Quality Improvement Program

Q1: How would you rate the presentation overall?

• Excellent – 40 responses
• Good –  46 responses
• Fair – 4 responses
• Poor –  0 responses
• Total – 90 responses

Q2: How would you rate the presenters?

• Excellent – 50 responses
• Good – 38 responses
• Fair – 2 responses
• Poor – 0 responses
• Total – 90 responses

Q3: Does this Provider Forum contribute to your overall satisfaction with Arizona Complete Health-Complete Care Plan?

• Yes – 74
• No – 16
• Total – 90 responses

Q4: Do you think the Provider Forum presentation adds value to the services you provide to your members?

• Yes – 83
• No – 8
• Total – 90 responses

Q7: What did you like best about the presentation?

• Helpful information and resources
• Different presenters were great
• I find these meetings informative, they always provide us information on how to better work claims
• how well organized it always is
• There were some good topics.

Q8: How can the presentation be improved?

• Maybe not quite as long?
• give us some feedback about overall health/performance on a variety of metrics.

Q9 Topics you would like to learn more about:

• Claims,Grievance and Appeals
• Claims
• Claims,Grievance and Appeals,Prior Authorization
• Claims,Grievance and Appeals,Prior Authorization
• Claims,Grievance and Appeals,Prior Authorization
• Claims
• Claims,Prior Authorization
• Claims,Care/Case Management
• Contract Deliverables

10: I represent a _______________ provider.

• Ancillary – 1
• Behavioral Health – 35
• FQHC – 3
• Health Home – 4
• Hospital Health System – 16
• Other – 11
• Primary Care – 2
• Specialty Care – 18

Arizona Complete Health-Complete Care Plan 11/04/2020 Provider Forum Feedback Survey

Q1: I represent a__________________________ provider.

• Primary Care – 1 response
• Specialty Care – 3 responses
• Ancillary Care – 0 responses
• Hospital Health System – 2 responses
• FQHC – 0 responses
• Health Home – 2 responses
• Behavioral Health – 1 responses
• Other (please specify) – 0 responses

Q2: How would you rate the presentation overall?

• Excellent – 1 response
• Good – 7 responses
• Fair – 1 response
• Poor – 0 responses
• Total – 9 responses

Q3 How would you rate the presenters?

• Excellent – 3 response
• Good – 5 responses
• Fair – 1 response
• Poor – 0 responses
• Total – 9 responses

Q4: Do you think the Provider Forum presentation adds value to the services you provide to your members?

• Yes – 3 responses
• No – 2 responses
• Please elaborate if you would like to:
• The education on what the health plan expects from the provider is very helpful.
• as a specialty provider it's good to know what else AzCH is striving for.
• 3 There is a lot of information that is provided in these forums and it involves 2 hours of our time for different types of providers to listen to each section that may or may not pertain to our purpose of business. It would be better if there were Forums for specific topic that would only last about an hour which included Q&A. There are many other Insurances that hold specific forums and it creates a small audience for those wanting to learning on the specific topic. 2hours is a long time to listen when your topic is at the end.

Q5 Does this Provider Forum contribute to your overall Satisfaction with Arizona Complete Health-Complete Care Plan?

• Yes it does
• no.
• Some what
• It is a great feature, but it does not resolve the issues with some of the processes for AzCH.
• Yes
• yes
• A little bit.
• I am looking for specific information provided to me as a home health agency reimbursement position. Such as timely filing, claims processing, COB issues, appeal process, refund process etc..
• no
• Total – 9 resposnes

Q6 What did you like best about the presentation?

• Claims
• nothing
• Claims section
• It was interesting and actually a relief, that some of the other practices gave the same feedback about the processes, i.e. Prior Authorization, it has been so frustrating. It isn't solved, but it really was validating for me because NIA is not at all easy to work with.
• Educational value
• Easy to understand
• Walking through some part of the contract where the most irregularities occur.
• the interaction to get the audience involved. Presenters are very knowledgeable in their fields
• the prizes
• Total – 9 responses

Q7: How do you think the presentation can be improved?

