the myers group information and services

Harnessing the Power of Information

The Myers Group

Advanced Survey Research and Resources Giving Health Plans The Power To Improve

www.themyersgroup.net

http://www.themyersgroup.net/

Are your disease management programs effective?

How satisfied are members with your health plan?

How can you improve employer group

How does your health plan compete?

Do you know how to improve patient satisfaction?

Do your new members understand their benefits?

Do you understand their cultural needs?

Knowledge Is Power

How will you leverage yours?

The Myers Group conducts extensive survey research and call center support services to give healthcare organizations the knowledge they need to continually improve and compete in today’s marketplace.

As a leader in healthcare research, we offer a full line of survey products and call center services. Healthcare organizations throughout the United States rely on The Myers Group for dependable survey administration, inbound and outbound call center support services, data collection, and insightful analysis.

Certified Healthcare Survey Vendor

NCQA-Certified CAHPS® Survey Vendor NCQA-Certified Medicare Health Outcomes Surveys

(HOS) Survey Vendor

CMS-Approved Medicare CAHPS Survey Vendor

NCQA-Certified CAHPS® PCMH Survey Vendor

In addition to CAHPS®, HOS and additional CAHPS Family of Surveys, we continually evaluate HEDIS® NCQA and CMS standards and regulatory guidelines to develop and enhance our service and the growing needs of our clients.

http://www.ncqa.org

Are members satisfied with access to care?

Do you need to improve claims processing?

Is your call center helpful to members and providers?

How satisfied are providers with your health plan?

Are members satisfied with their

How does your health plan compare?

Is your case management program effective?

Do you know where to start? Can you identify where to focus quality improvement efforts to transform your business from good (or not quite good enough) to great? The Myers Group works with some of the top health plan performers in the nation. These organizations rely on us to provide crucial information about member perception and plan performance.

Experienced survey consultants work with each client to determine the best survey research options and methodology. Survey design, sampling, segmentation and stratification of data are just some of the factors to consider. Our survey consultants personally work with you to obtain valid results and useful information.

Before you can start your journey to the top, you need to determine how to get there.

The Myers Group works with many of the top health

plan performers in the nation.

Information to Transform Your Business

The power of information lies in the ability to apply this knowledge to successful initiatives.

Known industry-wide for our comprehensive and reliable analysis, The Myers Group provides action-oriented reports including analysis of plan and/or industry comparison, trending and benchmarking at state, regional and national levels. Our reports are designed to fit your needs and provide a wealth of insight - giving you the power to succeed.

The Myers Group invites you to partner with us for reliable survey research, giving you

the power to improve

The Power to Improve Performance and Quality


CAHPS®

• Assesses patient satisfaction with health plan

• Comprehensive final reports provide a valuable tool for quality improvement

• Over a decade of CAHPS experience and knowledge

• Adult and Child versions

• Surveying Commercial and Medicaid populations

• Augmentation with abbreviated protocol offered

Developed jointly by the Agency for Healthcare Research and Quality (AHRQ) and the National Committee for Quality Assurance (NCQA), the CAHPS survey is the most comprehensive tool available for assessing consumers’ experiences with their health plans and affiliated providers. The CAHPS surveys include Adult and Child versions for both the Commercial and Medicaid populations.The Myers Group fully manages CAHPS surveys through all the required steps of administration including design and printing, database development, mailing, survey scanning, phone follow up through our on-site call center, data collection, analysis, and a comprehensive final report of results. With certification to conduct up to 500 samples, the highest amount possible, The Myers Group has administered a significant number of all CAHPS surveys submitted to NCQA. Within days of data submission, our clients receive an At-A-Glance Report which provides a summary of results. Health plans find these reports extremely useful, providing key information to share within the plan prior to receipt of the full final report. The value added features

of our final report sets us apart from other CAHPS vendors. We provide comprehensive analysis of CAHPS results in a format that is easy to understand and apply to quality improvement measures. Health plans have come to depend on these reports for in-depth and actionable information. Contact The Myers Group for a sample of our CAHPS final report.In addition, we provide a one-hour phone consultation with health plan representatives to review the final report and help plans better understand their CAHPS results.The Myers Group also offers augmentation in which additional plan members can be sampled following an abbreviated protocol to achieve results for a specific segment or population of the health plan. These results are not included in the standard CAHPS report. However, results from the specific segment or population collected during the CAHPS survey administration can be combined with results collected during the augment for analytic purposes.The Myers Group invites you to partner with us to conduct your 2012 CAHPS surveys.

The Myers Group has over a decade of experience administering the Consumer Assessment of Healthcare Providers and Systems Survey (CAHPS). As an NCQA CAHPS certified vendor since the program’s inception in 1998, health plans throughout the nation rely on The Myers Group for our knowledge and expertise.

Phone: (770) 978-3173 Fax: (770) 623-4076www.themyersgroup.net

1110

Clinician andGroup Survey

• Part of AHRQ’s CAHPS Family of Surveys

• NCBD to provide a Benchmark Component Allowing Organizations to Compare Results

• Individual Physician/Group Report Cards Provide Transparency and Accountability Across the Provider Network

The CAHPS® Clinician & Group Survey is designed to measure patient satisfaction and general experience with their primary care physician and/or physician practice. The Myers Group provides reliable and statistically valid survey results while streamlining the preparation process for health plans and provider groups.

The National CAHPS Benchmarking Database (NCBD) is currently developing a benchmark component for the Clinician & Group Survey as well as online reporting capabilities. This will allow organizations to compare their results to State, Regional, and National benchmarks. Health plans and provider groups administer the CG CAHPS Survey to determine where to focus their improvement efforts and track performance.

The Clinician & Group Survey asks patients to report on and rate their experiences with a physician and/or practice in the following areas:

• Getting Appointments When Needed • Courteous and Helpful Office Staff• How Well Doctor’s Communicate • Overall Rating of Doctor

There are three survey instruments available in English and Spanish:

• Adult Primary Care • Child Primary Care • Adult Specialty Care

The Myers Group offers multiple options for reaching the respondent. A mixed mail/phone methodology is recommended for effectively managing quotas to ensure statistically valid results. Careful evaluation of the member database is provided at the physician or group level to verify whether patient volume is sufficient to achieving the objective.

