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NFP Groups Release CA Patient Experience Rankings

 |  By cclark@healthleadersmedia.com  
   January 09, 2014

Payers, providers, patients, and the public can now view by medical group practice how consumers score California healthcare providers. The data has been compiled by three non-profit groups including Consumer Reports.

Any day now, physician groups with 100 or more eligible practitioners will see for the first time how their practices score nationally on patient experience when survey responses are uploaded to the federal website, Physician Compare.

But Consumer Reports, the California Healthcare Performance Information System (CHPI), and the California Healthcare Foundation this week beat CMS to the punch. The organizations released patient experience score rankings for more than 30,000 physicians in 170 practices in California. The project is similar to other smaller projects in Wisconsin, Minnesota, and Massachusetts launched in 2012 and 2013.

Payers, providers, patients, and the public can now view—by medical group practice only—how consumers scored their California doctors on 19 questions, from how well the physician provided explanations, to whether clerks and receptionists exhibited courtesy and respect, to frequency of follow up care. Individual doctors' scores were not included in this report, but may come later.

"Our primary goal is to get physicians and practitioners to improve quality and for patients to put more emphasis on quality when they chose their physicians," says John Santa, MD, medical director of Consumer Reports Health. He adds that hospital executives and their provider teams should care about this as well, whether they own the physician group practices or not.

The report used responses from nearly 59,000 commercially insured patients in HMOs and point-of-service plans who were treated in 2012 and early 2013. Eligible providers include specialists, nurse practitioners, and physicians assistants.

The scores were derived in multiple ways.

First, for an overall score for each medical group, patients were asked to rate their experience on a 0 to 10 scale, which is shown with a red bar. For example, the survey shows that Sierra Medical Group in Lancaster, CA, scored the worst, with an overall rating of 51. Sutter Gould Medical Foundation scored the best, with an overall score of 74.

Second, patients also were asked to rate providers on whether they "always," "usually," "sometimes," or "never" received a good experience on a type of care. Only "always" responses were counted toward a good score. The questions were then divided into categories of care, including communication with patients, timely care and service, coordination of care, and helpfulness of office staff.

The 3,800-physician Hill Physicians Medical Group of the East Bay, in San Ramon, CA tied with Valley Care IPA of Fillmore, Ventura, and Santa Paula, to receive top scores in those four categories. Sierra Medical Group in Lancaster received the worst scores in all four categories.

The questionnaire closely resembles the Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) and the Hospital Consumer Assessment of Healthcare Providers and Systems surveys used by the Centers for Medicare & Medicaid Services to chart experiences Medicare patients have in acute care and physician practice settings, and which is required for public reporting by the Patient Protection and Affordable Care Act on Hospital Compare and Physician Compare.

Consumer Reports lent its proprietary ratings system to the project.

Indicators of poor patient experience came in response to two questions: "How often did you see your doctor within 15 minutes of your appointment time (including time spent in the waiting room and the exam room)," and "How often did your doctor seem informed and up-to-date about the care you received from other doctors," in which only 36% and 54%, respectively, said "always."

Those responses indicate practices in general may have a lot of work to do to understand how they can improve their care for their patients, Santa says.

On the other end, patients expressed the best experience in response to the questions: "How often did your doctor show respect for what you had to say?" (84% replied "always"), "How often did your doctor listen carefully to you?" (80% replied "always), and "How often did your doctor explain things in a way that was easy to understand?" (79% replied always).

The surveys were distributed to patients by a contracted survey vendor, with the consent of participating medical groups, to patients who had recently seen a provider in a particular group. CHPI collated the results.

The survey responses show some striking findings in regional practice variation, Santa notes. Practice groups in Northern California appear to treat their patients better than practice groups in Southern California, scoring better in each of six categories: overall rating, communication, timely care and service, coordination of care, helpfulness of office staff and health promotion.

Santa says that survey researchers are looking into possible reasons for the disparity, but believes "practice groups in Northern California have more resources and have more experience with techniques to improve patient experience."

On questions related to how well physician practices encourage their patients to engage in healthy disease prevention lifestyles, the state fared poorly.

For example, less than one-third of respondents said anyone in their doctor's office spoke with them about stress, and only one-fourth said anyone asked about depressive symptoms. One-third of respondents said their physicians did not talk with them about exercise and physical activity, and just over half said their doctor talked about health diet and eating habits.

Officials for the Medical Group Management Association, the California Medical Association, the American Medical Association, Sierra Medical Group and Hill Medical Group did not respond to requests for comment.

The full survey results may be viewed on CalQualityCare.org.

As for when the CMS Physician Compare website will carry similar data for large medical practices in the U.S., CMS officials could not say definitively, only that it will be "early in 2014."

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