• More information concerning Behavioral Health Specialty Providers and claim submission.
• cancelled
• N/A
• I am not sure, this was my first time attending. It was quite a bit of information, that is good!
• Since we are radiation oncology/hematology/medical oncology and general surgery I would like more information directed to the different specialties.
• n/a
• use Audit results to determine topics.
• they do an awesome job but I would hope in the future that the Forums would be on a more specific subject and only an hour instead of 2 hour for all issues covered
• address claims appeals
• Total – 9 responses

Q8: Topics you would like to learn more about:

• Claims – 8 responses
• Grievance and Appeals – 6 responses
• Prior Authorization – 2 responses
• Credentialing – 2 responses
• Care/Case Management – 1 response
• Other (Please specify)
• None
• Chemo Drug education
• I do think that there are some improvements need to the claim checking and reconsideration process

Arizona Complete Health-Complete Care Plan June 2019 Forum Survey

Q1: In which county and on what date did you attend a forum?

• Pima: 6 responses
• Maricopa: 4 responses
• Total: 10 responses

Q2: How would you rate the presentation overall?

• Excellent: 2 responses
• Good: 4 responses
• Average: 2 responses
• Poor: 3 responses
• Very Poor: 0 responses
• Total: 11 responses

Q3: How would you rate the presenters?

• Excellent: 1 responses
• Good: 5 responses
• Average: 3 responses
• Poor: 1 responses
• Very Poor: 0 responses
• Total: 10 responses

Q4: Did the presentation meet the stated objectives?

• Excellent: 3 responses
• Good: 2 responses
• Average: 4 responses
• Poor: 1 responses
• Very Poor: 2 responses
• Total: 11 responses

Q5: Do you think the Provider Forum presentation adds value to the services you provide to your clients?

• Excellent: 3 responses
• Good: 4 responses
• Average: 1 responses
• Poor: 2 responses
• Very Poor: 1 responses
• Total: 11 responses

Q6: How many families/children do you expect to share this information with throughout the next month?

• Families Average: 28
• Children Average: 18
• Total: 8 responses

Q7: What did you like best about the presentation?

• The opportunity to meet the staff for Arizona Complete Health
• Very informative and presentation included a lot of data
• Seeing people face to face
• Connection w/ provider engagement rep
• Up to date information on what is expected from providers at this time from RBHA
• Total: 5 responses

Q8: How can the presentation be improved?

• I think giving more opportunity for provider feedback would be helpful
• Focus specifically on the needs of the providers. Much of the information was repeated from other presentations.
• Agenda and opportunities for questions and discussion
• As we are checking in, a sheet should be given listing the Providers/Facilities attending and who their Provider Rep is and where they will be sitting so we may meet them in person
• It would have been nice to have a presenter on billing/claims/appeals
• You should show the providers what you plan to do to correct the issues we are having. Like claims not being paid
• State the populations that data is being reviewed for
• Total: 7 responses

Q9: Topics you would like to learn more about

• I think reviewing different parts of the provider manual that seem to be most difficult would be a good use of the time in these forums.
• We would like to learn more about that the Health Home model looks like for your health plan
• How to connect with AzCH and how to get problems resolved
• Why claims are not paid!
• 5 More information on COE and COT expectations from RBHA
• Total responses: 5

Arizona Complete Health-Complete Care Plan Provider Forum May 2020 Feedback Survey

Q1: I am a __________________________ provider.

• Primary Care – 3 responses
• Specialty Care – 17 responses
• Ancillary Care – 3 responses
• Total – 23 responses

Q2: How would you rate the presentation overall?

• Excellent – 3 responses
• Good – 10 responses
• Fair – 9 response
• Poor – 1 response
• Total – 12 responses

Q3: How would you rate the presenters?

• Excellent – 4 responses
• Good – 10 responses
• Fair – 8 response
• Poor – 1 response
• Total – 23 responses

Q4: Do you think the Provider Forum presentation adds value to the services you provide to your members?

• Yes – 17 responses
• No – 6 responses
• Total – 23 responses

Q5: Does this Provider Forum contribute to your overall Satisfaction with Arizona Complete Health-Complete Care Plan?

