Member Satisfaction
Member Satisfaction
It is important for providers to know if members are satisfied with the care and services received. Community Care contracts with PressGaney to conduct an annual Member Satisfaction Survey using a modified version of the Experience of Care and Health Outcomes (ECHO) Survey. Overall, the 2024 Member Satisfaction Survey, which is based on care received in 2023, reflected high member satisfaction in several areas. With satisfaction rates at or above 90%, members and families responded that providers:
- Explained things in a way members could understand
- Respected what members had to say
- Made members feel safe during counseling or treatment
The Telehealth category received the highest satisfaction ratings, with over 93% of children and adults reporting satisfaction with the services received via telehealth. Another category reflecting high rates of satisfaction was the Community Care Behavioral Health category, with about 93% of adult members reporting no delays in counseling or treatment while waiting for approval of services by Community Care.
Community Care identified one opportunity for improvement (OFI) based upon the prior Member Satisfaction Survey results. This OFI was related to Urgent Access, which asks members if they got counseling or treatment as soon as they wanted. The Urgent Access question’s rates of 65.4% for both children and adults met the goal of 62.4% for children but did not meet the goal of 65.9% for adults. Due to goal achievement, this OFI for children was retired.
Community Care will continue to implement the interventions below to address Urgent Access for adults:
- In 2021, Community Care developed an internal Network Accessibility Workgroup that includes network, clinical, and quality staff. This workgroup synthesized access data and information to recommend contract-specific and company-wide interventions designed with the goal to increase access to BH providers. The workgroup also seeks to be an innovator in access, and opportunities with non-traditional service deliveries, such as additional telehealth options, have been explored. Community Care also seeks to become a payor of choice, which entailed rate increases for providers. Related to network adequacy, network expansion has been ongoing, with provider recruitment a key aspect of this workgroup that developed a brochure about joining the provider network (CCBH-Recruitment-Brochure.pdf). This group continues to meet regularly, evaluate access, and develop targeted interventions.
- Community Care published a Best Practice in Referral Management document highlighting expectations for providers when members are on a referral list (Provider Alert 11-September 20, 2023).
- Customer Service Representatives (CSR) offered access to the RxWell Application to members. This app provides coaching services and free or low-cost smartphones and data plans to provide options for members which could support them while they are waiting for an appointment.
- Customer Services implemented a Referral Tracking & Follow-up Project for members who call Community Care seeking a referral. If these members do not have a claim submitted within 30, 60, and 90 days after the referral, a CSR outreaches to the members to identify any additional assistance needed.
- Community Care developed a member tip sheet “What You Can Do if Waiting for Services,” which was presented at member meetings and posted on Community Care’s website (Members: What You Can do if Waiting for Services).
- CSRs make Welcome Calls to outreach to all new members. During these calls, the CSRs assist members to ensure they have timely access to care. Calls include screening for SDoH needs and sharing SDoH resources including Community Based Organizations and how to access them.
- The implementation of the 1135 waiver due to COVID-19 allowed for the loosening of precertification and authorization protocols as well as the expansion of telehealth, which enabled quicker and easier access to services. Although the 1135 waiver was terminated on May 11, 2023, some of these protocols remain in place.
- Customer Service and Care Management staff are available to help members schedule appointments. Community Care maintains a “Contact Us” link on Community Care’s main member webpage, so that members may easily contact Customer Service at any time.
- Access standards are shared at the Member and Family Advisory Meetings, with reminders that Community Care can be contacted if help is needed in scheduling appointments.
- A Provider Alert was issued in 2022 reminding providers of the Access standards and the requirement to notify Community Care when they are unable to accept members for services (Provider Alert #9 - Provider Requirements for Appointment Access).
- Member cards are distributed in the new member packets. These cards contain information regarding Community Care as well as how to access behavioral health services.
- Community Care publishes information for members relevant to access in the “Foundations” member newsletter. The Spring 2023 as well as the Spring 2024 newsletters address member access and how Community Care can assist members in finding a provider [Foundations | Volume 1, Issue 11 | Spring 2023 (ccbh.com) and Foundations | Volume 12, Issue 1 |Spring 2024 (ccbh.com)].
- Community Care maintains a webpage that outlines Access standards for members. This webpage also details Care Management interventions related to ensuring Access as well as how to contact Community Care if members are having problems getting an appointment soon enough to meet their needs (Getting an Appointment on Time: Members).
- Access expectations for urgent appointments are detailed for providers within the Provider Manual, which may be found on Community Care's provider website (Provider Manual: HealthChoices Providers - Community Care).
As part of the data analysis, Community Care further evaluates member satisfaction by examining the results by race, ethnicity, and language. Both the highest and lowest satisfaction scores by race, ethnicity, and language align with the overall results of the survey, with White and Black members having very high rates of satisfaction with Telehealth, and White, Black, and Asian members having low rates of satisfaction within the Urgent Access category. Please note these results should be interpreted with caution due to some of the lower sample sizes associated within the various sub-populations.
Community Care thanks providers for their efforts to increase members' satisfaction. If you have any thoughts, ideas, or comments please call your provider representative.