Putting Results on Patient Experiences with Physicians to Use

1. Putting Results on Patient Experiences with Physicians to Use July 2007 Ted von Glahn Director of Performance Information and Consumer Engagement Pacific Business Group on Health

2. Patient Experience Performance: Applying Results in California Market • Public Accountability • Performance Improvement • Pay for Performance • Consumer Decision Support

3. Public Accountability 20 Top Performing CA Medical Groups California Office of Patient Advocate 2005

4. Performance Improvement: Information Feedback to Doctor

5. Staff-Patient • communication • Timely service Reception • Access • Staff-Patient • Communication PATIENT FLOW INFORMATION FLOW Examination Room Prior to Visit Patient Experience • Coordination • of care • Nurse/MA-Patient • comm. • Coordination • of care Physical Examination Follow-up Care Outside of Office Visit • MD-Patient • communication • Coordination of • care

6. Pay for PerformanceIncentive Components Recommended • 50% Clinical results • 30% Patient experience • 20% IT/system • 10% Bonus doctor-level $ incentive program

7. Consumer ChoiceState of California Ratings California Office of Patient Advocate 2005

8. Patient ExperienceMeasurement and Reporting • Consumer demand • PBGH consumer research results • Good science • Strong psychometric properties • Proven feasibility • Work executed in diverse settings throughout CA yearly since 2003

9. Consumer DemandDoctor Choice -- What Matters *Respondents PBGH Choice of Doctor Research

10. Good Science2007 Survey Work with 3,500 Doctors • High reliability • > 0.70 reliability with 25 patient respondents per MD • Discriminates performance • Intraquartile range (25th-75th) mean scores 10-20 points across doctors • Improvement opportunities • Low end: 65 mean score health promotion and chronic care support • High end: 88 mean score patient-MD interaction

11. Proven FeasibilityFive Years of Work (2003-2007) • Medical group/IPA source for patient samples • 183 groups report group-level results (public) • 39 groups report MD-level results (internal) • Cost $185-$205 per doctor • 35% patient response rate • Common version of C/G CAHPS survey: adult primary care, pediatrics & specialty care (differ slightly)

12. Patient ExperienceLooking Ahead • Expand scope of survey content • New module: chronic care support for patients • Expand coordination of care module • Performance improvement • Research – what improvement approaches work • Spread strategies – disseminate best practices • Public reporting of doctor ratings • Pooling and cost-sharing strategies • Integration of clinical and efficiency results