• No
• Yes
• need more coding info
• No. You guys still have a lot of issues to work out.
• Yes
• No we still have to many system errors we are waiting on correction in order to get reimbursed, and once one issue is resolved have more to work on.
• N A
• Yes it makes me feel you care.
• I am always confused at who these meetings are trying to target. The information is all of the may from program level to mid management to CEO...seems like we get very little for the time spent.
• yes
• marginally - very canned presentation that is run through very, very quickly via reading a script.
• Yes
• yes
• YES
• same as above
• No
• Due to unpaid claims current satisfaction level is low, these are the behaviors and communications that change that so yes.
• It helps.
• no
• No, only because I was hoping this was a hospital forum. Any idea if you will be holding a session for hospitals
• No - this was a waste of time
• Yes
• No
• Total – 23 responses

Q6: What did you like best about the presentation?

• Handouts
• Virtual
• clear
• easy to understand presentation.
• The ability to bounce ideas and questions off of the health plan
• Appeals but I would like a way to contact them
• NA
• over all information.
• nothing
• How the pre-cert works
• Well intended, but not very engaging.
• Detail process and forms
• clear and concise
• all the presentation
• no dental mention
• Telehealth POS and Modifiers needed
• A lot of info but well organized so many different types of providers were able to get something out of the forum
• The information provided.
• The fact that we didn't have to travel 100 miles roundtrip to attend! :)
• That I was able to write notes on the webinar that caught the attention of AZ Complete management and that they are willing to communicate with me and hopefully help us with unaddressed issues.That is wrapped up early
• Very thorough
• Appreciate the actual leadership participating instead of proxies
• Total – 23 responses

Q7: How do you think the presentation can be improved?

• Don’t read us the power point. The speakers should just point out the highlights and the action steps. I hate to be read to in a meeting, as a waste of everyone’s time. T
• Dont read to us
• more coding for telehealth
• N/A
• More information regarding the merger of AZCH and Care 1st
• I like to see more resolution
• NA
• Some of it was not anything I would need to know but I do need to understand that it may have been relevant to other people.
• More current and specific info for CEO Level.
• Maybe a little more attentions to specific services, some are kind of vague.
• Slow down and allow for more interaction with the audience. Again, this was very script oriented and it felt like each presenter talked faster and faster.
• increase detail review of process
• I prefer in person training but for short presentations I understand it's unrealistic.
• I think it is okay
• speak on dental and medical the 2 relate to overall health of the patient its not just medical
• talking more about claims and appeals
• Separate forums by provider type/line of business to really hammer in on where there are still issues
• Monthly updates.
• Send the powerpoint presentation in advance, and let the providers read it. So much time is wasted listening to AzCH staff read the powerpoint to us, there is little time for questions/comments. We can read! And as always, claims/payments are left for the last 9 minutes, when those are the big issues providers would like to address. It would be great to see more (live) discussion, and real answers to questions, rather than promises of "we'll get back to you". The format of the forums has not really changed since the Cenpatico days. I appreciate the opportunity to be frank about my opinion! Thank you.
• Give facilities a presentation of what you are doing to improve that will benefit the hospitals and plan relationships. My personal experience is that AZ Complete is not responsive to my concerns. I hear this from my colleagues at other hospitals as well.
• Be more engaging- from this side it feels like the presenters are competing on who can speak the fastest and click thru their presentation without questions. Very stiff and not genuine in delivery.
• Spend more time on Justice involved and TIP program information.
• Less spin and more candid conversation
• Total – 23 responses

Q8 Topics you would like to learn more about:

• Claims – 18 responses
• Grievance and Appeals – 9 responses
• Prior Authorization – 7 responses
• Credentialing – 8 responses
• Case/Care Management – 6 responses
• Other (PLEASE SPECIFY) – 5 responses

1. quality metrics, ways for specialty providers to see how we are benchmarking with others
2. All areas, I would like better communication with all departments in order to provide quality services to AZCH members in a timely fashion. Issues with the claims and PA departments is ongoing along with a non-existent line of communication with the appeals department and work flow. Please reach out to the provider representative to be more engaged with the providers.
3. Your presentation is specific and to the point.
4. I will probably not be involved in future forums, but I do appreciate the opportunity to provide input.
5. Justice Involved and TIP Programs

Arizona Complete Health-Complete Care Plan November 2019 Forum Survey

Q1: In which county and on what date did you attend a forum?

