| | Senior Preferred Member Satisfaction with Gundersen Lutheran Health Plan (Medicare Advantage CAHPS 2005)
Purpose
To examine trends in Senior Preferred member satisfaction with Gundersen Lutheran Health Plan, and identify opportunities for improvement.
Background
The MA-CAHPS® (Medicare Advantage Consumer Assessment of Health Plans Study) is an annual survey conducted by the Centers for Medicare & Medicaid Services (CMS) to assess the experiences of beneficiaries in Medicare Advantage plans. In 1998, CMS launched a nationwide effort to collect information from Medicare beneficiaries enrolled in MCOs (Managed Care Organizations) about their experiences with, and evaluations of, their health plans. The MA-CAHPS Enrollee Survey has been conducted annually since that time. In the fall of 2000, CMS began to conduct a separate annual survey of beneficiaries who voluntarily disenrolled from Medicare Advantage plans to gather information about their experiences with the plan they left. This survey is known as the Medicare CAHPS Disenrollment Assessment Survey. Results from the Disenrollment Assessment Survey are combined with those from the MA-CAHPS Enrollee Survey for reporting. Both surveys were developed by a consortium of researchers from American Institutes for Research, Harvard Medical School, the RAND Corporation, and RTI (Research Triangle Institute) International under a cooperative agreement between CMS and the Agency for Healthcare Research and Quality (AHRQ). 1,2
Gundersen Lutheran Health Plan’s Medicare Managed Care product (Senior Preferred) first became eligible for the MA-CAHPS survey in 2001. The surveys are now conducted from January to May each year; health plans receive their survey results in September.
Aim
Gundersen Lutheran Health Plan member satisfaction ratings will be comparable to or exceed benchmarks.
Methods
CMS administers the MA-CAHPS. Westat and its subcontractor, Data Recognition Corporation (DRC), collected and processed the survey data using a random sample of enrollees and disenrollees selected from CMS records. For the MA-CAHPS Enrollee Survey, the population includes a random sample of 600 members who were continuously enrolled for at least six months. For the annual MA-CAHPS Disenrollee Survey, the sample rate fluctuates. The sample size is determined by the application of the sampling rate for the MA-CAHPS Enrollee Survey to the population of the disenrollees. For both samples, institutionalized beneficiaries were not eligible for selection, and, if identified during data collection, were excluded from the analysis. Most of the questions in the MA-CAHPS Enrollee Survey are the same as those in the Disenrollee Survey. However, the Enrollee Survey asks respondents to report on their experiences over the last six months, while the Disenrollee Survey asks them to report on their experiences during the six months prior to leaving the plan.1
The 2005 survey protocol included an advance letter, a survey packet, and a thank you/reminder postcard mailing to all sample members. Telephone follow-up interviews were conducted with those who did not return their mail survey. This protocol was similar to that of previous MA-CAHPS surveys with some important differences: a second survey mailing (to those who did not respond to the first survey) was eliminated in 2005; a third survey mailing (to those who did not return either mail survey and for whom a phone number was unavailable) was eliminated in 2005; telephone follow-up interviews were attempted with a sample (72%) of the mail survey non-respondents versus attempting to call all non-respondents as in the past.1 Our response rate for the 2005 MA-CAHPS Enrollee survey was 74%; response rate for the Disenrollee survey was 39%. These response rates are lower than in the past, probably due to the changes in the survey protocol.
Data from both surveys were combined for analysis and reporting. The data were weighted to reflect the numbers of enrollees and disenrollees in each health plan. Results were case-mix adjusted using person-level characteristics including age, education, and self-reported physical and mental health status. Data was case-mix-adjusted to compare each plan to statewide or regional means. Two-tailed t-tests were used to assess whether the case-mix-adjusted mean for each plan differed significantly from the overall adjusted mean for all plan members in the state or region. Researchers at Harvard Medical School analyzed the combined data to produce summary statistics for public reporting.1
Benchmark
The Wisconsin Average is based on a total of seven Medicare Advantage plans in Wisconsin who participated in the 2005 MA-CAHPS.
Results
| MEASURE | 2005 Gundersen Lutheran Health Plan | 2005 Medicare Advantage WI Avg |
| Highest Rating for Health Plans | 52%* | 43% |
| Health Plan Customer Service | 75% | 76% |
| Highest Rating for Health Care | 57% | 50% |
| Highest Rating for Personal Doctors | 55% | 49% |
| Highest Rating for Specialists | 55% | 48% |
| How Well Doctors Communicate | 78% | 73% |
| Getting Needed Care | 90% | 92% |
| Getting Care Quickly | 68% | 66% |
| Courteous & Helpful Clinic Staff | 88% | 86% |
*measures in which we scored significantly above the WI Average (p < 0.05)
Links to Graphic Displays of Data
Health Plan
Health Care
Conclusions
1. Gundersen Lutheran Health Plan’s 2005 MA-CAHPS scores were similar to the Wisconsin average for eight of the nine measures.
2. “Highest Rating for Health Plans” was the one measure in which Gundersen Lutheran Health Plan’s score was significantly better than the Wisconsin average.
3. Our rates decreased from 2004 to 2005 for a number of measures. Most notably were “Health Plan Customer Service Not A Problem”, which decreased from 86% to 75% and “Highest Rating for Health Plans”, which decreased from 62% to 52%.
Next Steps
1. Improve the readability of Senior Preferred written material by having a Health Plan team review all letters prior to mass mailings.
2. Simplify the ANOC (Annual Notice of Change) language. Include a flier with the ANOC mailing that clearly outlines the correct steps to take during open enrollment.
3. Develop a member handbook for Senior Preferred members.
4. Schedule information sessions for Senior Preferred members during open enrollment.
5. Improve information on the health plan website. A long-term goal (2008) is to allow members on-line access to their own benefit and claim information.
6. Schedule Senior Preferred member recognition events in 2007.
References
1. 2005 Medicare Advantage CAHPS Results, Issued September 2006, Centers for Medicare & Medicaid Services.
2. National Committee for Quality Assurance, HEDIS® 2006 Specifications for Survey Measures, Volume 3. Washington, DC. 2005.
Leaders
Charles Schauberger, MD; Andy Kyser, RN
Acknowledgments
Ann Kiel; Annette Kastenschmidt
CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA). |