priorityhealth.com

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Using Patient Experience in a Health Plan
Performance Improvement Program Presentation to
the Consumer-Purchaser Disclosure Project July
12, 2007
Todd Osbeck Senior Manager Quality
Improvement Priority Health
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Priority Health

• Nationally recognized health plan
• Commercial, Medicaid, Medicare Advantage
• 585,000 Members
• 12,000 Providers
• 125 Hospitals

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Physician Incentive Program

• 17 Primary Care Quality Patient Experience
  Measures
• Benchmarks
• HEDIS 90th Percentile
• Health Plan 75th Percentile
• 6.6 Million Awarded in 2006
• 97 of Members Assigned to Participating
  Physician
• Guided by Physician Advisory Committee
• Transparency of Measures, Patients and Outcomes
  to Physicians

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Patient Experience Measures Health Plan
Perspective

• Improvement
• Balance
• Focus
• Inclusion
• Consistency
• Sustainability

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Patient Experience

• What to Measure?
• Satisfaction vs. Experience?
• What can be changed?
• What impacts health improvement?
• What do patients want to know for choice?
• How many measures?

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Patient Experience

• Health Plan Survey
• 3rd Party Telephone Survey
• 10 Questions
• 30-60 Days from Office Visit
• Administered for Seasonal Variability
• 40 Completed Surveys per Practice Site

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Patient Experience Measures

• During your last visit to the doctors office,
  how would you rate the advice you received about
  the ways to avoid illness and stay healthy?
  (Benchmark 88)
• When calling your doctors office, how would rate
  the length of time it takes to return your call?
  (Benchmark 68)
• Incentive Reward 0.25 pmpm if either benchmark
  met

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Physician Incentive Program Patient Experience
Results
Measure 2004 2005 2006
Advice on Avoiding Illness 81 82 80
Returned Phone Calls 58 75 71
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Financial Rewards
2006 Patient Experience Awards 645,600
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Public Reporting
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Public Reporting
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Patient Experience

• Measurement Level
• Physician
• Specific information
• More costly
• Practice Site
• Recognize team concept Systems of Care
• More difficult to identify
• Physician Group
• Economical
• Difficult to motivate change (other guys problem)

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Patient Experience

• Survey Results
• Scores based on Excellent Very Good
• Comparison to Benchmark
• YTD Results Reported to Physicians Monthly
• Annual Results Incentives and Public Reporting
• Complete Survey Results Reported to Practice Site
• Same Measures for Incentives Public Reporting

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Patient Experience

• Public Reporting
• Report Using Symbols (Apples)
• Minimum Thresholds
• Limited Number of Measures
• Consistency of Measures Over Time

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Patient Experience

• Although we have limited research on the impact
  of our public reporting we have observed. . .
• 9- 10,000 Visits per Month to Find A Doctor
• Best Performing Physicians Attract 4x Members

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Patient Experience

• The Future
• Share our Learning from Provider Incentives and
  Public Reporting
• Continue to Improve our Measurement Reporting
  of Patient Experience
• Participate in West Michigans Aligning Forces
  for Quality Project

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