• Pima – 4 responses
• Maricopa – 10 responses
• Yuma – 5 responses
• Total – 19 responses

Q2: How would you rate the presentation overall?

• Excellent – 4 responses
• Good – 8 responses
• Average – 5 responses
• Poor – 2 responses
• Very Poor – 0 responses
• Total – 19 responses

Q3: How would you rate the presenters?

• Excellent – 4 responses
• Good – 8 responses
• Average – 6 responses
• Poor – 1 responses
• Very Poor – 0 responses
• Total – 19 responses

Q4: Did the presentation meet the stated objectives?

• Excellent – 2 responses
• Good – 9 responses
• Average – 7 responses
• Poor – 0 responses
• Very Poor – 1 responses
• Total – 19 responses

Q5: Do you think the Provider Forum presentation adds value to the services you provide to your clients?

• Excellent – 6 responses
• Good – 2 responses
• Average – 5 responses
• Poor – 5 responses
• Very Poor – 0 responses
• Total – 18 responses

Q6: How many families/children do you expect to share this information with throughout the next month (estimate)?

• Families – Average 26
• Children – Average 6
• Total – 14 responses

Q7: What did you like best about the presentation?

• the credentialing directors "I can do better"
• The ability to have interactive responses
• I thought that the WIC and AHA presentations had a lot of good information to share with
• patients and providers. I wish the AHA had spent more time going over their presentation and
• what they had to offer to practices.
• The honesty and straight forwardness of the issues.
• PRESENTERS WANTED THE FEED BACK
• Everything
• Very informative
• The investment in the community and transparency
• Billing and AHA and Lunch
• It was not a forum that helped anyone. All it was, was the insurance company making excuses for things not being done. I learned nothing. I knew more about somethings than some of the presenters knew. Customer reps need to be taught way better to answer questions and let providers talk to the authorization department when we need to.
• Set up, location, food. Courteous 
• Up front and honest about sanctions, issues affecting Az Complete
• Total – 12 responses

Q8: How can the presentation be improved?

• more emphasis on AZ CH and how to work better with you vs having the outside parties present most of the forum
• There be a bit more resolve and have individuals available that make decisions.
• Focus more on issues with billing, claims, credentialing
• Going step by step through a PDF on referrals was very hard to get through. It felt like this would have been better served as a handout and an offer to help anyone who had questions, afterward.
• Having them more often.
• Tailor presentation to the departments or roles of staff attending. The people attending this meeting are not the ones putting PAs into the AzCH portal
• NEED TO HAVE ANSWERS FOR ALL TYPES OF DOCTORS, AND GET YOUR NAME AND AT LEAST PHONE NUMBER TO CALL BACK WITH AN ANSWER. NO ONE ASKED FOR THIS INFORMATION OR MAKE SURE THAT YOU UNDERSTOOD THIS SO YOU KNEW WHO TO CONTACT
• none
• N/A
• Can't think of anything at the moment.
• Agenda or schedule of each session would be nice. Some don't apply to me but I sit through them because I don't know the agenda for the day.
• Educate your customer service reps. And let providers talk to who they need to talk to like the authorization department, Because the reps know nothing about authorizations. They waste our time and we are busy with our patients.
• ACH can probably be a bit better prepared in relation to consistent provider concerns as the tale end of the meeting was a complaint session with very little traction on resolution especially related to claims and or payor portal. It is also important to keep the speakers on time as the late speaker (s) were at a disadvantage given half the audience started to leave given time for conference had ended per schedule.
• AWC is a bit far and out of the way for most medical offices, possibly more center of town.
• Total – 14 responses

Q9 Topics you would like to learn more about:

