Study shows physicians are key to health plan success
Study shows physicians are key to health plan success
Enrollees rank provider choice, care as top priorities
A study of nearly 32,000 frequent users of health plans has shown that physicians are crucial to health plans’ ability to achieve high ratings from enrollees.
The study of 20 markets across the United States, performed by The MEDSTAT Group in Ann Arbor, MI, asked enrollees to rank 11 plan performance categories. Of the four categories the respondents ranked as most important, three are related to physicians. Physician-related performance categories account for almost 50% of a health plan’s overall rating by enrollees, the study concluded.
The performance measures ranked most important by the enrollees were:
• Choice of providers — The adequacy of the number of physicians to choose from and the ease of choosing a personal physician.
• Physician care — Listening skills and attentiveness of physicians and other health care professionals working on behalf of the plan and thoroughness of the care provided.
• Time pressures — Appearance of physicians and staff being rushed or overworked.
Other performance measure categories were access to care, administration, confidence in plan, customer service, limits on care, participatory decision-making style, personal cost, and waiting time.
The researchers also concluded that physicians have an influence on how enrollees rate plans in other areas as well. For instance, physicians were asked to rate plans on administrative hassles and policies that limit care. Those ratings were highly correlated with enrollees’ ratings of their confidence in their plan. Plans physicians rated high in the "hassle factor" were rated low in the enrollees’ "confidence in plan" category.
"Plans traditionally focus on administration and customer service, but these study findings suggest a larger payoff will result if plans improve the patient care aspect of their service offering," says Dennis J. Becker, senior vice president of The MEDSTAT Group.
Health plans sometimes ignore the patient care area because they see it as the providers’ responsibility, but the study clearly shows that enrollees hold plans accountable for the care being provided, Becker adds.
The study suggests health plans should focus on improving the patient care aspects of their service offerings, Becker says.
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