Summer 2011 PROVIDER NEWS Quality of Care: What is the Patient s Point of View? As physicians, we have a clear idea of what we mean by quality of care. It is based on evidence, expert consensus and adopting guidelines to our patients specific needs. But these ideas may bear little resemblance to how patients perceive and characterize quality. The National Committee for Quality Assurance has a well-defined process for surveying managed care patients about their satisfaction with doctors and health plans. Here are the questions your patients will be asked: INSIDE THIS ISSUE: Provider Relations Department of VNSNY CHOICE sponsors a Food Drive 2 Meet the VNSNY CHOICE 2 Provider Relations Department! VNSNY CHOICE 3 Commitment to Compliance Resources for Caregivers 4-5 Marketing item Medical Management Hours 6 In the last 6 months, how often did your personal doctor listen carefully to you? explain things in a way that was easy to understand? show respect for what you had to say? spend enough time with you? In the last 6 months, how often...was it easy to get appointments with a specialist? was it easy to get the care, tests or treatment you needed through your health plan? did you get care when needed when you needed care right away? did you get an appointment for your health care as soon as you thought you needed it -- not counting the times when you needed health care right away? continued on page 2
2 Quality of Care: What is the Patient s Point of View? continued from page 1 These questions indicate that there is a generally accepted view that quality must, in part, be judged by consumer perception, not only on technical clinical factors. As you can see, there is not an objective determination of relative urgency or clinical necessity or even a clearly defined meaning of such terms as respect, enough time, or listen carefully. Nonetheless, given enough survey results based on identical questions about member satisfaction, certain generalizations about a physician s overall rate of satisfaction may be used to distinguish superior from average from below average results. The purpose of this article is to let you know about an aspect of quality that isn t something we are taught in medical school or residency. It s important because, these dimensions of quality may directly impact the rate of growth of a doctor s practice, how he or she is seen in the community and even its financial success. Since VNSNY CHOICE is also being judged by how our members answer these questions, we re in this with you! As always, if you have any suggestions about how to improve member perception, feel free to email me your ideas to richard.bernstein@vnsny.org. Richard H Bernstein, MD, FACP Chief Medical Officer Provider Relations Department of VNSNY CHOICE Sponsors a Food Drive Meet the VNSNY CHOICE Provider Relations Department! Elizabeth Alvarez Manhattan & Queens MLTC Nicole De La Vega Brooklyn & Queens Medicare Sergio Ferguson Bronx MLTC Hopeton Gordon Brooklyn Medicare Ben Greis Queens Medicare Carl Ross-Jennings Bronx & S.I. Medicare, S.I. MLTC Stephen Lai CAIPA Pictured in the photo as they packed up the goods for delivery to the Food Bank are, from left to right: Melissa Stinnett (Business Analyst), Vidya Motiram (Network Development Coordinator), Victor Roque (Data Analyst), and Christine Montanez (Credentialing Specialist). During the last two weeks of April, volunteers from the Provider Relations Department of VNSNY CHOICE sponsored a food drive to benefit the Food Bank for New York City. The Food Bank provides food to needy New Yorkers throughout the five boroughs, both directly and through local food pantries. Widlyne Mentor Brooklyn & Queens Medicare Elizabeth Vargas Manhattan Medicare The VNSNY food drive, which was held at 1250 Broadway, collected more than 700 items (canned and boxed goods) and raised $200. The Provider Relations team hopes to make this an annual event and raise even more food and money next year..
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4 The double impact of caring for caregivers When you have a patient with a family caregiver, you have a unique opportunity to help two people at once. Clinical studies show that many caregivers are under debilitating stress, which can inhibit their ability to provide effective help to those in their care -- and yours. VNSNY CHOICE understands the needs of aging, chronically ill New Yorkers and their caregivers; we created this "Resources for Caregivers" tool to help you provide added support to the family members you serve.
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VNSNY CHOICE 1250 Broadway, 11th Floor New York, NY 10001 How to Reach Us Provider Services: Phone: 1-866-783-0222 Monday through Friday from 8:00 AM to 8:00 PM www.vnsnychoice.org Expanded Medical Management Hours Our Medical Management Department now has weekend hours. You can call 1-866-597-6674 and press option 2 between 9:00 am and 5:00 pm, Saturdays and Sundays, to speak with a nurse regarding urgent member issues. Our regular business hours are 8:00 am to 5:00 pm, Monday to Friday. Remember to drink enough water during the hot summer months to prevent dehydration, heat exhaustion and heat stroke seniors are especially at risk for these heat-related issues, so remind your patients to do so, too. A reminder Remember to drink enough water during the hot summer months to prevent dehydration, heat exhaustion and heat stroke seniors are especially at risk for these heat-related issues, so remind your patients to do so, too. Has your office moved? Have you added a practice location? Remember to notify VNSNY CHOICE of changes to your office address or telephone number so we can update our records, including provider directories.