1. DIRIGO HEALTH AGENCY’S MAINE QUALITY FORUM Statewide Patient Experience Survey August 2012 Patient Experience Matters

2. The Clinical Benefits of a Good Experience of Care Good patient experience is correlated with more activated and engaged patients who are more adherent to advice and treatment plans. Better care experiences lead to better outcomes. Measuring patient experience is first step to practice level and system-wide improvements Positive correlation between patient experience and preventive/disease management processes.

3. Good Patient Experience: Financial Benefits! Better patient experience lowers likelihood of lawsuit. Measuring and improving patient experience enhances culture which lowers staff turnover and increases employee satisfaction. Better experience leads to patient loyalty – good for practices and good for patient care. Payers planning future tie financial incentives to patient experience.

4. Why Survey Patients on Experience of Care? Surveying patients helps engage patients in delivery of their care Places patient at center of healthcare encounter and re-emphasizes focus of provider to that center It results in improved communication between patients and providers Through public reporting, survey results provide basis for standards and comparison points to improve quality Provides patient experience data to payers and consumers

5. Why is DHA-MQF interested in Collecting & Reporting Patient Experience Data? Law directs the Maine Quality Forum to evaluate and compare health care quality and provider performance DHA-MQF is a convener together with MHMC and Maine Quality Counts for the Patient Centered Medical Home pilot, Medicare’s MAPCP demonstration as well as for Aligned Forces for Quality in Maine. As such, Patient Experience surveying is a natural progression

6. Partners Lead: DHA/Maine Quality Forum Partners:  Maine Quality Counts  Maine Health Management Coalition  Maine’s Aligning Forces for Quality Adviser  Dale, Shaller, Principal, Shaller Consulting, Inc. Staff support  Muskie School of Public Service

7. Statewide Survey Design Voluntary Target population/practice sites:  Adult patients of primary care and specialty care practice sites  Parents of children served by pediatric practice sites Survey conducted & reported at practice-site level

8. Use of CAHPS Survey Instruments Endorsed by the National Quality Forum Growing use of CAHPS as nationally accepted instrument for assessing patient experience (e.g., Medicare Compare, ACOs, Medical home demos) Availability of regional and national benchmarks

9. Selected CAHPS Instruments Primary Care Adult: Adult PCMH 12-month Survey, version 2.0 Primary Care Child: Child PCMH 12-month Survey, version 2.0 Specialist Adult: Core questions from CG-CAHPS 12-month survey, version 2.0 with subset of PCMH items to be determined with stakeholder input

10. Modes of Survey Administration* Mail only Mixed mode of mail with telephone follow-up Mixed mode of e-mail with mail follow-up Mixed mode of e-mail with telephone follow-up

11. Sample Frame Sample will be based on patients seen by a practice site over the prior 12-month period Size of random sample based on number of providers per practice site and expected response rate Number of required completed surveys per practice site based on guidelines developed by AHRQ

12. Estimated Sample Size # Providers at Practice Site* Required # of Completed Surveys per Practice Site** Estimated Sample Size per Practice Site*** 150143 2100286 3150429 4-9175500 10-13200571 14-19250714 20+300857 * Providers include physicians, nurse practitioners and physician assistants who independently manage a patient caseload. **Based on AHRQ guidelines for practice site sampling *** Based on an estimated 35% response rate

13. Survey Administration Health systems/practice sites with existing survey vendor relationships:  Existing vendor apply to be designated vendor  Leverage existing efforts by replacing or supplementing current survey with common instrument for limited period. Practice sites without existing survey vendor:  Select from DHA list of designated vendors

14. Subsidy Available to practices which use designated vendors that:  Use selected CG-CAHPS PCMH instruments  Administer survey at the practice site level between Sept- Nov 2012  Follow specifications of DHA Survey Guidelines  Submit practice site level results to CAHPS Database  Obtain Data Use Agreement from practice sites allowing access to survey results for public reporting by DHA

15. Subsidy Levels Based on best bid from RFP Practice sites contracts directly with preferred vendors DHA will cover 90% of survey costs up to a maximum cost of $9.55 per completed survey.

16. Estimated Subsidy Levels Number of Providers per Practice Site Required # Completed Surveys Estimated Total Survey Costs* Estimated DHA Practice-Site Subsidy** Estimated Balance to be Paid by Practice Site 150$600$540$60 2100$1200$1080$120 3150$1800$1620$180 4-9175$2100$1890$210 10-13200$2400$2160$240 14-19250$3000$2700$300 20 +300$3600$3240$360 *Estimate based on $12 per completed survey ** Assumes 90% DHA contribution

17. DHA Public Reporting Practice sites must agree to have practice site-level survey results publicly reported as a condition of subsidy Practice site level survey data will be publicly reported on the DHA website Design a DHA public reporting website will be developed with input from Maine Quality Forum Advisory Council and stakeholders

18. Estimated Timeline Apr’12 May’12Jun’12Ju’12lAug’12Sep’12Oct’12Nov’12Dec’12Jan/Feb 2113 Mar/Apr 2013 May/Jun 2013 Survey Monkey DHA Survey Guidelines Vendor RFP Designated Vendor Proces Public Awareness Campaign Survey Administration Data Submission to CAHPS Database Preliminary Findings Public Reporting

19. Next Steps Vendor Selection Complete  Vendors will be announced within the next two weeks Public Reporting Sub-Committee Purpose: Advise DHA on content/format of public reports on patient experience survey results Commitment: up to four 6-hour meetings When: August 2012 – March 2013