Experience Survey Results CTC Practice Reporting Workgroup 2017 CAHPS PCMH Patient Experience Survey Results CTC Practice Reporting Workgroup Marie Sarrasin April 25, 2017

2017 CAHPS Survey Topics CAHPS Adult Survey Version 3.0 Survey Profile 2016/2017 Medians and Targets Cohort and Site Results Summary Questions

CAHPS Version 3.0 Version 3.0 of the CAHPS PCMH Survey released in June 2015 Version 3.0 includes the following domains: *Access - revised *Communication - revised *Office Staff Care Coordination - new Self-Management Total number of core questions was reduced from 52 to 37 Look-back period is 6 months *contract measures

2017 Adult Survey Conducted in November, 2016 – January, 2017 Mixed mode – 1 survey mailing, 5 follow-up phone calls English and Spanish Oversampling at sites with low response rates Same survey vendor as 2016, comparative contract scores Adults age 18 and older

2017 Adult Survey Thirty seven (37) sites 13,529 patients randomly selected to participate 128-1029 per site 3,857 completed surveys 2,196 mail surveys 1,661 phone surveys Response rate: 26.9% overall 2016 rate: 25.3% overall

Patient Demographics 2017 patient respondent demographics compared with 2016 survey 2016 Survey 2017 Survey Age >55 58.8% 53.2% Gender – Female 62.7% 63.3% Education High School + 58.5% 55.2% Race – White 77.8% 68.6%

Access and Communication Composites CAHPS 3.0 Survey updated Access and Communication Composites One question from Access 2016 dropped Two questions from Communication 2016 dropped

Access and Communication Composites For a fair comparison, RIQI recalculated 2016 Access and Communication scores using the 2017 composite: Access median increased from 62% to 69% Communication median increased from 84% to 86% Targets were increased to match medians

CAHPS Version 3.0 Access Composite Survey Version Q6  Always obtained appt. for urgent care as soon as needed Q9  Always obtained appt. for check-up or routine care as soon as needed Q14  Always received same day response to phone calls made during regular office hours   Q16  Always received a response as soon as needed to phone calls made after regular office hours Q18  Always saw provider within 15 minutes of appointment time Median score Target 2016 CAHPS Access Yes 61% 2016 CTC Access No 62% 60% Re-calculated 2016 CTC scores using CAHPS 2017 Access composite 69%

CAHPS Version 3.0 Communication Composite Survey Version Q12 Provider always explained things in way that was easy to understand Q20 Provider always listened carefully to you Q22 Provider always gave you easy to understand information about health questions or concerns Q23 Provider always seemed to know the important information about your medical history Q24 Provider always showed respect for what you had to say  Q25 Provider always spent enough time with you Median score Target 2016 CAHPS Communication Yes 84%  84% Re-calculated 2016 Communication No 86%

Access & Communication Score Distribution 2016 v 2017 Comparison of original CTC Access 2016, re-calculated CTC Access 2016 and 2017 score Original CTC 2016 Quartile Range 2016 # Practices in Quartile Re calculated 2016 Quartile Range 2017 Quartile Range 2017 # Practices in Quartile 25th percentile or less 37.4-54.5 19 45.4-61.9 43.1 - 59.5 10 25-50th percentile 54.9-62.1 17 62.1 - 69.1 18 60.6 - 68.2 9 50th-75th percentile 62.4-69.6 69.2 - 78.0 68.4 - 77.6 75th percentile and over 70.7-96.6 78.4 - 94.6 15 77.9 - 99.0 Median 62.0 71 69.1 68.1 37   Comparison of original CTC Communication 2016, re-calculated CTC Communication 2016 and 2017 score Original CTC Quartile Range Recalculated 2016 Quartile Range 59.2-79.6 61.3 - 81.9 64.7 - 78.6 11 80.1-84.1 82.2 - 86.1 81.5 - 86.0 8 84.3-89.2 16 86.2 - 92.1 86.2 - 91.3 89.4-97.3 20 92.2 - 100 91.4 - 98.2 84.1 86.1

2014-5 Contractual Performance Standards 2017 Contractual Standards 2014-5 Contractual Performance Standards 2014-5 Contractual Performance Standards Practices must pass Access “gate” measure Two methods for achievement Method 1 – Meets or exceeds Access target and meets or exceeds Communication OR Office Staff Method 2 - Does not meet Access target but improves score by 2.5 from prior years score and meets or exceeds Communication AND Office Staff Measure 2016 Target 2017 Target Access 60% 69% Communication 84% 86% Office Staff 76%

