242718 Using annual CAHPS surveys for root cause analysis: Problems with informational materials reported by Medicaid patients living with disabilities, 2008-2009

Tuesday, November 1, 2011

S. Rae Starr, MPhil, MOrgBehav , Healthcare Outcomes & Analysis, L.A. Care Health Plan, Los Angeles, CA
Earl Leonard III, MS , Healthcare Outcomes & Analysis, L.A. Care Health Plan, Los Angeles, CA
Navigating the health care system typically occupies a larger part of daily life for people living with disabilities than for other users of the U.S. health care system. Accommodating the health information needs of patients with disabilities is a persistent challenge in health plans.

This presentation will report the experience at one large urban Medicaid health plan in California to identify the specific difficulties and barriers encountered by patients with disabilities, in obtaining and using health care information.

(1) Innovations in surveys to solicit feedback from patients with disabilities: One often overlooked tool is the CAHPS member experience survey conducted annually by many health plans. At little additional cost and labor, the survey tool can be adapted to provide analyses to identify communication barriers, to guide the evolution and design of informational materials and the processes for delivering them.

(2) Three innovations can make CAHPS surveys more actionable in improving information services: (a) adding data to distinguish patients with disabilities as a group to enable creation of reports; (b) adding questions that probe barriers to information access; (c) soliciting free-text suggestions on how to improve information services for members with disabilities.

(3) Analyses: This presentation will report on small-sample findings (pooled 2008-2009) from questions that asked (a) what problems members with disabilities experienced with written materials; (b) which types of materials were most prone to have those problems; (c) where the problem materials most often originated; and (d) percentages of members preferring different mediums of communication (written, audio, visual, Internet).

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs

Learning Objectives:
1. Identify which health promotion and health plan materials cause the most problems. 2. Identify what kinds of problems are reported by patients with disabilities in seeking health care information. 3. Design an integrated bloc of questions for the patient member survey to aid in targeting interventions to resolve problems in disseminating informational materials. 4. Discuss ways to improve annual CAHPS surveys to better capture data about the information and service needs of patients with disabilities.

Keywords: Disability, Health Education

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Experience: Six years as the Senior Biostatistician at L.A. Care Health Plan, managing the CAHPS survey for L.A. Care Health Plan from 2006 to 2011, including all facets of the survey to be discussed in the presentation. Designed survey of seniors and people living with disabilities (SPD) membership as a 2006 needs assessment to augment CAHPS in response to proposed policy in California to transition Medicaid SPD beneficiaries from fee-for-service to managed care coverage. Routinely survey members regarding media and format preferences for health information materials. Setting: L.A. Care Health Plan is a public entity serving Los Angeles County, California, and the largest public health insurer in the United States. L.A. Care's CAHPS survey represents voice for approximately 850,000 Medicaid and SCHIP members in an ethnically diverse, urban county in the southwest United States. The challenges addressed at L.A. Care likely reflect those of other urban Medicaid insurers, and of state agencies that sponsor the CAHPS survey directly. Education: Master of Philosophy in Policy Analysis from the RAND Graduate School of Policy Analysis (Santa Monica CA); Master of Organizational Behavior from Brigham Young University (Provo, UT); Bachelor of Political Science with Honors from Brigham Young University (Provo UT).
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.