medical practice patient experience overview - amazon s3 · medical practice patient experience...

Copyright © 2016 Studer Group. Please do not quote or disseminate without Studer Group authorization

Medical Practice Patient

Experience Overview

Matthew Bates, MPH

Managing Director

CG CAHPS


Charles A. Stanley, M.D.Pediatric Endocrinologist

Chief, Division of Endocrinology/Diabetes

C Everett Koop, M.D.Pediatric Surgeon

Former US Surgeon General


• Congenital Hyperinsulinism (HI), the secretion of insulin is not properly regulated, causing excess

insulin secretion and low blood sugar. Blood sugars can drop rapidly (20+ pts in <15 mins). Prolonged

or severe low blood sugar can cause seizures or permanent brain damage. Treated with Diazoxide

and/or removal of majority of the pancreas.

• Rare disease. NIH estimates 1 in 50,000 births (~75 cases per year in US today)

– In the 1970s, most children died before age 18 and many that survived suffered brain damage

• Only 1 specialized treatment center in the US (CHOP) and 3 in the world.

My Brother My Niece & her dog Sage


Healthcare Flywheel®

4


“Cure sometimes, treat often,

comfort always”-Hippocrates, born 460 BC


Three Dimensions of QualityPatient Experience, Clinical Safety and Effectiveness

“The data presented display that patient experience is positively associated

with clinical effectiveness and patient safety, and support the case for the

inclusion of patient experience as one of the central pillars of quality in

healthcare.”

“It supports the argument that the three dimensions of quality should be looked

at as a group and not in isolation.”

“Clinicians should resist sidelining patient experience as too subjective or mood-

oriented, divorced from the ‘real’ clinical work of measuring safety and

effectiveness.”

Source: A systematic review of evidence on the links between patient experience and clinical safety and effectiveness; BMJ Open, 2013

Studies

Positive

Associations

No

Association

Negative

Association

557 429 (77.8%) 127 (22%) 1 (0.2%)


Patient Experience is Positively Correlated

with Patient Engagement and Adherence

Communication & Medication Refill Adherence

•9,377 diabetic patients

•…30% of participants had poor cardiometabolic

medication refill adherence. The prevalence of poor

adherence increased by 0.9% (P = 0.01) for each 10-

point decrease in CAHPS score.

Source: JAMA Internal Medicine 2013; 173 (3): 210-218

Additional medication adherence studies: DiMatteo, 1994; DiMatteo MR, 1993; Safran DG, 1998


The Quadruple Aim

8

Experience

of Care

Per Capita

Costs

Population

Health

Caregiver

Well-BeingReferences:

• Annals of Family Medicine, November/December 2014vol. 12 no. 6 573-576

• BMJ Quality & Safety, doi:10.1136/bmjqs-2015-004160


NCQA: State of Healthcare Quality

“How patients feel—both in terms of their

symptoms and in terms of their care—is central to

medicine’s mission as a helping profession.”

“... patients with better experiences have better

health outcomes.”

Source: Improving Quality and Patient Experience: The State of Health Care Quality 2013, NCQA, October 2013.


“Patients First” is the guiding principle of Cleveland Clinic. We

strive to provide outstanding and compassionate care and

service, every step along the way.

Geisinger Health System is committed to providing you and

your family with the best possible patient experience, each

and every time you visit us.

Our goal is to provide exceptional care and service to you and

your family. --Kaiser Permanente

The Needs of the Patient Come First --Mayo Clinic


QualityTo provide a level of patient care and

service good enough for our own mothers,

without the need for special arrangements


We Attract & Retain Patients…

with Remarkable Patient Experience

No Margin, No Mission

Volume

Patient

Satisfaction

Positive Patient Experience “Pays”


Do you want high patient experience or

high productivity? I can’t do both!

Source: Perm J 2012 Fall; “Patient Experience and Physician Productivity: Debunking the Mythical Divide at HealthPartners Clinics”

There are many physicians with high

productivity and high patient experience!

Low Productivity

High Experience

Low Productivity

Low ExperienceHigh Productivity

Low Experience

High Productivity

High Experience

Pa

tie

nt

Ex

pe

rie

nc

e

Provider Productivity

Copyright © 2016 Studer Group. Please do not quote or disseminate without Studer Group authorization15

Physician Compare Example

Source: ttps://www.medicare.gov/physiciancompare/

SUTTER GOULD MEDICAL FOUNDATION

Top Box or

% Always

CG CAHPS

Domains

STARS (Relative

Percentile Rank

compared to others)

https://www.medicare.gov/physiciancompare/


State / Public Example

Source: www.mnhealthscores.org


CMS and other payers are leveraging Patient Experience (CAHPS)

surveys to drive two priorities:

Quality (VBP)

Transparency

17

WHY Patient Experience (CAHPS) Surveys?


“Could a greater

miracle take

place than for us

to look through

each other's eyes

for an instant?”