Results – Performance Groups

Results – 50%> Medicaid vs Not 50%> Sites

2015 Top Performers Comm. Office Staff Wickford Family Medicine 99.1 Site Access Comm. Office Staff Wickford Family Medicine 99.1 Barrington Family Medicine 98.2 Solmaz Behtash 100 North Kingstown Family Practice 94.8 John Chaffey 97.3 John Chaffey DO LTD. 93.2 87.8 96.3 Internal Medicine Partners 89.3 84.8 Coventry Primary Care Associates, Inc. 96.2 88.6 83.1 94.6 Richard M Del Sesto 88.5 82.9 CNE Medical Group - Arcand Family Medicine 93.5 84.5 81.4 Primary Care of Barrington 82.3 PCHC - Prairie 92.5 SCHS - Tiverton Family Practice 81.9

Sites with Greatest Improvement 2016 Access 2016 Access Recalculated 2017 Access Difference 2016 recalculated and 2017 CNE Medical Group - Arcand Family Medicine 60.7 71.0 81.4 10.4 PCHC-Prairie 60.1 71.1 10.3 CCAP: Family Health Services - Cranston 47.8 51.5 59.2 7.7 Coventry Primary Care Associates, Inc. 73.2 76.7 83.1 6.4 SCH - Primary Care Family and Internal Medicine-Wakefield 62.1 64.3 69.1 4.8 Wickford Family Medicine Ideal Medical Practices 96.6 95.5 99.1 3.6 Charter Care Medical Associates 64.2 74.8 77.2 2.4 SCHS - Linden Tree Family Health Center 37.4 46.4 48.6 2.2 Site 2016 Communication 2016 Communication Recalculated 2017 Communication Difference 2016 Recalculated and 2017 PCHC- Chad Brown 59.22 61.3 76.8 15.6 SCHS - Linden Tree Family Health Center 72.36 75.2 86.2 11.0 PCHC- Chafee 64.71 65.4 74.8 9.3 PCHC- Prairie 65.98 69.3 78.6 PCHC- Central 69.68 71.5 7.1 SCHS - Family Medical Middletown 82.20 87.1 91.3 4.2 Solmaz Behtash - Ideal Medical Practices 92.35 92.3 96.3 4.1 Primary Care of Barrington - Ideal Medical Practices 87.56 89.8 93.5 3.6

Sites with Greatest Improvement 2016 Office Staff 2017 Office Staff Difference PCHC - Chad Brown 50.0 74.1 24.1 CharterCARE Medical Associates 59.2 77.8 18.6 John Chaffey DO LTD. 78.9 93.2 14.4 Solmaz Behtash - Ideal Medical Practices 86.9 100 13.1 SCHS - Linden Tree Family Health Center 49.5 61.7 12.2 SCHS - Family Medical Middletown 71.1 81.4 10.3 Women's Medicine Collaborative 64.6 74.4 9.8 CNE Medical Group - Brookside Family Medicine 63.5 71.7 8.2 Plan 2016 Self Management 2017 Self Management Difference PCHC - North Main 50.9 71.5 20.6 Richard M. Del Sesto M.D., M.S. 43.1 62.5 19.4 PCHC - Central 36.9 54.9 18.0 SCHS - Family Medical Middletown 48.3 65.3 17.1 SCHS - Tiverton Family Practice 43.4 60.0 16.6 PCHC - Crossroads 63.5 77.0 13.5 PCHC - Prairie 28.8 42.2 13.3 Women's Medicine Collaborative 52.8 65.7 12.9

Summary CAHPS Version 3.0 substantially different from previous Access – removal of “after hours response” and “15 minute wait time” improved scores Communication – removal of “easy to understand information about health concerns” and “always seemed to know important information about medical history” improved scores

Summary Consistent with the CAHPS Consortium’s analyses of CG-CAHPS 2.0 data from the 2014 CAHPS Clinician & Group Survey Database, which indicates that the access and communication composite measures have higher scores on the 3.0 version than on the 2.0 version of CG-CAHPS

Questions What do these analyses say about patients’ concerns about providers? How actionable is this data? Is this the best measure of RI’s patient experience?

2017 CAHPS Child Survey CAHPS Survey Version 3.0 Survey Profile Cohort Results Summary Questions

CAHPS Child Version 3.0 Version 3.0 includes the following domains: Access - revised Communication - revised Office Staff Care Coordination - new Child Development- revised (PCMH Item Set) Child Prevention – revised (PCMH Item Set) Total number of core questions was reduced from 62 to 49 Look-back period is 6 months

2017 Child Survey Nine (9) sites 3,949 patients randomly selected to participate 343-515 per site 854 completed surveys 437 mail surveys 417 phone surveys Response rate: 21.9% overall

Patient Demographics 2017 Parent/Respondent demographics 2017 Survey Education High School + 77.3% Gender – Female 89.2% Race – White 68.6% Under 18-24 4.5% 25-34 23.3% 35-44 39.5% 45-64 4.1%

PCMH Kids Results

PCMH Kids Results

PCMH Kids Access Results

PCMH Kids Communication Results

PCMH Kids Office Staff Results

PCMH Kids Care Coordination Results

PCMH Kids Child Development Results

PCMH Kids Child Prevention Results

Summary First Year All Sites Participated No Version 3.0 national results to compare More to Come Questions?