Putting Results on Patient Experiences with Physicians to Use July 2007 Ted von Glahn Director of Performance Information and Consumer Engagement Pacific Business Group on Health

2 Patient Experience Performance: Applying Results in California Market  Public Accountability  Performance Improvement  Pay for Performance  Consumer Decision Support

California Office of Patient Advocate Public Accountability 20 Top Performing CA Medical Groups

4 Performance Improvement: Information Feedback to Doctor

5 Reception Prior to Visit Examination Room Physical Examination Follow-up Care Outside of Office Visit Patient Experience Coordination of care Coordination of care Nurse/MA-Patient comm. MD-Patient communication Coordination of care Staff-Patient communication Timely service Access Staff-Patient Communication PATIENT FLOW INFORMATION FLOW

6 Pay for Performance Incentive Components Recommended  50% Clinical results  30% Patient experience  20% IT/system  10% Bonus doctor-level $ incentive program

California Office of Patient Advocate Consumer Choice State of California Ratings

8 Patient Experience Measurement and Reporting  Consumer demand  PBGH consumer research results  Good science  Strong psychometric properties  Proven feasibility  Work executed in diverse settings throughout CA yearly since 2003

*Respondents PBGH Choice of Doctor Research 9 Consumer Demand Doctor Choice -- What Matters Aspects of Choosing a Doctor % Patients Rated It One of Top 3 Choice Factors* Patient ratings of doctor51% Office location & hours39% Doctors training & experience38% Advice from professionals27% Doctor’s age, gender, ethnicity, languages spoken 25% Advice from family/friends24%

10 Good Science 2007 Survey Work with 3,500 Doctors  High reliability  > 0.70 reliability with 25 patient respondents per MD  Discriminates performance  Intraquartile range (25 th -75th) mean scores points across doctors  Improvement opportunities  Low end: 65 mean score health promotion and chronic care support  High end: 88 mean score patient-MD interaction

11 Proven Feasibility Five Years of Work ( )  Medical group/IPA source for patient samples  183 groups report group-level results (public)  39 groups report MD-level results (internal)  Cost $185-$205 per doctor  35% patient response rate  Common version of C/G CAHPS survey: adult primary care, pediatrics & specialty care (differ slightly)

12 Patient Experience Looking Ahead  Expand scope of survey content  New module: chronic care support for patients  Expand coordination of care module  Performance improvement  Research – what improvement approaches work  Spread strategies – disseminate best practices  Public reporting of doctor ratings  Pooling and cost-sharing strategies  Integration of clinical and efficiency results