• Community resources for clients all types, housing for both smi and gmhsa, children's services, community based services not connected to health plans.
• billing, claims, credentialing
• I was really interested in the BP AHA conversation.
• NA
• MORE FORUMS TO KEEP THE PROVIDERS UP TO DATE THIS SHOULD BE FOR ALL ON THE PRODUCT LINE OF CENTENE
• claims and credentialing
• How my provider rep can increase in communication with our practice. We still have not heard from our provider rep as she promised.
• Billing Denials
• Billing policies, medical policies, processes. 
• Clarify ahcccs to your reps. NO Allergy Coverage for patients over 21.. They tell pcps and patients it is a covered service and then they get upset with us when we tell them it is not covered. They say then why did my pcp refer me to your office.. A lot of pcp office also do not know the guidelines for allergy specialists. Please educate them too. You would have happier patients and doctors.
• Claims process and common errors which can impact any backlogs for ACH and or payors. How can we all work together to make these a smoother process?
• 12 n/a
• Total – 12 responses

Scope of Work

Arizona Complete Health-Complete Care Plan– RBHA (AzCH-CCP) developed a Monthly Member Survey aimed at capturing member’s satisfaction with their services and service delivery. Survey results will assist AzCH-CCP with ongoing monitoring of member satisfaction, agency performance, and assist with identifying areas of improvement.

The survey questions measure the following:

Questions 1 – 5:   Patient Experience
Question 6:          Outcomes and Improved Functioning
Questions 7 – 8:   Access to Care
Question 9:          Overall Satisfaction with Health Plan
Question 10:        Tobacco Cessation

Timeline

Survey results are due to AzCH-CCP quarterly, 30 business days after the end of the quarter. AzCH-CCP will submit survey results to Arizona Health Care Cost Containment System (AHCCCS) quarterly, 30 business days after the end of the quarter. AzCH-CCP will submit individual survey results to the corresponding providers quarterly, 30 business days after the end of the quarter.

Original Monthly Survey Start Date:  February 1, 2018

The submission of the survey analysis will occur on the following dates:

• January 31 CY2021 Q1 (October 1 – December 31)
• April 30 CY2021 Q2 (January 1 – March 31)
• July 30 CY2021 Q3 (April 1 – June 30)
• October 30 CY2021 Q4 (July 1 – September 30)

Methodology

Data collection conducted by Qualtrics survey platform for the CY2021 Member Satisfaction Survey is administered as a single-wave email study. In Q2 of CY2021, 2,250 surveys were emailed to AzCH-CCP RBHA members.

ANALYSIS

Response Rate Qualtrics survey platform emailed surveys for the period of January 1, 2021 through March 31, 2021.  The survey answers are weighted from one, “Strongly Disagree”, to five, “Strongly Agree”; the option of “Not Applicable” is not included when calculating answer averages. Results include an overall rating average from one (low) to five (high) based on the answer weights mentioned above, for each question. The minimum performance standard (MPS) is a rating average of 4 for each question. The AzCH-CCP RBHA rating average goal is 4.5 or greater for each question.

 

 

The total count for Member Satisfaction Surveys sent during CY2021 Q2 was 2,250 with a response rate of 1.73%. Total response count for the CY2021 Q2 period was 39.

	Q2 2021
	RBHA
Mail out size	2,250
Completed surveys	39
Response rate	1.73%

Figure 1 displays the response count by location. Tucson was identified by 48.72% of respondents as their place of service, with a total count of 19.

Figure 1

 

Response Rate Interventions

AzCH-CCP RBHA began using the Qualtrics survey platform and changing from a mailed letter to email method of delivery. Quality Improvement continues to explore opportunities to increase member participation in the survey process. Quality Improvement collaborates with other key internal departments, including our Office of Individual and Family Affairs and the Care Management teams, to strategize potential interventions to increase response rates.

 

Survey Results

Figure 2 compares overall rating averages from CY2021 Q2 to CY2021 Q1 reporting period. Overall, all but two of the survey questions exceeded the MPS of four for member satisfaction for the CY2021 Q2 reporting period.   There four questions that achieved higher averages in CY2021 Q2.

Figure 2

Table 1 provides a comparison of the ratings of each question (Questions 1 through 10) between the CY2021 Q1 and CY2021 Q2.