The Myers Group provides a comprehensive final report including individual Physician/Group Report Cards to support transparency and accountability across the provider network. This information can be used in accordance with Pay-for-Performance initiatives as well as quality improvement programs.

The Myers Group looks forward to assisting organizations with this important quality measurement tool.

Physician Report Card Practice HealthJones, Sinjayah Member Experience with Physician SurveyNEUROLOGY

30 Total Respondents

Department OverallTop Box

ScoreTop Box

ScoreTop Box Health Plan Score Score

2006 2005

1 Able to get an appointment as soon as you wanted with this provider? Yes 81.8% 80.8% 87.7% 95.0%

3 Wait in provider's office more than 10 minutes past your appointment time? No 66.7% 44.0% 81.7% 82.8%

4 Explains things in a way I can understand 81.0% 65.4% 68.8% 78.9%

5 Listens carefully to me 72.7% 79.2% 72.8% 81.8%

6 Respects what I have to say 81.0% 79.2% 68.8% 81.7%

7 Spends enough time with me 71.4% 73.1% 72.5% 75.3%

8 Examinations are thorough 85.0% 76.9% 69.7% 79.9%

9 Advice given on ways to avoid illness and stay healthy 61.9% 52.0% 57.5% 69.3%

10 Clear and complete explanation of tests and procedures 71.4% 64.0% 67.9% 78.4%

11 Clear and complete explanations about what to do in certain situations 66.7% 45.8% 61.3% 76.4%

12 My privacy is respected 94.7% 96.0% 90.8% 93.4%

13 Reception staff at this office treat me with courtesy and respect 66.7% 69.2% 73.8% 83.8%

14 Reception staff respects my privacy 95.0% 80.0% 86.1% 88.1%

15 Nursing staff demonstrate respect and compassion 85.7% 73.1% 81.0% 85.7%

16 Nursing staff respects my privacy 95.0% 87.5% 92.4% 90.8%

17 Treated with respect, compassion, & privacy - x-ray services 100.0% 80.0% 85.7% 86.7%

18 Treated with respect, compassion, & privacy - lab services 81.8% 94.4% 78.9% 85.7%

19 Treated with respect and concern - billing department 62.5% 60.0% 72.7% 69.6%

20 If Specialty services were needed, who were you referred to? Practicephysician 87.5% 88.9% 69.7% 84.2%

21 How would you rate the time on hold to get an appointment? 41.7% 59.1% 75.0% 81.7%

22 How would you rate the time on hold to get medical advice from the nurse? 54.5% 42.1% 68.8% 80.6%

23 How would you rate this provider? 8-10 90.9% 80.0% 90.2% 91.2%

26 Recommend this healthcare provider to family or friends? Definitely Yes 57.1% 69.2% 70.4% 78.0%

27 How would you rate Practice Clinic overall? 8-10 83.3% 61.5% 80.3% 80.5%

28 Would you recommend Practice to family or friends if they needed care? Definitely Yes 45.5% 48.0% 66.3% 63.9%

Overall Healthcare Provider

Access

Your Healthcare Provider's Care

Reception Staff

Nursing Staff

Always

Always

Not a problem

Other Services

Calling Your Healthcare Provider

Composite/Attribute/Rating Item

Always

Response Options

Always

S. JONES


1201

CAHPS®

Medicare HOS

Call Center

New Member

Benefit Manager

ECHO

Provider Access

Member Experience

Provider Satisfaction

• The doctor

The Myers Group provides a reliable approach for measuring the effectiveness of disease management programs.

Healthcare organizations are placing increased focus on disease management for patients with chronic conditions and/or complex healthcare needs. Disease management programs can help to reduce costs while increasing patient satisfaction.

The Myers Group’s Disease Management Survey measures program effectiveness and patient satisfaction. The survey supports NCQA Standard QI 8: Disease Management, Element J: Satisfaction with Disease Management.

The Disease Management Survey provides healthcare organizations with information to help improve the quality and effectiveness of their programs. Participants of the disease management program are asked about:

• Satisfaction with the Program and Helpfulness of the Program

• Improvement to Quality of Life

• Access to Care

• Coordination of Care

• Helpfulness of Program/Educational Material

The Myers Group delivers comprehensive analysis of the survey data to provide clients with useful information that is easy to understand and apply to quality/program improvement measures.

2351 Henry Clower BoulevardSuite DSnellville, GA 30078-3107

Phone: (770) 978-3173 / x358Fax: (678) 430-0080

w w w.themyersgroup.net

Rev 6/07

Segmentation Analysis ABC Health Plan2006 Summary Rates by Provider Type Asthma Quality of Life Study

Valid n** Summary Rate Valid n** Summary

Rate Valid n** Summary Rate

1 Confidence in ability to control asthma. (Very/Pretty confident) 217 77.9% 76 69.7% 379 79.7% 9.9%

2 Do you have a written Asthma Action Plan (AAP)? (Yes) 210 73.8% 72 66.7% 362 67.1% 7.1%

2A Do you use the AAP when you have symptoms? (Yes) 151 94.7% 48 97.9% 233 96.6% 3.2%

3 Has your doctor told you to use a peak flow meter? (Yes) 206 68.4% 67 53.7% 341 43.4% 25.0%

5 Do you use an inhaled quick-relief medicine when you have difficulty breathing? (Yes) 221 94.6% 76 92.1% 377 92.3% 2.5%

6 Has your doctor prescribed long-term asthma control medicines to you? (Yes) 217 82.9% 75 86.7% 371 76.5% 10.1%

7A How often does your asthma limit your ability to do your daily activities/Attend school? (None of the time) 215 36.7% 72 41.7% 365 45.8% 9.0%

7B How often does your asthma limit you from sleeping through the night? (None of the time) 216 33.8% 72 23.6% 369 36.0% 12.4%

7C How often does your asthma limit you from exercise/Physical activity? (None of the time) 217 24.4% 74 28.4% 366 32.5% 8.1%

7D How often does your asthma limit you from engaging in social activities/Playing with friends? (None of the time) 214 36.9% 73 39.7% 373 47.2% 10.3%

8 Have you seen your doctor for an asthma condition in the last 6 months? (Yes) 213 66.2% 74 74.3% 370 67.8% 8.1%

8A Satisfaction with the health care you have received for your asthma. (Very/Somewhat satisfied) 139 94.2% 54 90.7% 246 95.9% 5.2%

9 Was the asthma education material sent to you helpful? (Yes) 175 94.9% 54 98.1% 292 97.6% 3.3%

10 Do you or anyone in your household smoke tobacco products in your home? (No) 220 80.5% 75 84.0% 373 85.8% 5.3%

** Valid n refers to total number of respondents answering the item within the subgroup under the column heading.

Note: Summary Rates are defined by TMG and are used to facilitate comparisons. See Technical Notes for more information.

