To Dial-in: or Event Number: # 4/21/2016
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1 To Dial-in: or Event Number: # 4/21/2016
2 Today s Agenda 1. CG-CAHPS and Current Developments 2. Why CG-CAHPS? 3. Engaging Physicians Polyclinic 4. Why AMGA? Why Avatar Solutions? 5. Platinum, Gold and Silver Survey Options 6. Demonstration of ImprovingCare.com 7. Next Steps
3 1. CG-CAHPS and Current Developments National standardized survey Measures experiences of Clinician and Group patients Several versions: Visit, 12-month, 6-month, PCMH, ACO Five composites: Access to Care Office Staff Courtesy Provider Communication Rate Provider Recommend Clinic
4 1. CG-CAHPS and Current Developments Various Versions with different timeframes, lengths, and supplemental items. CG-CAHPS CORE Supplemental Customized CG-CAHPS Access to Care Office Staff Courtesy Provider Communication Rate Provider Recommend Clinic Health Promotion & Education Shared Decision Making Health & Functional Status ACO PQRS PCMH CG-Visit CG-6 month CG-12 month
5 2. Why CG-CAHPS? Currently required by CMS for all medical groups with more than 100 healthcare providers that are participating in PQRS using the GPRO reporting option. PQRS and CG-CAHPS are expected to be required for all medical groups by Some insurance companies require this data for payment purposes. Get a head start now!
6 QUESTIONS?
7 3. Engaging Physicians Using Statistics and Physician Coaching to Gain Back Organizational Trust in Patient Satisfaction Surveying
8 About The Polyclinic Large, multispecialty group practice Approximately 200 physicians 40% primary care 30 specialties 1,100 staff members Comprehensive ancillaries 230,000 patients from across the Puget Sound 13 locations, mostly in Seattle Our Mission To promote the health of our patients with personalized care. Vision The best place to receive care. The best place to provide care.
9 Our Patient Satisfaction Survey Story Started sending year round patient satisfaction surveys in Initial provider reports were a disaster! Small sample sizes Little communication No improvement resources provided Individual provider scores displayed publically Result: Anger! Frustration! Disengagement!
10 How do we regain provider trust and engagement? New survey vendor. Frequent communication with providers and staff. Large sample sizes: Minimum of 75 surveys annually per provider to increase trust in the data. Confidence intervals to quantify variability and increase trust in the data. % Top Box for goals rather than percentiles to give a static target/goal. Coaching and communications training.
11 Data is Important!
12 Developed Custom Reports to Include Confidence Intervals Number of surveys returned. Report only distributed when providers have 75 or more surveys. % Top Box Score 90% confidence interval around score.
13 Number of Providers Distribution of Provider Scores We used graphs with confidence intervals to look not only at individual providers, but also at variation between providers. Found three categories of physicians: Bottom Performers Average Performers Top Performers Low Score High Score We can identify top performers to learn best practices that average performers and bottom performers can learn about. Improving performance of average performers is very different tactically, than improving performance of bottom performers. Graphs with confidence intervals allow us to reliably evaluate performance and deploy resources appropriately.
14 Provider Scores with Confidence Intervals
15 Our Innovation: Scores by Specialties with Confidence Intervals Use graphs with confidence intervals to look at our clinic-wide goals by specialty. Able to reliably highlight departments that are not meeting goals and then devote resources to improvement in these areas.
16 Less Debating the Validity of the Data We often heard from our Physicians One angry patient tanked my scores. The survey sample isn t representative of my patients. I don t trust this data. I see 2500 patients a year, how can you really send out a few surveys and know what my patients really think about me. By using confidence intervals we can say Dr. X, you are right, the surveys are not a perfect representation of your patient panel, but we can say that with 90% confidence your actual score falls within this specific range. Result: Less time spent debating the data!
17 Move Toward Transparency Outlined transparency plan early: January Began surveying and outlined plan for transparency July 2015 October 2015 First provider reports distributed January 2016 April 2016 Blinded provider reports distributed July 2016 First fully transparent reports distributed At least a year between providers first seeing their scores and scores published transparently. Providers have an opportunity to see their performance and make changes before reports are distributed publically.
