266352 Using provider satisfaction surveys to identify areas for improving access and treatment for patients with disabilities in managed care

Sunday, October 28, 2012

Earl Leonard III, MS , Healthcare Outcomes & Analysis, L.A. Care Health Plan, Los Angeles, CA
Eleanor Young, MPH, RHIA , HealthCare Outcomes and Analysis, LA Care Health Plan, Los Angeles, CA
S. Rae Starr, MPhil, MOrgBehav , HealthCare Outcomes & Analysis, L.A. Care Health Plan, Los Angeles, CA
Healthcare agencies monitor the quality of care and services to patients with disabilities through a variety of data. Annual provider satisfaction surveys are one source. Although these surveys focus on physicians' concerns, those concerns include aspects of managed care where physicians' and patients' interests align: access to specialists, tests, and treatments. Physicians use the surveys to note the problems they have in ordering special care. (1) Study design: This study is based on feedback from small samples of physicians and office staff responding in annual provider satisfaction surveys, using demographics for the patient panel as explanatory variables.

(2) Setting: Data are from a large urban Medicaid health plan in southern California, serving a diverse population through a complex provider network involving multiple health plans and several dozen medical groups.

(3) Descriptive findings: The presentation will report provider satisfaction regarding several aspects of the managed care process. Patient demographics, including disability status, will be summarized and reported.

(4) Analysis: The briefing will analyze the association between a patient's disability status and provider satisfaction with the managed care process, as a means to identify which steps in the process create bottlenecks or frustration. The analysis will also explore other mediating factors, such as patient age, physician specialty type, setting of care, etc.

(5) Implications: The briefing will discuss how to streamline access to treatments for patients with disabilities; and ways to improve the process by which patients with disabilities choose doctors and are assigned to provider groups based on patients' specialized needs.

Learning Areas:
Biostatistics, economics
Chronic disease management and prevention
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
Program planning

Learning Objectives:
1. Among physicians who see more patients with disabilities, identify which elements of managed care stand out as areas for improvement. 2. Compare which elements of the managed care process cause most or least difficulty for providers who see more patients with disabilities versus providers with relatively few patients with disabilities. 3. Describe how provider satisfaction varies across different provider group structures and settings, and discuss whether patients with disabilities gravitate toward settings where physicians are satisfied or unsatisfied with managed care processes. 4. Describe whether physicians' satisfaction or dissatisfaction with the managed care process vary by specialties used heavily by patients with disabilities. 5. Analyze provider satisfaction by patient disability status and provider satisfaction, for insights on ways to improve assignment of patients to provider groups. 6. Among patients with disabilities, describe how different demographic groups fare in terms of provider feedback on the ease or difficulty of interacting with the managed care process.

Keywords: Disability, Medicaid Managed Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am employed as a Senior Biostatistician at L.A. Care Health Plan the Local Initiative Health Authority of Los Angeles County, California. L.A. Care is a public entity competing with commercial insurers in the Medicaid and S-CHIP markets in L.A. County. I participated in the design, analysis, interpretation, and writing of the reported findings. I am the principle biostatistician for the provider satisfaction survey study at L.A. Care.
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.