Arizona Health Care Cost Containment System Administrator Meeting

1. Arizona Health Care Cost Containment SystemAdministrator Meeting Quality Update March 19, 2014

2. CAHPS • CHPRA legislation required State Medicaid programs to conduct a CAHPS member satisfaction survey by December 2013 for the CHIP (KidsCare) population • The AHCCCS 2011 Demonstration Waiver requires AHCCCS to conduct the CAHPS survey for: • KidsCare in 2013 and at the end of the Waiver (2015) • SMI Integrated Population - pre-integration, mid-Waiver and at the end of the Waiver • CRS Integrated Population - pre-integration, mid-Waiver and at the end of the Waiver • Goal: The goal of the CAHPS Health Plan Survey is to provide performance feedback that is actionable and that will aid in improving overall member satisfaction

3. CAHPS Baseline Measurement • The 2013 CAHPS results represent a baseline assessment of member’s (or their parents’/caretakers’) satisfaction with the AHCCCS program across the following lines of business: • KidsCare • Acute • Seriously Mentally Ill (pre-integration) • Children’s Rehabilitative Services (pre-integration) • The CAHPS was completed by the CMS External Quality Review Organization, Health Services Advisory Group

4. CAHPS Survey Tool • In 2012, the Agency for Healthcare Research and Quality (AHRQ) released the CAHPS 5.0 Medicaid Health Plan Surveys • The National Committee for Quality Assurance (NCQA) introduced new HEDIS versions of the Child Health Plan Surveys in August 2012, which are referred to as the CAHPS 5.0 Child Medicaid Health Plan Surveys • There were no changes made to the four CAHPS global ratings: • Rating of Health Plan • Rating of All Health Care • Rating of Personal Doctor, and • Rating of Specialist Seen Most Often • This allowed comparisons to national data to be performed for all global rating categories

5. CAHPS Composite Measures • Getting Needed Care • Getting Care Quickly • How Well Doctors Communicate • Customer Service • Shared Decision Making • Coordination of Care • Health Promotion and Education • Children with Chronic Conditions

6. Scoring Methodology • The results of the health plan surveys were scored using the NCQA Star Ratings National Medicaid results. The rating scale is as follows: • ***** 90th Percentile or above • ****75th– 89th Percentile • ***50th– 74th Percentile • ** 25th – 49th Percentile • * Below 25thPercentile • For the children’s measures, the rates and proportions were compared to NCQA Child Medicaid Quality Compass data

7. KidsCare CAHPS Results • Results are at the Program Level only • The KidsCare program scored at or above the national average on seven measures: • Rating of Health Plan • Rating of All Health Care • Rating of Specialist Seen Most Often • Getting Needed Care • Getting Care Quickly • How Well Doctors Communicate • Customer Service

8. KidsCare CAHPS Opportunities for Improvement • Based on the results of the NCQA comparisons, priority assignments were derived for each measure • The following are the high priority areas for KidsCare: • Getting Care Quickly • How Well Doctors Communicate • Rating of Specialist Seen Most Often

9. KidsCare High and Low Percentile Results • KidsCare scored at or above the 90th percentile on one measure: • Rating of All Health Care • KidsCarescored below the 25th percentile on none of the measures

10. Acute Care Program Adult and Child Medicaid CAHPS Results • Acute Care Program: Results are at the Program Level and the Health Plan Level • Arizona Physicians IPA • Bridgeway Health Solutions • Department of Economic Security/Comprehensive Medical and Dental Program (DES/CMPD) • Care 1st Health Plan of Arizona • Health Choice Arizona • Maricopa Health Plan • Mercy Care Plan • Phoenix Health Plan • University Family Care • Acute Care Program Aggregate

11. CAHPS Adult Composite Results – NCQA Comparison

12. CAHPS Adult Composite Results – NCQA Comparison

13. Health Plan Satisfaction Ranking Based on Number of AdultMeasures at or Above the NCQA National Average

14. Adult Acute Care Health Plan NCQA Comparison Highlights

15. CAHPS ChildComposite Results – NCQA Comparison

16. CAHPS ChildComposite Results – NCQA Comparison

17. Health Plan Satisfaction Ranking Based on Number of Child Measures at or Above the NCQA National Average

18. Health Plan Satisfaction Ranking Based on Number of Child Measures at or Above the NCQA National Average

19. Child Acute Care Health Plan NCQA Comparison Highlights

20. CAHPS Results for the Seriously Mentally Ill (SMI) Program Pre-integration – reflects care in both the physical and the behavioral health plans

21. Health Care Satisfaction Ranking Based on Number of SMI Measures at or Above the NCQA National Average • The SMI members cored their health care at or above the national average on two measures: • Getting Needed Care • Customer Service • The SMI members scored their health care below the national average on seven measures: • Rating of Health Plan • Rating of All Health Care • Rating of Personal Doctor • Rating of Specialist Seen Most Often • Getting Care Quickly • How Well Doctors Communicate • Coordination of Care

22. High and Low Percentile Scores of SMI Member CAHPS Survey Results • The SMI Program scored at or above the 90th percentile on none of the measures • The SMI Program scored below the 25th percentile on six measures: • Rating of Health Plan • Rating of All Health Care • Rating of Personal Doctor • Rating of Specialist Seen Most Often • Getting Care Quickly • How Well Doctors Communicate

23. SMI Program’s Priority Assignments to Improve Member Satisfaction

24. CAHPS Results for the Children’s Rehabilitative Services Program – NCQA Comparison

25. CRS Program CAHPS Comparison to NCQA Averages • Results reflect pre-integration member satisfaction with an acute, CRS and behavioral health Contractor • The CRS Program scored at or above the national average on eight measures: • Rating of All Health Care • Rating of Personal Doctor • Rating of Specialist Seen Most Often • Getting Needed Care • Getting Care Quickly • How Well Doctors Communicate • Customer Service • Coordination of Care • The CRS Program scored below the national average on one measures: • Rating of Health Plan

26. High and Low Percentile Scores of CRS Members’ CAHPS Survey Results • The CRS Program scored at or above the 90th percentile on two measures” • Rating of Personal Doctor • Rating of Specialist Seen Most Often • The CRS Program scored below the 25th percentile on one measure: • Rating of Health Plan

27. CRS Program’s Priority Assignments to Improve Member Satisfaction

28. CAHPS Survey Results Next Steps • Contractors should review results and identify top priorities/opportunities to improve member satisfaction results • Contractors should review positive results and determine what the drivers were for the results • AHCCCS will notify Contractors of need to submit action plans to improve member satisfaction with its health plan • AHCCCS will identify priorities to improve systemic member satisfaction • AHCCCS will work with Contractors in the development of action plans to improve systemic member satisfaction