Quality Management Update February 11, 2015

CAHPS Survey Results A baseline assessment of parents’/caretakers’ satisfaction with the AHCCS program across the following lines of business: KidsCare Acute Adult Acute Children Pre-Integration – Seriously Mentally Ill Pre-Integration – Children’s Rehabilitative Services 2 Reaching across Arizona to provide comprehensive quality health care for those in need

Follow-up Work Satisfaction Improvement - Adults Adult CAHPS Survey All Contractors: o Getting Care Quickly Additional individual Contractor focus areas: o Care 1 st : Getting needed care o Phoenix Health Plan: Getting needed care 3 Reaching across Arizona to provide comprehensive quality health care for those in need

Follow-up Work Satisfaction Improvement - Children Children’s CAHPS Survey All Contractors: Getting care quickly Additional individual Contractor focus areas: Care 1 st : How well doctors communicate CMDP: Rating of Health Plan, rating of specialist seen most often and how well doctors communicate Maricopa Health Plan: How well doctors communicate Phoenix Health Plan: How well doctors communicate 4 Reaching across Arizona to provide comprehensive quality health care for those in need

Follow-up Work - Satisfaction Improvement Members Diagnosed with Serious Mental Illness Focus areas: Getting needed care Customer service Additional focus area opportunities: Below the 25 th percentile: o Rating of Health Plan o Rating of all health care o Rating of personal doctor o Rating of specialist seen most often o Getting care quickly o How well doctors communicate 5 Reaching across Arizona to provide comprehensive quality health care for those in need

Follow-up Work - Satisfaction Improvement Children’s Rehabilitative Services Focus areas Getting Needed Care Additional focus area opportunities Below the 25 th percentile o Rating of Health Plan Between the 25 th and 49 th percentile o Getting care quickly o How well doctors communicate o Customer service 6 Reaching across Arizona to provide comprehensive quality health care for those in need

Actions AHCCCS work group aimed at the “all Contractor” focus area: o Acute Adult: Getting care quickly o Acute Children: Getting care quickly Individual Program or Contractor focus areas: o Corrective action plan (with a work plan and associated timeline) o Contractors with similar focus areas may choose to work collaboratively on topic area o Communications to Contractors on the expectations will be sent out by the end of the week. 7 Reaching across Arizona to provide comprehensive quality health care for those in need

Oral Health Secret Shopper Follow-Up Survey Results (Fall 2014) Secret shopper survey conducted September and October Requested appointments for the following: o Urgent care appointments – within 3 days of request o Routine care appointments – within 45 days of request 234 providers chosen at random from Acute-care Contractor online provider listings. 8 Reaching across Arizona to provide comprehensive quality health care for those in need

Overall Secret Shopper Survey Results Overall results found that there was access to dental care 73.4 percent of the time (this is down from 78 percent of the time in 2012). There were 41 issues identified that need to be addressed by Contractors including: o providers who are no longer accepting AHCCCS o providers no longer at the practice o disconnected or incorrect telephone numbers o Several large practices such as included public health, FQHC’s, etc. no live answering of phones (phone tree and voice mail) Calls that continuously went to “voic ” were counted as non- access to care. 9 Reaching across Arizona to provide comprehensive quality health care for those in need

Urgent Appointment Availability Urgent appointment scheduling found that there was access to urgent visits 70.7 percent of the time (within the contractual requirement of three days of calling). 10 Reaching across Arizona to provide comprehensive quality health care for those in need

Routine Appointment Availability Routine appointment scheduling found that there was access to routine appointments 74.4 percent of the time (within the contractual requirement of 45 days of calling). 11 Reaching across Arizona to provide comprehensive quality health care for those in need

Urban versus Rural Appointment Availability Results of urban counties appointment availability, access was documented 80 percent of the time (urban defined as Pima and Maricopa counties). Results of rural counties appointment availability, access was documented 59.2 percent of the time. 12 Reaching across Arizona to provide comprehensive quality health care for those in need

Special Needs Member Appointment For calls identified as special needs, appointment availability was documented 69.4 percent of the time within contractual access to care standards. For urgent calls of members with special health care needs, appointment availability as documented 100 percent of the time within contractual access to care standards (3 days). Some of the reasons that resulted in non-access to an appointment included: o practices not being able to accommodate wheelchairs o doors could not accommodate wheelchairs o practices not being aware that they had to accommodate special needs such as the member being deaf o practices generally stating that they could not accommodate the member with special health care needs 13 Reaching across Arizona to provide comprehensive quality health care for those in need

Spanish Speaking Appointment Availability All providers chosen for Spanish speaking member appointments were identified as being able to accommodate Spanish-speaking members in the Contractor network. Appointments could be scheduled within access standards 67.9 percent of the time. Urgent appointments were able to be scheduled 50 percent of the time. In urban counties, appointments were available 75 percent of the time. In rural counties appointments were available only 50 percent of the time. 14 Reaching across Arizona to provide comprehensive Appointments were available 75 percent of the time in urban counties (15 of 20) while only 50 percent (4 of 8) in rural counties quality health care for those in need

Next Steps Individual Contractor results will be sent to Contractors. Contractors will be required to submit corrective action plans. Corrective action plan will need to include: o Network adequacy and accuracy review o Website accuracy o Actions to ensure member appointment calls are answered 15 Reaching across Arizona to provide comprehensive quality health care for those in need

Thank You. 16 Reaching across Arizona to provide comprehensive quality health care for those in need