Patient ratings of health plans decline
Interpersonal issues shape ratings of docs
Patients are voicing slightly less satisfaction with their health plans, particularly as they face problems over prescriptions and customer service, according to a report from CareData Reports, a managed care consumer research company in New York City. While 57% of patients said they were "highly satisfied" with their health plans, that reflected a drop of 3% from 1996.
The report also shows that patient satisfaction varies dramatically based on the type of treatment received. For example, only 25% of those treated for arthritis and 30% of those treated for pain rated their care as "excellent," while 78% of maternity patients gave top ratings to their care during pregnancy and delivery.
"That could be a reflection of the state of the art in terms of care and technology and medication," says Tod Cooperman, MD, president of CareData. "We do see variation by plan. Some plans are doing much better in certain disease categories than others."
Spend more time on disease management
In fact, physicians and health plans can impact patient satisfaction with specific types of care through disease management programs, says Cooperman.
"We typically see an association between plans that are known to have made a real effort in an area and scoring well in an area," he says. "It could be something as simple as sending out reminders to members to get their cholesterol checked, or [it could relate to] more involved disease management programs."
In the 1998 Merck Report on Medicare Managed Care Satisfaction, prepared by CareData, Medicare patients cited interpersonal and communication issues as the top drivers of their satisfaction with primary care physicians.
Beyond having a wide choice of doctors in the health plan network, patients ranked their top three factors that lead to satisfaction with the primary care physician:
- physician’s explanation of diagnosis and treatment;
- physician’s interest in getting to know you;
- physician’s advice on how to stay healthy.
Those issues were even more important than the amount of time spent with the physician notes Cooperman. "It’s quality rather than quantity that’s important," he says.
The Merck report suggested that health plans could provide draft letters for physicians to send to patients with strategies on staying healthy, and for customer service representatives to follow up after sick visits.
Meanwhile, cost-saving policies that restrict pharmaceutical formularies appear to be brewing dissatisfaction. Some 20% of patients who requested a specific medication from their doctor were not prescribed that drug, according to a CareData survey of commercial health plan members. Those who didn’t receive the requested medication were twice as likely to be dissatisfied with their health plans — even if they received a generic equivalent or another brand drug, the report found.
In fact, satisfaction with pharmacy benefit, typically the highest rated aspect of plans, fell 7% to 69%.
CareData surveyed about 60,000 commercial and Medicare health plan members in 27 major managed care markets and measured satisfaction on 138 indicators.
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