Background – Survey and Methodology

 

NCQA requires plans to conduct an annual survey to evaluate member experience with behavioral health care and services. These Behavioral Health (BH) satisfaction surveys are administered to all Anthem Blue Cross and Blue Shield (Anthem) NCQA Accredited Commercial and Marketplace health plans. Additionally, some state regulations require the need to assess member satisfaction with BH services. 

 

Internal Anthem accreditation and clinical behavioral health staff, including psychiatrists as well as other medical directors, developed Anthem’s BH survey. The survey was designed to target actionable issues about behavioral health providers related to quality of care, access to care, interaction with the patient, coordination of care, billing, prescriptions, and quality of the office site. The survey was conducted by an independent NCQA-certified research firm, DSS Research, Inc.

 

The results of the 2019 survey of Missouri HMO/POS providers, along with the Anthem averages, are listed below. On the following measures, the Missouri HMO/POS provider scores were comparable or better than the Anthem average. Measures with fewer than 20 respondents have been excluded. 

 

Category

Measure

Missouri HMO/POS 2019 Score

Anthem
Commercial Plan Average 2019 Score

Access and Timeliness

Got initial routine appointment within 10 business days

76%

68%

Got follow-up appointment within 30 calendar days

88%

82%

Location and Staff

Transportation options to the provider’s office were easy to get

77%

76%

Parking at the location of services was easy

82%

80%

Office or Clinic

The office was located in a safe neighborhood and the outside was well-lit

96%

96%

The office was neat and clean

96%

97%

The waiting room was soundproof and adequately met patient needs

84%

85%

Billing

Had a discussion with the provider about the charges

77%

79%

Provider billed more than the amount covered by insurance, copay

5%

4%

Prescriptions

How much the doctor talked about reasons to take medicines

96%

92%

How much the doctor talked about reasons not to take medicines

71%

64%

Provider asked what the patient thought was best

86%

88%

 

The goal for all measures is to be at least meeting the Anthem average. On the following measures, the Missouri HMO/POS providers scored at least one standard deviation below (or above on the financial/billing measure) the Anthem average. Measures with fewer than 20 respondents have been excluded. 

 

Category

Measure

Missouri HMO/POS 2019 Score

Anthem
Commercial Plan Average 2019 Score

Access and Timeliness

Able to get Behavioral Health care

86%

91%

Location and Staff

Staff willing to see patient as often as necessary

81%

84%

Staff returned calls within 24 hours

69%

83%

Able to get all needed services

71%

84%

Able to see a provider when patient wanted

73%

79%

Interaction with Patient

Attention paid to what patient had to say

84%

90%

Respect for what patient had to say

79%

91%

Understanding of patient’s concerns

81%

89%

Explanation of things in a way that was easy to understand

82%

90%

Thoroughness and skill of the provider

86%

89%

Success in meeting patient needs

75%

84%

Respect for cultural and/or religious/ spiritual beliefs

82%

91%

Willingness to allow patient to take part in the treatment plan

86%

90%

Coordination of Care

Provider spoke with other treating providers when appropriate

82%

85%

Office or Clinic

Waiting room had enough seating

91%

94%

Prescriptions

Told about possible side effects of medicines

82%

91%

Billing

Received unexplained bill from the provider

14%

7%

 

Summary/Next Steps

 

At Anthem, we strive for excellence in all aspects of service to our members. We know that our participating providers strive for the same goal. The survey results indicate many areas with potential for improvement. Please review the survey and consider ways that together, we can provide a better member experience. If you have questions or concerns about the survey results, please contact your network consultant.

 

519-0720-PN-MO

 



Featured In:
July 2020 Anthem Provider News - Missouri