Community Health Centers

Hospital Based Clinics

* Range - percentage point difference between Summary Rate percentages shown. The larger the number, the greater the difference in Summary Rate between segment groups for any given item.

Survey Item Range*

Private Practice Providers

The Myers Group Asthma Quality of Life Survey 5D

Three Year Trend Comparisons ABC Health PlanAttributes and Ratings of Member Satisfaction Asthma Quality of Life Study


2006 2005 2004 2006 to 2005 2006 to 2004

Controlling your asthma

Q1. Confidence in ability to control asthma. 78.0% 76.6% 76.0% Not sig. Not sig.

Q2. Do you have a written Asthma Action Plan (AAP)? 69.3% 65.9% 64.0% Not sig. Not sig.

Q2A. Do you use the AAP when you have symptoms? 96.1% 96.8% 93.6% Not sig. Sig. increase

Q3. Has your doctor told you to use a peak flow meter? 52.9% 49.7% 53.5% Not sig. Not sig.

MedicationQ5. Do you use an inhaled quick-relief medicine when you have difficulty breathing? 93.0% 89.4% 85.6% Not sig. Sig. increase

Q6. Has your doctor prescribed every day, long-term asthma control medicines? 79.8% 71.1% 67.2% Sig. increase Not sig.

Daily EffectsQ7A. How often does your asthma limit your ability to do your daily activities/attend school? 42.3% 38.1% 35.1% Not sig. Not sig.

Q7B. How often does your asthma limit you from sleeping through the night? 33.9% 30.9% 30.2% Not sig. Not sig.

Q7C. How often does your asthma limit you from exercise/physical activity? 29.4% 27.1% 25.4% Not sig. Not sig.

Q7D. How often does your asthma limit you from engaging in social activities/playing with friends? 43.0% 41.3% 42.9% Not sig. Not sig.

Q8. Have you seen your doctor for an asthma condition in the last 6 months? 68.0% 65.9% 67.0% Not sig. Not sig.

Q8A. Satisfaction with the health care you have received for your asthma. 94.8% 92.8% 93.7% Not sig. Not sig.

Information

Q9. Was the asthma education material that was sent to you helpful? 96.7% 92.7% 92.3% Sig. increase Not sig.

Q10. Do you or anyone in your household smoke tobacco products in your home? 83.8% 79.0% 77.3% Sig. increase Not sig.

* Summary Rates are defined by TMG and are used to facilitate comparisons.

** "Sig. Decrease" denotes the result that would be found if a hypothesis test were conducted to determine if the percentage is lower. "Sig. Increase" denotes the result that would be found if a hypothesis test were conducted to determine if the percentage is higher. "Unable to Test" denotes that there was insufficient sample size to conduct the statistical test.

Attribute/Rating ItemSignificance Testing**Summary Rates*

The Myers Group Asthma Quality of Life Survey 3A

Disease Management

The Disease Management

Survey Provides a Reliable

Approach for Measuring

Disease Management

Program Satisfaction

and Effectiveness

Disease Management surveys assess patient satisfaction and program effectiveness.

Health care organizations are placing increased focus on disease management for patients with chronic conditions and/or complex healthcare needs. Effective disease management programs can help to reduce costs while improving patient care. The Myers Group provides a dependable approach for measuring the effectiveness of disease management programs.

Organizations choose The Myers Group to conduct their Disease Management Surveys because of our reliable results and flexibility in survey design and methodology.

Our surveys include:

The Myers Group Disease Management Survey which supports NCQA Standard QI 8 (Disease Management), Element J (Satisfaction with Disease Management).

The DMAA Participant Satisfaction Surveys - both the long and short versions. The Myers Group is partnering with DMAA as part of their Participant Satisfaction Survey Users Group for their disease management survey and upcoming benchmark, scheduled to be released in late 2010.

Custom Disease Management Surveys based on specific programs and organizational needs.

The Myers Group delivers comprehensive analysis of the survey data to provide useful information that is easy to understand and apply to quality and program improvement initiatives.

The Disease Management Survey provides a reliable approach for measuring disease management program satisfaction and effectiveness.

The Myers Group offers:

• The TMG Disease

Management Survey

• The DMAA Participant

Satisfaction Survey –

long and short versions

1009


CAHPS®

Medicare HOS

Call Center

New Member

Benefit Manager

ECHO

Provider Access

Member Experience


The Behavioral Health Survey assesses members’ behavioral health treatment, needs, and outcomes. With increased focus on behavioral health, and the growing number of members receiving behavioral health care, this survey is a valuable research tool for today’s health care organizations.

The Behavioral Health Survey is an effective method for measuring the satisfaction of members who have received behavioral health care. In addition, The Myers Group provides a survey benchmark so organizations can compare their results to gain additional insight into their performance.

The Myers Group has extensive experience conducting Behavioral Health Surveys. Our comprehensive final report provides useful and actionable information regarding behavioral health program(s) for MBHOs and health plans.

Survey DesignOur Behavioral Health Survey was adapted from AHRQ’s ECHO® Version 3.0H survey. The 42-question survey tool is designed to assess the experience, needs and perceptions of members withtheir behavioral health care services. The Myers Group can also assist plans in adding custom questions to obtain additionalinformation for the health organization.

Survey AdministrationThe Behavioral Health Survey can be conducted using a mail-only protocol or a mixed methodology to include mail with telephone follow-up. The Myers Group works with our clients to determine the best methodology and protocols to fit your specific needs.

