The trusted source for
healthcare information and
Physician practices that thrive in a managed care arena are ones that offer superior access and engage customers in their health care, according to a study published by InterStudy Publications of Minneapolis.
The study, Changing Expectations of Consumers: A 27-Market Review, looks at consumer satisfaction among health plans based on the maturity of the managed care market. The study, based on research conducted by Evanston, IL-based Sachs Group, divided markets into four stages: stage one/entry (little managed care penetration); stage two/growth (growing managed care presence but a loose and fragmented market); stage three/maturity (marked by increasing competitiveness among health plans); and stage four/decline in number of plans (evidenced by consolidation among health plans and even higher competitiveness than stage three markets).
For physician practices in stage-two markets, the priority is to sign up with as many health plans as possible, says Les Stern, vice president of business development at the Sachs Group. "If there are five health plans in your market and you’re only signed up for two, then you’re out of luck no matter how satisfied your patients are," he says.
Whether a physician is a member of the health plan’s provider network becomes less important to stage-three and stage-four consumers when picking a health plan, the study says. This decreased importance may be due to more consumer experience with HMOs (and thus more comfort in switching doctors), or growth among physician panel size in the more mature managed care markets.
The Sachs survey during the past three years has shown that patient loyalty to physicians is not high, underscoring the importance of keeping patients satisfied, Stern says. Quality in health care is assumed, especially in the more mature managed care markets, "and it’s still a little bit above the head of the average consumer." Access has emerged as the key satisfier, specifically waiting time to get an appointment with a physician, and how long the patient sits in the waiting room once he or she comes in to see the doctor.
Physician practices also can work with the health plan to help give consumers a sense of participation in their health plan, which in turn leads to greater customer satisfaction, the study found. For example, practices can make a point to remind patients to come in for mammography or cholesterol screenings if these services are covered under the member’s health plan.
[Editor’s note: For a copy of the report, Changing Expectations of Consumers: A 27-Market Review, contact Interstudy Publications at (800) 844-3551.]
Following are names and telephone numbers of sources quoted in this issue:
• The Orthopaedic Clinic, Phoenix; Chuck Redwing, FACMPE, administrator. Telephone: (602) 277-6211.
• Medical Group Management Association Consulting, Denver; Bruce Johnson, consultant. Telephone: (303) 397-7877.
• Raleigh Orthopaedic Clinic, Raleigh, NC; Deborah Howard, executive director. Telephone: (919) 781-5600.
• Georgia Multispecialty Group, Atlanta; Ramie Tritt, MD, FRCS, president. Telephone: (404) 256-7511.
• American Medical Association, Chicago; Carol O’Brien, senior attorney. Telephone: (312) 464-4430.