 

Table 1

Question	Q1 2021	Q2 2021
Sample Size	n=26	n=39
1. The provider’s office is safe, clean, comfortable and inviting.	4.4	4.4
2. I was treated in a friendly and welcoming manner by my health care provider.	4.4	4.4
3. The team listens to me and believes we can accomplish our goals.	4.0	4.1
4. I am working with staff on activities to improve my health and wellness.	4.0	4.0
5. I know who to call if I have a problem or need help with my health care.	4.1	4.1
6. My services are helping me to get better.	3.9	4.0
7. I receive services when I need them.	4.2	4.1
8. I am satisfied with Arizona Complete Health as my Health Plan.	4.0	4.0
9. My provider stays in touch with other providers/organizations in my life.	3.8	3.8
10. My health care provider talks to me about smoking and tobacco use cessation.	3.6	3.9

Survey Result Interventions

 

Member focused interventions:

·        Automated Member Calls – These automated calls use a simulated, real, human voice and are scheduled to communicate valuable information to: (1) onboard new members, verify PCP, Complete and HRA; (2) close gaps in care and improve HEDIS outcomes; (3) improve how members manage their health and includes a live transfer for Members to Member Services to assist with appointment scheduling, transfer to Case Management or EPSDT team. This program began May 2018. This intervention is driving survey score increases for the following questions: Question 4 – I am working with staff on activities to improve my overall health and wellness; Question 6 – Services are helping me to get better; Question 8 – I receive services when I need them; and, Question 9 – I am satisfied with Arizona Complete Health as my health plan.

 

CY2021 Q2 Update: automated calls continue to be utilized for member outreach and education, as well as, for various quality improvement initiatives.

·        Appointment Availability Flyer – This flyer is aimed at helping the member differentiate between routine, urgent, and emergency/crisis care; and, how to schedule their routine or urgent are appointments with an expected timeline of how soon appointments should be made by the health care provider. The flyer contains contact information for AzCH-CCP ACC Member Services, Nurse Advice Line, Peer Warm Line, and Crisis Services. This intervention is driving the survey score increases for the following questions: Question 5 – I know who to call if I have a problem or need help; Question 6 – Services are helping me to get better; Question 7 – I receive services where I need them; Question 8 – I receive services when I need them; and, Question 9 – I am satisfied with Arizona Complete Health as my health plan.

CY2021 Q2 Update: The Appointment Availability Flyers continue to be utilized for member outreach and education. AzCH-CCP will update this resource on an annual basis.

Provider focused interventions:

·        Patient Experience Toolkit – This toolkit is collaborative effort developed by providers for providers and distributed to assist in improving the patient experience by offering useful guidelines, tips, and other materials. The toolkit is based on recommendations, feedback, and best practices that were received from participating providers. The Toolkit was initially distributed to providers in 2018. Quality Improvement department partners with the Provider Engagement to distribute this resource during scheduled meetings with provider organizations.

 

CY2021 Q2 Update: The Patient Experience Toolkit continues to be utilized. Beginning in February 2019, the AzCH-CCP Quality Improvement team began providing this toolkit to providers post audit. The Quality Improvement team will focus on presentations on this toolkit to providers in CY2021.  This tool is being utilized with by the Quality Improvement CAHPS team during Delegated Vendor JOC meetings. During CY2021 Q2, the Quality Improvement department distributed the Toolkit during the monthly Essential Provider Communication Teleconference. The Toolkit is accessible to providers on the Provider Portal and was highlighted in the recent Medicaid Provider Forum.

·        Coordination of Care (COC) Protocol – This protocol is to assist health care providers coordinate care and develop comprehensive treatment plans with physical, specialty, and behavioral health providers for all patients with a direct focus on complex care patients with a behavioral health and/or substance abuse diagnosis, and/or other comorbid chronic condition. This intervention is driving the survey score increases for the following questions: Question 3 – My team listens to me and believes I can accomplish my goals; Question 4 – I am working with staff on activities to improve my overall health and wellness; Question 7 – I receive services where I need them; Question 8 – I receive services when I need them.