• Measures behavioral health treatment, needs and health outcomes

• TMG Benchmark for comparison of results

• Segmentation analysis

• Assesses MBHO and health plan behavioral health program(s)

Phone: (770) 978-3173Fax: (770) 623-4076www.themyersgroup.net

0411

CAHPS®

Custom Member

Call Center

New Member

Benefit Manager

ECHO

Provider Access

Member with Physician

Provider w/Plan

Employer Satisfaction

• Concerns addressed

before employer group

becomes at-risk

• Measures key drivers

• Phone methodology

recommended

• Optional Web-based

survey offered

The Myers Group offers a proven Employer Satisfaction Survey to help managed care organizations identify and improve factors that are important to these stakeholders. Some of the measurable objectives include:Employer retention rateIncrease in sales and contract valueReferral of the plan to employees

The survey measures several composites, including those identified as “key drivers”. These include the staff’s knowledge of materials and ability to answer questions; the quality of the benefits and plan design; the adequacy of the provider network; and the adequacy of the facilities and access to care.

The survey includes approximately 40 scaled questions combined with two open-ended questions for participants’ comments. A phone methodology is recommended along with the option of a web-based survey hosted on The Myers Group site.

A mid-sized health plan conducts this survey annually so that the changes in employer group perceptions and satisfaction levels can be trended or compared from year to year. As a result of this survey, this health plan has been able to identify the key issues that contribute to decisions made by employers considering a change in the health plan offered to their employees.

Many plans are recognizing the importance of obtaining feedback from decision-makers in large or key employer groups to determine their satisfaction with the administration of the health plan. By surveying decision-makers and/or plan administrators, health plans become aware of employer perception and overall satisfaction so that any concerns may be addressed before the employer group becomes at-risk to change health plans.

1009


Medicare CAHPS®

• CMS-Approved Medicare CAHPS Survey Vendor

• Insightful Analysis to Identify Improvement Opportunities

• Knowledge and Expertise Conducting Surveys to the Medicare population

The Medicare CAHPS® Survey assesses members’ experience and satisfaction with their plan in the areas of services provided and quality of care.

As a CMS-approved Medicare CAHPS Survey vendor, The Myers Group provides Medicare Advantage plans with valid and reliable survey results, along with insightful analysis to help plans identify areas for potential quality improvement.

With recent healthcare legislature focusing on measurable quality and member satisfaction for additional bonuses and funding, plans look to The Myers Group to provide valuable insights and improvement opportunities based on member feedback.

The Myers Group conducts all components of survey research onsite at our corporate headquarters near Atlanta, Georgia. Our processes undergo rigorous audits, and all functions are performed by highly trained and qualified staff members. From incoming mail and survey scanning - to our state-of-the-art Call Center - to survey collection and comprehensive analysis, we adhere to high standards of quality to provide exceptional client service and satisfaction.

The Myers Group has been a leader in health care survey research for over a decade. As an NCQA-certified CAHPS and Medicare Health Outcomes survey vendor, we have extensive experience conducting the CAHPS Survey and studies for the Medicare population.

The Myers Group provides plans with dependable results and information to improve quality, performance, and patient care.


1009

Medicare CAHPS Drill-Down Survey

Because You Still Have Questions

Simplifying The Process Enhancing The Results The Myers Group realizes you may need more information than the standard Medicare CAHPS Survey provides. That’s why we developed our comprehensive drill-down study. Questionnaire designed to drill down on

key components of the Medicare CAHPS survey.

Focus on areas related to Star Ratings.

In-depth questions designed to identify opportunities to improve satisfaction and experience of care.

Developed by TMG’s experienced research analysts and Medicare CAHPS specialists.

Full analysis package providing actionable information and insight.

Designed for quick start up.

Developed to help Medicare Advantage plans obtain actionable information based on their member-specific data.

Includes core Medicare CAHPS questions, supplemental questions to explore member perceptions, open-ended questions, and write-in response choices.

ABOUT THE MYERS GROUP The Myers Group is an NCQA-Certified CAHPS®, Medicare HOS, and CAHPS® PCMH survey vendor, and a CMS-Approved Medicare CAHPS® survey vendor. The company has been a leader in healthcare survey research and survey design since 1993, employing traditional methodologies as well as innovative technologies in data collection, analysis, and reporting. With extensive experience in survey administration, survey methodologies, and comprehensive analysis of survey data, The Myers Group conducts hundreds of survey projects for managed care organizations (MCOs), government agencies, public agencies, and State QIOs. www.themyersgroup.net

The Myers Group | 1965 Evergreen Blvd., Suite 100, Duluth, GA 30096 | 770-978-3173 | www.themyersgroup.net

CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ)


http://www.themyersgroup.net/index.asp

Medicare HOS

• Over 15 years of

healthcare survey

experience

• NCQA-Certified HOS and

CAHPS Vendor

• CMS-Approved Medicare

CAHPS Vendor

• Specialized HOS

consultation and

guidance

The Medicare Health Outcomes Survey (HOS) is designed for the Medicare population in managed care settings. It assesses a plan’s ability to maintain or improve the physical and mental health of its Medicare members over time.

The Myers Group is uniquely qualified to administer the Medicare HOS survey. As a National Committee for Quality Assurance (NCQA) vendor certified to conduct HOS, our core expertise is in identifying and measuring quality initiatives for the healthcare community.

Reasons for choosing The Myers Group:

We have the experience and reliability plans trust to conduct their healthcare surveys. The Myers Group is an NCQA-Certified HOS and CAHPS® vendor and a CMS-approved Medicare CAHPS Survey vendor.

The Myers Group has successfully conducted hundreds of HOS surveys for Medicare Advantage plans throughout the country.

With 15 years of experience as a national healthcare survey research firm and with over 20% of our healthcare respondents represented by the 65 years and older population, The Myers Group is uniquely qualified to administer HOS to Medicare beneficiaries of managed care organizations.

The Myers Group provides specialized HOS consultation and guidance throughout the process. Clients receive ongoing status updates throughout the project.

The Myers Group participated with NCQA in the Spanish pilot testing program for Puerto Rico. We have extensive experience conducting thousands of mail and phone healthcare surveys to the Spanish-speaking population.