18 Blinded Provider Reports
19 Success Case Study: Dr. C Vocal Detractor Top Performer Dr. C is a prominent surgeon in our clinic and holds leadership position. He scores below the 50 th percentile on patient satisfaction survey. Vocal questioner of the value of patient satisfaction surveying. Dr. C attends communication training and receives coaching on best practice communication techniques. Dr. C is now one of our top performing physicians with scores above the 90 th percentile.
20 Success: In 2015 The Polyclinic was one of only four medical groups in Washington State with above average scores across all four categories!
21 Theo Epstein, Curse Killer: How Chicago Cubs Exec's 'Moneyball' Approach Sparked NLCS Run Data can do miraculous things The 41-year-old executive used his data-based approach to bring the once-hapless Cubs within striking distance of ending their century long championship drought, just as he did for the Boston Red Sox in 2004.
22 Lessons Learned: Add statistical rigor whenever possible. Get key physicians on board. Engage detractors. Do not publish scores with small sample sizes. Be up front about survey challenges and short comings. Don t surprise anyone with publicly displayed scores. Give physicians time to see their scores and make adjustments. Provide improvement resources to physicians.
23 QUESTIONS?
24 4. Why AMGA? AMGA has more than 20 years experience in administering patient, provider, and employee satisfaction surveys, using state of the art survey tools and methodologies. AMGA provides superior customer service The joint AMGA-Avatar program is only available to AMGA members, who receive a significant discount on these services
25 5. Why AMGA partnered with Avatar Solutions Avatar Solutions has been conducting CG-CAHPS surveys for the past 5 years, and has been in business for more than 30 years Avatar s database contains over 18,000 providers from across the country. Avatar s online reporting tool, Improvingcare.com Provides easy segmentation of your data by provider, location and others at the click of a mouse Includes tips and best practices to help participating groups address any problem areas
26 5. Why AMGA partnered with Avatar Solutions AMGA can provide contact information or an introduction to these individuals upon request
27 6. Platinum, Gold and Silver Survey Options Platinum Level Participating organizations gain access to Avatar's online reporting system, Improvingcare.com. Mailings sent in single waves of 15 surveys per provider per month in the CMS standard languages (English and Spanish). You can also request additional languages. surveys are sent to available patient addresses in a single wave. Minimum target goal for the number of surveys collected per provider is 50 per year. Cover letter for the survey forms can be customized with the image of the provider and name of the practice site. Cover letters include the clinic name, corporate logo, provider name and option of provider photo.
28 6. Platinum, Gold and Silver Survey Options Platinum Level Patient comments are sent to the group as a PDF, while also being analyzed for content. Group may add up to 20 custom questions of its own to the survey package. Previous participants in AMGA s Patient Satisfaction Survey may add AMGA questions as part of custom questions. CG-CAHPS data submitted to CMS directly from Avatar every quarter.
29 6. Platinum, Gold and Silver Survey Options Gold Level Quarterly reports with your results at the overall and individual provider level. Patient comments will be reported verbatim via PDF. Mailings sent in single waves of 15 surveys per provider per month in the CMS standard languages (English and Spanish). No ed surveys. Minimum target goal for the number of surveys collected is 50 per provider per year Survey cover letter includes the name of the organization, logo and the provider s name. CG-CAHPS data submitted to CMS directly from Avatar every quarter.
30 6. Platinum, Gold and Silver Survey Options Silver Level Minimum surveying level to produce sufficient surveys to comply with CMS regulations. CMS currently requires at least 300 completed surveys per clinic. Mailings sent in single waves, with 85 surveys sent per month for the entire group in the CMS standard languages (English and Spanish) Quarterly reports will be provided for the group as a whole, with custom reports available at additional cost. Survey cover letter will include the name of the organization, its logo and the provider s name. CG-CAHPS data submitted to CMS directly from Avatar every quarter.
31 QUESTIONS?
32 7. Demonstration of ImprovingCare.com
33 7. Next Steps Choose Platinum, Gold or Silver option. Contact Mark Babey at ext.337 to get materials and information needed to get started. Send in your survey customization form, logos and other images as needed. Set-up data collection for patients and providers. Test data collection process and send sample surveys. Starting the 5 th of the following month, the process goes live. Within a few days, the surveys are sent and data collection begins. Set-up Test Go!
34 QUESTIONS? Mark Babey Program Manager, Employee and Patient Experience ext.337
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