Giving voice to older patients in a child-rich Medicaid health plan: Using CAHPS satisfaction surveys to identify areas for improvement in health services for older patients, 2008-2010

Providing health services to an aging population requires health plans to contract provider networks that are suited to the needs of older patients. This poses an emerging challenge to redesign services in Medicaid health plans that evolved to serve disproportionately-pediatric populations and mothers.

(1) Setting: This presentation will report on the experience of one large urban Medicaid health plan in the southwestern United States, in reconfiguring services and its provider network to address the needs of elderly patients.

(2) Feedback from older patients: One source of guidance should be the voices of elderly patients, themselves. One sometimes overlooked tool is the CAHPS member experience survey conducted annually by many health plans (often in addition to the Medicare CAHPS survey).

(3) Innovations in surveys: The presentation describes ways to adapt CAHPS to provide analyses (despite small samples) to inform health care administrators about differences between older patients and younger patients on key dimensions of health care service quality. Three innovations can make the results more actionable in designing interventions to improve provider services: (a) adding independent variables for rating programs; (b) adding questions that probe barriers to access; (c) soliciting verbatim suggestions on how to improve services.

(4) Analyses: This presentation will (a) profile differences between older patients and other age groups on key dimensions of health care quality from 2008-2010; (b) describe barriers identified by older members in seeking health care; (c) state how frequently older patients report that their doctors need training on how to work with older patients.