We are a value leader, providing clients with a reliable survey process, up-to-date and relevant information, and personalized assistance and consultation.

1009


Medicare Constellation of Services

• Years of experience

working with Medicare

plans

• Stars improvement

recommendations and

resources

• Comprehensive results

reporting

Medicare Advantage Plans are faced with several challenges today. With our Medicare Constellation of Services, we offer solutions to turn these challenges into opportunities for improvement.

The Myers Group (TMG) offers a full line of services to navigate your way to the stars!

• Medicare CAHPS® Survey - The Myers Group is a CMS-approved Medicare CAHPS Vendor with extensive experience conducting surveys for the Medicare population.

• Medicare CAHPS Drill-Down Survey - Developed by TMG’s experienced research analysts and Medicare CAHPS specialists to drill down on key components impacting your Star ratings.

• Medicare Voluntary Disenrollment Survey - TMG provides plans with information to understand why members disenroll from their Medicare Advantage plan. Beginning in 2012, CMS will include voluntary disenrollment rates in Star bonus payments.

• Outbound Enrollment Verification (OEV) - TMG conducts OEV calls to new enrollees, meeting CMS requirements to confirm the member’s intent to enroll, verify understanding of the plan, and ensure plan information was explained correctly.

• Medicare New Member Outreach - TMG gives members a warm welcome, ensures their understanding of benefits, and provides answers to basic benefit questions, helping plans meet CMS requirements that newly enrolled members be contacted within 90 days.

• Medicare Health Outcomes Survey (HOS) - As an NCQA-certified HOS vendor, we conduct this survey for Medicare plans throughout the country.

• Medicare Health Status Survey - In conjunction with New Member Outreach or separately, TMG’s Health Status Survey enables plans to identify programs and conduct early outreach based on the member’s health status.

• Medication Therapy Management - TMG ensures members are enrolled in the program and surveys their understanding and satisfaction with the program.

• Call Center Support Services - TMG’s Onsite Call Center provides phone outreach and support services such as after-hours coverage, reminder calls, mail and marketing follow-up calls, customer service phone support, information/awareness calls to members.


1201

CAHPS®

Medicare HOS

Call Center

New Member

Benefit Manager

ECHO

Provider Access

Member Experience


New Member Understandingand Satisfaction

New member research provides a valuable opportunity for the health plan to assess awareness and perceptions of members both as consumers (pre-enrollment) and as new enrollees with the health plan.

The New Member Understanding and Satisfaction Survey provides quantitative and qualitative feedback on the plan’s overall eectiveness and/or quality improvement needs within the following areas:

• Pre-enrollment Marketing Materials vs. Competitors• New Member Written Materials and Information• New Member Awareness and Understanding of Benets and Coverage• New Member Awareness and Understanding of Plan Services and Website• New Member Cultural/Language Needs Assessment• New Member Health Status and Continuity of Care Assessment

This survey serves to provide direction on quality improvement needs in the following areas of the plan:

• Marketing • Enrollment Services• Communications • Member Services• Collateral and Fulfillment • Quality Assurance

In order to enhance the value and eectiveness of this research, The Myers Group incorporates an ocial Welcome Message on behalf of the health plan. Health plans may also contract for this service separately.

For plans seeking NCQA accreditation, the following standards are supported by the full The Myers Group survey tool:

• RR4 — Subscriber Information• RR7 — Marketing Information • QI 4 — Availability of Practitioners

• New Member

Welcome Messaging

• New Member Assessment— Understanding of Benets

— Quality of Written Materials

— Cultural and Language Needs

— Awareness of Plan Services

• Customizable Survey and Report

1204


CAHPS® Patient Centered Medical Home (PCMH)

• Part of AHRQ’s CAHPS Family of Surveys

• Results reporting at the practice level

• In depth client consultation on all project specifications

• Adult and Child Version

Developed jointly by AHRQ, NCQA and the Commonwealth Fund. The Consumer Assessment of Health Care Providers and Systems (CAHPS®) Patient Centered Medical Home (PCMH) Survey is the most comprehensive tool available for accessing patients’ experiences with their clinicians practices.

The CAHPS PCMH Survey is an expanded version of the core Clinician & Group CAHPS Survey. The survey provides clinicians, medical practices, accountable care organizations and health plans with a comprehensive and reliable survey tool by which to assess the patient's experience and overall satisfaction with health care received from their clinicians.

Recognized practices, or practices applying for recognition, can earn additional distinction in collecting and reporting patient experience data using the CAHPS-PCMH Survey by submitting results to NCQA. However, practices do not need to be an NCQA recognized patient-centered medical home in order to conduct the CAHPS PCMH Survey. NCQA does require that the survey be administered by an NCQA-certified CAHPS PCMH survey vendor, such as The Myers Group

The CAPHS-PCMH Survey asks patients about their experiences with their primary care providers and addresses the following domains of care:

• Access to care • Comprehensiveness• Self-management support • Shared decision making (adult only) • Coordination of care • Information about care

There are two survey instruments available in English and Spanish that capture patients’ experiences of care: • CAHPS PCMH Adult version (52 items) • CAHPS PCMH Child version (66 items)

The Myers Group conducts all of the five NCQA-approved methods for survey administration: Mail, Phone, Mixed Mail/Phone, Internet, and IVR. Our personalized consultation can help determine the best survey methodology to maximize response rates and results reporting.

The Myers Group looks forward to assisting you with this important quality measurement tool. 1201


NCQA is a private, non-prot organization dedicated to improving health care quality. NCQA accredits and certies a wide range

of health care organizations. It also recognizes clinicians and practices in key

areas of performance. NCQA is committed to providing health care quality

information for consumers, purchasers, health care providers and researchers.

Provider Access

• CAHPS® drill-down tool

• Provider offices can be

surveyed

• Members’ perceptions

can be assessed

• Satisfies NCQA standard

• Customized survey

encouraged

Health plans measure Provider Access in several ways. Provider offices can be called to measure compliance with health plan standards for appointment availability, as well as access to after hours availability.