 

CY2021 Q2 Update: The Coordination of Care Protocol continues to be utilized by the Quality Improvement department in partnership with the Provider Engagement department as a tool that is distributed to our network of providers. The protocol was initiated in 2018, the AzCH-CCP ACC Quality Improvement Audit team is currently on hold from performing audits due to Covid-19 pandemic. However, the Quality Improvement Audit Team will begin providing this toolkit to providers post audit once audits are approved to resume by AHCCCS.

·        Path to 5 Stars – The QI department created a quick reference guide for quality measurements. This guide offers information and recommendations on accessing/getting needed care, effective communication with members, outreaching patients regarding preventive screenings, wellness visits, or follow ups, member experience, and more. This intervention is driving the survey score increases for the following questions: Question 3 - The team listens to me and believes we can accomplish our goals; Question 4 - I am working with staff on activities to improve my health and wellness; Question 5 - I know who to call if I have a problem or need help with my health care; Question 6 - My services are helping me to get better; Question 7 - I receive services when I need them; Question 8 - I am satisfied with Arizona Complete Health as my Health Plan; Question 9 - My provider stays in touch with other providers/organizations in my life; Question 10 - My health care provider talks to me about smoking and tobacco use cessation?

 

CY2021 Q2 Update: Path to 5 Stars quick reference guide is being distributed to our network of providers.

 

·        Coding for Quality – This reference guide assists providers in the automation of reporting quality metrics such as test results and other events with high impact on member care to reduce medical records requests and increase care gap closure by utilizing CPTII codes. This intervention is driving the survey score increases for the following questions: Question 4 - I am working with staff on activities to improve my health and wellness; Question 5 - I know who to call if I have a problem or need help with my health care; Question 6 - My services are helping me to get better; Question 7 - I receive services when I need them; Question 8 - I am satisfied with Arizona Complete Health as my Health Plan; Question 9 - My provider stays in touch with other providers/organizations in my life; Question 10 - My health care provider talks to me about smoking and tobacco use cessation.

CY2021 Q2 Update: The Coding for Quality reference guide is being distributed to our network of providers.

Figure 3

The written comments are member responses to the open-ended statement at the end of the survey.  The following statement was included on the survey: Please list your concerns or ideas for how we can improve.  There were a total of 11 comments.

Member Written Comments

Below is a small sample of positive comments:

·        I am a cancer patient and I have third stage kidney disease, everyone has been extremely helpful and my doctors take good care of me, I used to have to spend hours on hold trying to get questions answered or attempting to set up transportation to get to my appointments your company has been very helpful and expedient when setting things right. But I do have one problem, I am having the hardest time trying to figure out how to set up transportation. Can someone please point me in the right direction?  Thank you ·        I appreciate reminders for needed appointments for myself and my family. ·        They have been very good and easy to work with thanks for all the help!

Below is a small sample of comments for improvement:

·        [Provider1] all around is trash, [Provider2] behavior health is good, [Provider2] primary care is trash, no one calls me back, phone receptionist hang up and very rude. Bad customer service. Arizona Complete Health phone reps hang up or tell you to Google the issue ·        I been sexual and physically assaulted. The mental trauma and drug dealing banner medical provides is appalling. No one’s body should ever be a student’s grade. This is not health care it is human trafficking ·        My name is [Member Name]. My husband is [Member Spouse Name] with one [letter]. If you keep expecting me to cooperate with dumb surveys, you should at least know your clients name!!

 

Response Actions/Interventions: AzCH-CCP monitors care from providers across the network to ensure high quality of care. This includes, but is not limited to, member experience, quality performance metrics, and cost of care, utilization, complaints, quality of care concerns, and appeals and grievances. Data from the monitoring is explored consistently through the team, coordination, and committee meetings. Specific action plans are put in place when deficiencies or trends are found, to include working with specific providers or agencies to ensure high quality of care. In addition, AzCH-CCP has implemented a number of value-based purchasing contracts to further incentivize high quality care. AzCH-CCP is constantly working to educate members on various aspects of the plan for which they are targeted as an appropriate audience. Beginning CY2021 Q1, while utilizing the Qualtrics survey platform, members identified as needing additional support are escalated to appropriate departments for member outreach.