Hoosier Healthwise Briefing
Primary Medical Provider Satisfaction Survey
Objective
A Hoosier Healthwise satisfaction survey is conducted annually to assess the attitudes, behaviors and perceptions of the Hoosier Healthwise program by the participating primary medical providers (PMPs).
Method
This research is based upon a mail survey conducted among all PMPs participating in the Hoosier Healthwise program for all regions and health plan networks during calendar year 2002. Questionnaires were completed by PMPs, office managers and other office staff. From a total of 2,159 questionnaires distributed, 840 completed questionnaires were returned to an independent market research organization, Market Measurement, for data analysis. This translates to a response rate of 39 percent.
A technique called "data weighting" was used to ensure that the total/aggregate study findings accurately reflect the true size of the populations of PMPs for each region/network combination. Comparisons were made with the results of earlier PMP Satisfaction Surveys.
Summary of Key Findings
- PMP satisfaction of program.
- 67 percent of the PMPs were very or somewhat satisfied with the Hoosier Healthwise program. This represents a slight decline from the high of 71 percent in 2001.
- PMP satisfaction rarely differs by:
- practice type;
- family practitioners,
- pediatricians,
- general internists.
- OB-GYNs, or
- general practitioners.
- practice profile;
- solo practitioners or
- group practitioners.
- geographic location, or
- network through which care is provided to Hoosier Healthwise members.
TABLE 1
Level of Satisfaction
Hoosier Healthwise Program
(2002 Total Responding = 734)***Level of satisfaction 2002 2001 2000 1999 1998 Very satisfied** 13% 14% 15% 13% 10% Somewhat satisfied** 54% 57% 53% 54% 53% Somewhat dissatisfied 21% 18% 22% 21% 26% Very dissatisfied 12% 11% 12% 12% 11% - practice type;
- Favorable ratings for Hoosier Healthwise for 9 out of 12 criteria.
Well over half of all PMPs provide at least a “1,” “2” or “3” rating (1=excellent and 5=poor) for the Hoosier Healthwise Program when considering the following evaluation criteria:
- Ease of enrolling, as a PMP in your network (91%)
- Communicating your responsibilities to you as a PMP (89%)
- Accuracy of responses to your questions/concerns (75%)
- Indiana Health Coverage Program Provider Updates (91%)
- Communication from your network (82%)
- Authorization process for patients to access care from another provider (73%)
- Ease of verifying patient eligibility (86%)
- Timeliness of claims processing (79%)
- Hoosier Healthwise patients, in terms of following physician instructions (54%)
- Key opportunities for improvement (i.e., low ratings of "4" or "5" where 1=excellent and 5=poor) for 3 out of 12 criteria.
- Reimbursement Rates (61%)
- Autoassignment process (60%)
- Hoosier Healthwise patients on keeping appointments (56%)
- Patient Load
There has been a trend of increasing proportion (i.e., 18% in 1998 versus 25% in 2002) of PMPs who report having “too many” Hoosier Healthwise patients as shown in Table 2.
Table 2
2002 Sentiments Toward Total Patient
Load, vs. Hoosier Healthwise Patient Load
(Among Those Providing A Rating)Total Hoosier Healthwise Members Too few 25% 14% Just right 66% 60% Too many* 9% 25% * In 2001, total = 12%, and HH = 24%
- Program concerns from a PMP perspective
Among the PMPs providing a write-in response to the open-ended question at the end of the questionnaire, focusing on “problems or concerns” PMPs have with the Hoosier Healthwise Program, about one-in-four (29%) criticized reimbursement (i.e., typically “too low”). Comments were grouped in the following categories:
- Reimbursement 29%
- Auto Assignment/Patient Mix 27%
- Communication 23%
- Patient Compliance/ER Abuse 22%
- Referral/ Precertification Issues 19%
- Expand/Improve Formulary 12%
- Claim/Coverage Issues 10%
- Patient Load 10%
- Patient Criticisms 7%
- Paperwork 3%
- Other 12%
- Positive attributes from a PMP perspective are heavily focused upon providing access to medical care for lower income patients.
Among the PMPs providing a “write-in” response to the open-ended question asking about the “positive aspects” of the Hoosier Healthwise program, well over one-third specifically focused upon the value of this program in providing access to medical care to those who could not otherwise afford these services. Comments were grouped in the following categories:
- Access To Medical Care 42%
- General Positive Comments 23%
- Good Staff/ Communications 19%
- Reimbursement/Claim Filing 14%
- Coverage Issues 7%
- Internet Access Comments 5%
- Referral Issues 3%
- Requests For Improvements 2%
Recommendations
- To base planning activities on the possibility that negative sentiment toward the Hoosier Healthwise Program among PMPs may be shifting to a more challenging environment in which “PMP patience” with some program elements may be decreasing.
- Assume that there is a close relationship between PMP sentiment toward the patient/physician relationship and overall satisfaction with the Hoosier Healthwise Program.
- As has been consistently evident in this research, planning activities should reflect the likelihood of highly consistent PMP sentiment toward this program, regardless of MCO, region, type of practice or primary care specialty, i.e., activities should be program-wide.
- Attempt to identify issues that could have translated into deteriorating sentiment toward patient/physician relationships among those in solo practice.
- It may seem obvious that opportunities to improve patient/physician relationships should emphasize patients keeping appointments (i.e., or calling to cancel), as well as compliance with physician instructions. Nevertheless, these were the only two “aided” evaluation criteria, relevant to patient/physician relationships, included in the study. Consequently, efforts to improve PMP sentiment toward these relationships should include a more thorough investigation of all issues that could undermine PMP satisfaction ratings.
In summary, with the exception of reimbursement and the auto-assignment process, PMPs are comparatively more likely to be critical of their patient/physician relationships, than their interactions with the Hoosier Healthwise program. In response to these findings, work plans will be developed by the managed care entities and OMPP for program improvements.
For more information about the Hoosier Healthwise PMP Satisfaction Survey, please contact:
Office of Medicaid Policy and Planning, MS-07
402 W. Washington St.
Indianapolis, IN 46204-2739
Telephone: (317) 233-8800
Fax: (317) 232-7382