Measuring Provider Access involves determining both appointment availability and after hours access for members. One way to accurately gauge this factor is to contact providers’ offices during office hours to determine their appointment availability. In addition, the offices are contacted after hours to audit the availability of services or referrals after hours. A second way to measure Provider Access is to survey the members directly to measure their perception of their providers’ appointment availability and after-hours care. The sample consists of members who have recently visited their doctors.

As a result of this study, the health plan gains valuable information from members which ensures that the plan is meeting internal performance measures regarding Access standards. In addition, this information helps the plan monitor how effectively the network meets the needs and preferences of its membership (QI 4).

Although The Myers Group encourages a customized survey designed to meet the health plan’s internal access standard, the standard survey tool consists of 20-scaled questions and asks members about:

• Wait times on hold while trying to make an appointment

• Wait times while in the physician’s office

• Ease of accessing physician care

• Length of time to obtain physician care

Administered by phone, the survey takes members about five minutes to complete.

Phone: (770) 978-3173 Fax: (770) 623- 4076www.themyersgroup.net

1009

CAHPS®

Medicare HOS

Call Center

New Member

Benefit Manager

ECHO

Provider Access

Member Experience


Provider Satisfaction Survey

• Assesses Provider

and Practice Manager

Satisfaction

• Supports NCQA

Standards

Health plans administer the Provider Satisfaction Survey to assess the provider’s and practice manager’s overall satisfaction with the health plan. Additionally, health plans use this survey to support NCQA standards. Standards that the survey tool helps to measure include such indicators as:

• UM 10 – Satisfaction with the UM Process

• QI 10 – Continuity and Coordination of Medical Care

• QI 11 – Continuity and Coordination between Medical and Behavioral Healthcare

Other reasons plans may choose to conduct this survey are to:

• Measure physicians’ satisfaction with the plan as compared to “all other plans” in which they participate

• Identify issues that physicians have regarding the health plan and their ratings of provider services

• Identify and improve issues regarding physician satisfaction and loyalty to the plan

Provider surveys are challenging to administer due to the targeted respondent audience. The Myers Group has the experience to help clients navigate this process. The physician response rate improves with well-designed surveys that ask pertinent questions. In addition, introducing the survey through various communications methods, employing sound sampling methodologies, and providing results feedback to the provider group increases physician cooperation.

Segmentation Analysis ABC Health PlanArea of Practice (QA) Provider Satisfaction Survey


Valid n2006SRS* Valid n

2006SRS*

Call Center/Member Services Staff 31.0% 40.5%

Q1. Process of obtaining member information 50 42.0% 52 48.1%

Q2. Member's understanding of the referral process. 58 8.6% 52 13.5%

Q3. Member's understanding of their benefits. 59 42.4% 50 60.0%

Provider Relations 26.5% 35.8%

Q4. Responsiveness and courtesy of the health plan's provider relations representative 59 42.4% 50 60.0%

Q5. Timeliness to answer questions and/or resolve problems 51 25.5% 52 34.6%

Q6. Frequency and effectiveness of provider representative visits. 48 16.7% 42 19.0%

Q7. Quality of provider orientation process. 46 17.4% 38 26.3%

Q8. Quality of written communication, policy bulletins, and manuals 56 30.4% 49 38.8%

Network 29.2% 38.6%

Q9. Quality of the health plan's primary care providers 52 38.5% 32 31.3%

Q10. Quality of health plan's specialists 58 20.7% 34 38.2%Q11. Specialist network has an adequate number of high quality specialists to whom I can refer my patients. 58 27.6% 26 53.8%

Q12. Behavioral health network has an adequate number of high quality practitioners to whom I can refer my patients. 52 38.5% 32 31.3%

Q13. Health plan takes physician input and recommendations seriously. 58 20.7% 34 38.2%

Utilization & Quality Management 22.4% 27.6%

Q14. Process of obtaining pre-certifications/referral/authorization information. 53 24.5% 46 32.6%

Q15. Timeliness of UM'S pre-certification process 52 28.8% 41 22.0%

Q16. Phone access to UM staff. 35 17.1% 18 33.3%Q17. Extent to which UM staff share review criteria and reasons for adverse determinations. 53 20.8% 40 25.0%

Q18. Consistency of review decisions. 53 20.8% 40 25.0%

Q19. Timeliness of UM appeals process. 50 32.0% 32 31.3%

Q20. Timeliness of resolution requiring Medical Director intervention. 53 28.3% 30 33.3%Q21. Degree of improvement plan has made to reduce/eliminate the "hassle factor" of getting patients the services they need. 45 24.4% 23 26.1%

Q22. The health plan's administration of PCP's referrals to a specialist. 58 32.8% 26 38.5%

Q23. The health plan's support of appropriate clinical care for patients. 50 32.0% 32 31.3%

Q24. Phone access to Case/Care Managers. 35 17.1% 18 33.3%Q25. Alternative care and community resource options offered by the Case/Care Manager to my patients. 53 20.8% 40 25.0%

Q26. The health plan's commitment to chronic disease management programs. 53 20.8% 40 25.0%Q27. Degree to which the plan covers and encourages preventive care and health wellness. 50 32.0% 32 31.3%

Finance Issues 24.1% 20.7%

Q28. Extent to which the plan controls costs while maintaining a high quality of care. 50 28.0% 49 24.5%

Q29. Reimbursement rates for services you provide. 49 26.5% 47 27.7%

Q30. Accuracy of claims processing. 49 12.2% 48 18.8%

Q31. Timeliness of claims processing. 43 25.6% 36 8.3%

Q32. Resolution of claims payment problems or disputes. 50 28.0% 49 24.5%

* SRS (Summary Rate Scores) are the sum of the most favorable response options.Continued on the following page.

