Do Medicare patients like managed care?
Do Medicare patients like managed care?
New survey focuses on needs of elderly
Health plans serving Medicare patients will be required to administer an independent, federally funded satisfaction survey to enrollees sometime in 1997, and responses will be used to help consumers choose among some 250 available plans, according to the Health Care Financing Administration (HCFA). That means millions of Medicare patients will be evaluating their care and office visits based on a new, standardized survey that could become a benchmark in patient satisfaction.
The HCFA-required survey is the first to focus on the needs and attitudes of elderly patients and to create a Medicare plan "report card."
Such standardized surveys provide valuable comparative information, says Peter L. Miller, MS, market research manager at the Cleveland Clinic Foundation. "I think it will have a positive impact in improving patient satisfaction across the board," he says. But he notes that physicians and health care centers will still want satisfaction surveys that focus on the specific needs of their own patient base.
The Consumer Assessment of Health Plans (CAHPS), a project of the Agency for Health Care Policy and Research in Rockville, MD, is a patient satisfaction survey that contains a special Medicare component as well as a standard 50-item survey. The survey is available in draft form and a final version is expected this spring. While the CAHPS survey was not designed to measure performance of individual physicians, it contains questions related to the patient-physician relationship. (For sample questions, see p. 6.)
"All plans that have a Medicare contract for at least one year will be required to participate," says Beth Kosiak, PhD, senior social science analyst in HCFA’s office of managed care. "Our goal is to sample at least 500 [Medicare patients] from each plan, and to get responses from at least 350."
The Medicare module of the survey will include questions targeted toward the older population. For example, the survey will ask patients whether they received a flu shot or hearing test, whether their prescriptions were covered by the plan, and whether they feel their physician treats them with respect, says Charles Darby, MA, co-project officer of CAHPS.
CAHPS modules also are being developed for the chronically ill, the disabled, and pediatric and Medicaid patients. HCFA is expected to require the use of these surveys by late 1997.
"The CAHPS survey is designed to be relevant to consumers," says Kosiak. "It’s designed to provide them with information to help them make health care choices. That’s also our goal.
"We want to provide reliable, valid, meaningful information to our Medicare beneficiaries to help them make health plan choices," Kosiak says. "They need the feedback they can get from these plans to decide whether they want to enroll in any managed care plan, and which managed care plan to choose."
Currently, some 3.5 million Medicare beneficiaries are enrolled in managed care plans, or about 10% of the total Medicare population. However, the number of Medicare managed care enrollees is growing at a rate of 70,000 a month, Kosiak says.
Other, existing patient satisfaction tools were not appropriate for the Medicare population, Kosiak says. "They were developed for use in a healthy, employed, younger population," she notes.
CAHPS is being developed by a consortium of the Research Triangle Institute in Raleigh, NC; the RAND Corp. in Santa Monica, CA; and Harvard University in Cambridge, MA.
The CAHPS survey, manual, and consumer reports will be made available free of charge and will be in the public domain. Darby says one goal of the survey is to reduce the variability of the current patient satisfaction tools used to assess health plans.
"We want to come to some single standard that everyone can use," he says. "Plans will always want to ask certain specific questions that are of particular interest to them in their quality improvement. I hope this would simplify matters for them, but I would imagine they would still do other surveys."
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