups or IPAs provide good access to medical treatment, how well physicians communicate with patients, and whether physicians are coordinating a patient’s care.
For the eighth year in a row, CCHRI administered a patient experience survey at the physician group-level. The 2009 Patient Assessment Survey (PAS) is derived from the clinician-group CAHPS survey, which has been endorsed by the National Quality Forum as the national standard survey for assessing patient experience with care.
This Report summarizes the findings of the 2009 PAS. The results presented show overall ratings of care and composite measures of performance. Composite measures are created by combining information from questions that measure similar aspects of care. For example, the doctor-patient interaction composite included questions on whether the doctor listened carefully, explained things clearly, and treated the patient with respect.
CCHRI was able to implement the 2009 PAS because of the financial support and assistance from participating physician groups and the following health plans:
Aetna Health of California
Anthem Blue Cross
Blue Shield of California
CIGNA
Health Net of California
Kaiser Permanente Northern California
Kaiser Permanente Southern California
Pacificare, a UnitedHealthcare Company
Western Health Advantage
Patient Assessment Survey
The 2009 Patient Assessment Survey (PAS) evaluated patients’ experience with the care they received from 145 distinct medical groups and IPAs in Northern and Southern California (this represents 184 reporting units). These physician groups ranged in size from 2,500 to 2.8 million members. The results were calculated from 65,362 individual patients who responded to the survey, for an overall response rate of 38.6%. Participating physician groups agree to publicly report the results from the survey, and the results are used to determine payouts for the statewide Integrated Healthcare Association’s pay-for-performance program that 7 of the 9 plans are participating in.
HMO and POS adult patients enrolled in the 145 medical groups and IPAs participating in the survey were asked to evaluate the following aspects of their care experience:
- Overall ratings of their Primary Care Physician (PCP), specialist, and all care received from providers
- Interactions between the patient and physician (i.e., communication)
- Access to primary and specialty care for urgent and non-urgent situations
- Interactions with the office staff
- Coordination with care
- Counseling on preventive care topics, such as diet, nutrition and exercise.
Nine hundred adults (ages 18 and older) who had a minimum of one E&M visit in the prior year (January 1, 2008-October 31, 2008) were randomly selected (450 with PCP encounters and 450 with specialist encounters) from each physician group to participate in the survey. The PAS survey was mailed and made available for completion via the internet. Phone-follow-up interviews were conducted for those patients who did not respond via the internet or mailed copies of the survey.
About the Results
Responses included in a composite measure are combined to obtain a single mean score and items are weighted equally. Scores are computed as a mean value, based on a 100 point scale. Most questions are based on a six-item response choice set; however, the overall rating items used a 0-10 rating scale. Each physician group’s score has been case-mix adjusted to account for differences across groups in the mix of their patient populations (i.e., age, sex, race/ethnicity-language spoken, specialty type, language survey was completed in, response mode, specialty type of physician, mental health status, functional health status, body mass index, and presence of chronic conditions).
Each group’s mean score is compared to the overall statewide mean score and statistically significant results above or below the statewide average are displayed by arrows.
When reviewing the results, please compare each group’s score to the statewide average and not to the scores of other individual groups.
Provider After-Hours Access Survey
In order to supplement important access information obtained from the Patient Assessment Survey, CCHRI also conducted an after-hours telephone survey of physicians’ offices. This Provider Telephone Access Survey focused on the same primary care physicians associated with the medical groups and IPAs participating in the PAS. An impartial research firm used a CCHRI-developed telephone interview survey to assess whether office recordings and answering services offer appropriate information to after-hours callers experiencing a medical emergency or urgent care need.
CCHRI asked participating medical groups and IPAs to assist with the provider survey by supplying contact information and telephone numbers for their primary care physicians. Fifty PCP offices were randomly selected from each provider organization. Results obtained from these phone calls are included, side-by-side, in the same tables that contain results for the access to care questions from the Patient Assessment Survey.
Results for the after-hours phone calls are shown as percentage scores. Calculations were made based on the total number of interviews completed and the total number of appropriate responses.
|