Henry David Thoreau1817-1862


CG = Clinician and Group–Its about your whole team

CAHPS = Consumer Assessment of

Healthcare Providers and Systems–Its about the patient’s experience

Note: CG CAHPS = CG-CAHPS = CGCAHPS


CG CAHPS Family Tree (10 and counting…)

CG CAHPS

CG CAHPS

6-Month

Longitudinal CG CAHPS Visit

Adult Child

PCMH

12-Month

CMS

6-Month

Adult Child Adult Child ACO PQRS

9 12

Source: AHRQ v2.0 & v3.0 CG-CAHPS, CMS and NCQA

MA-PDP CAHPSOAS CAHPS


Common “Payer Requested” Surveys for 2016

•CAHPS for PCMH– NCAQ Optional for Patient Certified Medical Homes (PCMH)

– 60% of US hospitals/health systems have or are working to create a PCMH*

•CAHPS for PQRS– CMS Required for Groups of 100+ EPs

– CMS Optional for Groups of 2-99 EPs

– 99% of US hospitals/health systems physician groups are participating in PQRS*

•CAHPS for ACOs– CMS Required for groups participating in CMS ACO programs

– 58% of US hospitals/health systems have created or are creating an ACO*

*Source: American Hospital Association (AHA), 2014 Survey of Care Systems and Payment


CG CAHPS Surveys

CG CAHPS

Core

Questions

CG CAHPS Supplemental

Questions

CG CAHPS

Surveys

Examples:

• CAHPS for PQRS

• CAHPS for ACOs

• CAHPS for PCMH

Source: CG CAHPS longitudinal surveys from AHRQ


So …… what’s at the core?


CG CAHPS Survey (Version 3)13 scored questions grouped in 5 domains

Access to Care

• Patient got appointment for urgent care as

soon as needed

• Patient got appointment for non-urgent

care as soon as needed

• Patient got answer to medical question the

same day he/she contacted provider’s

office

Overall Rating of the Provider

• Overall rating of your Provider (0 to 10)

Provider Communication

• Provider explained things in a way that was

easy to understand

• Provider listened carefully to patient

• Provider showed respect for what patient

had to say

• Provider spent enough time with patient

Courteous and Helpful Office Staff

• Clerks and receptionists helpful

• Clerks and receptionists courteous and

respectful

Care Coordination

• Provider knew important information about

patient’s medical history

• Someone from provider’s office followed up

with patient to give results of blood test, x-

ray, or other test

• Someone from provider’s office talked about

all prescription medications being taken

Source: AHRQ, CG CAHPS Survey version 3


Patient Experience is about High Reliability

There are 4 standardized answers to the core CG CAHPS questions

Always

Usually

Sometimes

Never

Only “Always” Counts

Top Box = Percent Always

Source: CG CAHPS 3.0 longitudinal survey; standardized answers


Response Scale: Never, Sometimes, Usually, Always; Top Box = Always

1. Patient got appointment for urgent care as soon as

needed?

2. Patient got appointment for non-urgent care as soon

as needed?

3. Patient got answer to medical question the same day

he/she contacted provider’s office?

Access to Care



1. Provider explained things in a way that was easy to

understand

2. Provider listened carefully to patient

3. Provider showed respect for what patient had to say

4. Provider spent enough time with patient

Provider Communication



1. Clerks and receptionists helpful

2. Clerks and receptionists courteous and respectful

Courteous and Helpful Office Staff



1. Provider knew important information about patient’s

medical history

2. Someone from provider’s office followed up with

patient to give results of blood test, x-ray, or other

test

3. Someone from provider’s office talked about all

prescription medications being taken

Care Coordination


Overall Provider Rating Question

Only responses of 9 & 10

count as Top Box

0

8

3

1

7654

9

2

10 Best

Worst

Question:

Using any number from 0 to

10, where 0 is the worst

provider possible and 10 is the

best provider possible, what

number would you use to rate

this provider?

Source: CG CAHPS v2.0 & v3.0 longitudinal survey


Studer Group’s CG CAHPS RecommendationsSkate to where the puck is going to be…

• If you haven’t started yet, start

conducting CG CAHPS surveys

ASAP

• Follow the $ and focus on

Longitudinal Surveys (ver. 2 or 3)

• Start by focusing on the “Core

Questions” that every CG

CAHPS survey contains

• Focus on improving your “top

box results” vs. vendor

benchmarks


They may not remember

what you said…

They may not remember

what you did…

They always remember how

you made them feel.

-Maya Angelou

Connecting at a "gut level"


Matthew Bates, MPH

Managing Director

[email protected]

720-355-1053 (mobile)

EVALUATION REMINDER:

We want your feedback to get

better. Please remember to take

the session evaluation. Thank you!

mailto:[email protected]


Next Presentation: Office Staff Courtesy

Julie O'Shaughnessy

Coach Leader

A Commitment to Continuous Improvement

medical practice patient experience overview - amazon s3 · medical practice patient experience...

Documents