247556 Loosening CAHPS on prescriptions: Surveying how patients in a large urban Medicaid health plan rate the quality of pharmacist instructions, 2007-2010

Tuesday, November 1, 2011: 11:15 AM

S. Rae Starr, MPhil, MOrgBehav , Healthcare Outcomes & Analysis, L.A. Care Health Plan, Los Angeles, CA
Susan Leong, RPh , Pharmacy & Formulary, L.A. Care Health Plan, Los Angeles, CA
As health administrators seek to get more value from health care expenditures, there is an increasing focus on improving quality of services. Pharmacy is a largely neglected dimension in patient surveys about service quality. Pharmacists clearly have a role customer service quality and patient education -- but until recently quality improvement surveys such as CAHPS have only addressed pharmacy services tangentially. The role of pharmacists as health educators needs better assessment.

(1) Methodology: This briefing will cover results from pharmacy service questions appended to the CAHPS Medicaid instrument from 2007 to 2010 in annual surveys conducted for a large urban Medicaid health plan in the southwest United States serving an ethnically and linguistically diverse population of 875,000 adults and pediatric members.

(2) Assessments: Each respondent was asked to rate the quality of the instructions received from pharmacists. The presentation will compare the results for adults and children, and will report results by language and ethnicity. To provide guidance on how to improve the quality of instructions and communication with patients, other questions rated overall pharmacy services and asked if language was a barrier at the pharmacy.

(3) Analysis: The briefing also explores the relationship between the pharmacists' score on the quality of health instructions given to patients, and the patient's assessment of the quality of all health care received during the study period. The point of that analysis is to determine whether the quality of pharmacist instructions drives other measures that NCQA and government agencies use to rate health plans.

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
Social and behavioral sciences

Learning Objectives:
1. Describe how patients rate pharmacists as sources of instruction on health literacy. 2. Evaluate patients' ratings of the quality of pharmacist instructions. 3. Assess the impact of pharmacist instructions on the patient's overall rating of the quality of the health care they experience. 4. Design question sets on patient surveys to give actionable feedback to pharmacist networks. 5. Identify barriers that impair pharmacists' communication with patients at the pharmacy.

Keywords: Health Education, Patient Satisfaction

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 a bloc of supplemental questions to augment CAHPS to ask patients to rate pharmacist instructions, pharmacy services, and note barriers to access PD beneficiaries from fee-for-service to managed care coverage, 2007-2010. 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.