Primary Care SpecialtyArea of Practice (QA)

Composite/Attribute

The Myers Group 6A-1

Mean Score Analysis ABC Health PlanProvider Satisfaction Survey

129 Total RespondentsGap

Difference

ABC OtherPlans

ABCGap Sponsor Other

PlansSponsor

Gap

ABC Gapminus

Sponsor Gap

Call Center/Member Services Staff 2.994 2.943 0.051 NA NA NA NAQ1. Process of obtaining member information 3.371 3.243 0.129 NA NA NA NAQ2. Member's understanding of the referral process. 2.116 2.295 -0.179 NA NA NA NAQ3. Member's understanding of their benefits. 3.496 3.292 0.204 NA NA NA NA

Provider Relations 2.984 2.869 0.115 3.084 3.034 0.050 0.065Q4. Responsiveness and courtesy of the health plan's provider relations representative 3.496 3.292 0.204 3.480 3.210 0.270 -0.066

Q5. Timeliness to answer questions and/or resolve problems 3.065 3.029 0.037 3.060 3.100 -0.040 0.077Q6. Frequency and effectiveness of provider representative visits. 2.649 2.347 0.302 2.920 2.840 0.080 0.222Q7. Quality of provider orientation process. 2.636 2.612 0.025 2.800 2.950 -0.150 0.175Q8. Quality of written communication, policy bulletins, and manuals 3.074 3.065 0.009 3.160 3.070 0.090 -0.081

Network 3.003 3.255 -0.252 3.028 3.010 0.018 -0.270Q9. Quality of the health plan's primary care providers 3.161 3.376 -0.216 3.290 3.250 0.040 -0.256Q10. Quality of health plan's specialists 2.796 3.170 -0.375 3.240 3.370 -0.130 -0.245Q11. Specialist network has an adequate number of high quality specialists to whom I can refer my patients. 3.103 3.181 -0.077 2.850 3.040 -0.190 0.113

Q12. Behavioral health network has an adequate number of high quality practitioners to whom I can refer my patients. 3.161 3.376 -0.216 2.780 2.720 0.060 -0.276

Q13. Health plan takes physician input and recommendations seriously. 2.796 3.170 -0.375 2.980 2.670 0.310 -0.685

Utilization & Quality Management 2.705 2.667 0.039 NA NA NA NAQ14. Process of obtaining pre-certifications/referral/authorization information. 2.784 2.922 -0.137 NA NA NA NA

Q15. Timeliness of UM'S pre-certification process 2.747 2.716 0.032 3.100 2.920 0.180 -0.148Q16. Phone access to UM staff. 2.642 2.419 0.222 3.260 2.940 0.320 -0.098Q17. Extent to which UM staff share review criteria and reasons for adverse determinations. 2.677 2.638 0.039 2.710 2.800 -0.090 0.129

Q18. Consistency of review decisions. 2.677 2.638 0.039 3.010 2.890 0.120 -0.081Q19. Timeliness of UM appeals process. 2.788 2.892 -0.103 2.820 2.790 0.030 -0.133Q20. Timeliness of resolution requiring Medical Director intervention. 2.881 2.886 -0.005 2.790 2.890 -0.100 0.095

Q21. Degree of improvement plan has made to reduce/eliminate the "hassle factor" of getting patients the services they need.

2.714 2.708 0.007 2.720 2.800 -0.080 0.087

Q22. The health plan's administration of PCP's referrals to a specialist. 2.948 0.147 3.150 3.020 0.130 0.017

Q23. The health plan's support of appropriate clinical care for patients. 2.788 2.892 -0.103 3.160 3.090 0.070 -0.173

Q24. Phone access to Case/Care Managers. 2.788 2.892 -0.103 NA NA NA NAQ25. Alternative care and community resource options offered by the Case/Care Manager to my patients. 2.881 2.714 0.167 2.740 3.080 -0.340 0.507

Q26. The health plan's commitment to chronic disease management programs. 2.708 0.007 3.080 2.970 0.110 -0.103

Q27. Degree to which the plan covers and encourages preventive care and health wellness. 3.095 2.948 0.147 3.180 3.020 0.160 -0.013

* Mean scores are the average of all responses.** B.o.B. refers to the 2005 TMG Commercial Book of Business.Continued on the following page.

Composite/Attribute/Rating ItemSurvey Means* TMG B.o.B Means**

1204


TMG Connect Campaigns ANNUAL NOTICE OF CHANGE CAMPAIGN Supports CMS Standards Call campaign is designed to supplement the Annual Notice of Change mailing that is typically sent to Medicare Advantage and Medicare Part D members in September. Phone outreach will notify members of plan changes in premiums and benefits to take effect on January 1st of the following year. Supports efforts to keep Medicare members informed of all changes that impact their coverage. COORDINATION OF BENEFITS CAMPAIGN Supports CMS Standards Outbound calls to confirm and reconcile Medicare member information about additional health insurance coverage. Designed to identify health benefits available to a Medicare beneficiary and to coordinate the payment process to prevent inaccurate payment of Medicare benefits. CUSTOMER SERVICE SATISFACTION CAMPAIGN

Calls are placed to members regarding their recent contact with the health plan’s Customer Service Department. TMG Connect agents verify service perceptions such as accessibility to customer service, ability to get issues resolved and ease of getting questions answered. This campaign can also target members who have contacted the plan’s customer service department on multiple occasions in a short period of time. If further resolution is needed, the TMG Connect agent documents needed follow-up or the member is transferred to plan’s customer service team. Helps improve member satisfaction and retention. DISENROLLED MEMBER CAMPAIGN Supports some Medicaid State Requirements Phone outreach to members who have voluntarily disenrolled from their health plan. Gathers information from the member to determine reason(s) for disenrolling. Assists the health plan in retaining current members by increasing customer loyalty and satisfaction. FAILURE TO PAY CAMPAIGN Supports CMS Standards Medicare plans are required to provide a grace period for the payment of plan premiums. Phone outreach notifies members when the grace period has been entered as well as the payment requirements and time-frame for payment to avoid potential disenrollment due to non-payment of plan premiums. Assists health plans in member retention. NEW MEMBER WELCOME CAMPAIGN Supports CMS Standards and some Medicaid State Requirements Phone contact is made to all plan members within 30 days of their enrollment. Customer Service agents welcome members to the plan, provide details on plan benefits and can also conduct health risk assessments. Promotes member satisfaction and retention and can also serve as an early indicator of needed services for new members.

“We were impressed with the attention given by the TMG Connect team in the planning and implementation phase of our OEV campaign. TMG Connect exceeded our expectations so they are now conducting our OEV calls year-round.” -UPMC

“The call center services we utilized through TMG Connect helped us to maintain the very high standards we have for serving our members. TMG Connect is reliable and committed to providing excellent service.”

-Gundersen Lutheran Health Plan

OUTBOUND ENROLLMENT VERIFICATION CAMPAIGN Supports CMS Standards Personal and interactive calls to new enrollees ensure applicants understand the plan they have applied for and the plan rules. TMG Connect utilizes CMS approved call scripting and can provide mail service support for the delivery of the required member communication.

PREVENTIVE CARE MEASURES CAMPAIGN Supports CMS Standards Complies with CMS requirements for Medicare plans to provide certain preventive care services to their members. Phone outreach to plan members notifies them of their complimentary preventive care measures and any additional benefits available to them. This campaign encourages members to remain enrolled in the plan and can have a direct impact on member retention. Can also be coordinated as birthday reminder calls. PROVIDER ACCESS CAMPAIGN Supports CMS Standards and some Medicaid State Requirements Assists plans by auditing provider appointment availability and after-hours access to care. Phone outreach is made to provider offices to determine next available appointments as well as after-hours accessibility. Information is then compared to health plan’s access standards. Helps to target non-compliant provider offices for improvement initiatives. PROVIDER VERIFICATION CAMPAIGN Outbound calls are made to provider offices to verify contact information, practice address and any other items typically found in health plan provider directories. Helps plans remain current with published provider network information. Prevents member dissatisfaction with plan due to old or outdated information found in directories or on-line. REQUEST FOR INFORMATION CAMPAIGN Phone outreach to notify plan members of an incomplete enrollment application or to request supporting documentation for the application, especially pertinent to the OEV process for Medicare Advantage enrollees. Assists health plan applicants in successfully completing the application process for plan enrollment. RETENTION AND RENEWAL CAMPAIGN Promotes member retention by contacting members during open enrollment. Reminds members to re-enroll in the plan. Helps to maintain the plan’s overall market share. The call can also assist members in updating their records including, but not limited to, primary care physicians, addresses and phone numbers. TRANSITION OF CARE CAMPAIGN

Supports CMS Standards

Members who have a chronic or long term condition are eligible for Transition of Care which allows them to continue to see their current primary care physician in cases where the primary care physician is not within network or not participating with the plan. Call is conducted at the end of the 90 day Transition of Care period to ensure a smooth transition to the member’s newly selected or assigned primary care physician.

The Myers Group Healthcare organizations dedicated to quality improvement look to The Myers Group for reliable data collection and in-depth analysis. Our survey results report provides information that is easy to understand and apply to quality improvement measures and targeted performance initiatives.

The Myers Group has built a solid reputation for service and dependability. Our dedicated team approach and ongoing guidance provide clients with a personal level of service.


Security, Standards and Ethics in Survey Research

As a member of the Council for American Survey Research Organizations (CASRO), The Myers Group adheres to the CASRO Code of Standards and Ethics for survey research. CASRO’s Code of Standards and Ethics is a rigorous, internationally-cited set of standards recognized as the benchmark for the research industry.

The Myers Group is committed to protecting the privacy, security and integrity of information received from or on behalf of our clients. We adhere to the highest standards of integrity in the performance of our business and maintain compliance with HIPAA and other regulatory requirements.

The Myers Group

The Clear Choice When You Want The Best


CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ) Phone: 770-978-3173 Fax: 770-623-4076 www.themyersgroup.net

Advanced Survey Research Giving Health Plans The Power To Improve

CAHPS® 4.0H Survey

The Myers Group is NCQA® certified to conduct the CAHPS 4.0H Survey which measures key aspects of member satisfaction with the health plan and affiliated providers.

CAHPS Clinician & Group Survey / Member Experience with Physician Survey Measures patient satisfaction and general experience with their primary care physician. Can be used as part of a Pay-for-Performance program, and as specific information to physicians about patient issues. Call Center Satisfaction Survey Measures members’ experience with the call center. Respondents are asked about their satisfaction with the customer services department. Call Center Support Services/TMG Connect®

The Myers Group’s full-service Call Center provides valuable support services such as reminder calls, mail/marketing follow up calls, new member welcome calls, outbound enrollment verification (OEV), information awareness calls to members.

Case Management Survey Developed in response to NCQA’s new QI 7 Complex Case Management Standard, specifically Element G (Satisfaction with Case Management), this survey measures overall satisfaction and program effectiveness. Disease Management Survey Provides a targeted and reliable approach to measuring the effectiveness of patient care and satisfaction with their disease management program. Experience of Care and Health Outcomes (ECHO)/Behavioral Health Survey Specifically designed to measure and understand the consumer’s experience regarding mental health and chemical dependency services. Medicare CAHPS® Survey

The Myers Group is a CMS-approved vendor to conduct Medicare CAHPS. This survey assesses Medicare members’ experience and satisfaction with services provided and quality care.

Medicare Health Outcomes Survey (HOS) The Myers Group is NCQA certified to conduct HOS. This survey assesses an MCO’s ability to maintain or improve the physical and mental health of its Medicare members over time.

Member Satisfaction and Drill-Down Surveys Member Satisfaction surveys measure satisfaction and performance specific to the plan’s needs. Excellent tool for drilling down to obtain additional information than available in standardized surveys.

New Member Understanding and Satisfaction Survey(s) Provides quantitative and qualitative feedback regarding new members’ understanding of benefits, quality of written materials, cultural and language needs and health risk assessment. Outbound Enrollment and Verification (OEV) Supports CMS requirements for verification calls. The Myers Group’s OEV program contacts recently enrolled members to confirm their intent to enroll in the plan and verifies understanding of the plan type.

Patient Centered Medical Home (PCMH) Survey The Myers Group is NCQA® certified to conduct the PCMH survey. Assesses PCMH program and patients’ access to care, information, communication, coordination of care and comprehensiveness.

Provider Satisfaction Survey Measures physician satisfaction with the health plan and with other plans in the network. Physician loyalty to the health plan is also assessed and national benchmarking is available.

Provider Access Audit Determines if providers in the network are adhering to the health plan’s appointment availability and after-hours protocol.

Knowledge Is P

Are Your Members

The Myers Group Advanced Survey Research

Giving Health Plans The Power To Improve

