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Understanding variations in Medicare Consumer Assessment of Health Care Providers and Systems scores: California as an example.

Abstract：

OBJECTIVE:To understand reasons why California has lower Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores than the rest of the country, including differing patterns of CAHPS scores between Medicare Advantage (MA) and fee-for-service, effects of additional demographic characteristics of beneficiaries, and variation across MA plans within California. STUDY DESIGN/DATA COLLECTION:Using 2008 CAHPS survey data for fee-for-service Medicare beneficiaries and MA members, we compared mean case mix adjusted Medicare CAHPS scores for California and the remainder of the nation. PRINCIPAL FINDINGS:California fee-for-service Medicare had lower scores than non-California fee-for-service on 11 of 14 CAHPS measures; California MA had lower scores only for physician services measures and higher scores for other measures. Adding race/ethnicity and urbanity to risk adjustment improved California standing for all measures in both MA and fee-for-service. Within the MA plans, one large plan accounted for the positive performance in California MA; other California plans performed below national averages. CONCLUSIONS:This study shows that the mix of fee-for-service and MA enrollees, demographic characteristics of populations, and plan-specific factors can all play a role in observed regional variations. Anticipating value-based payments, further study of successful MA plans could generate lessons for enhancing patient experience for the Medicare population.

journal_name

Health Serv Res

journal_title

Health services research

authors

Farley DO,Elliott MN,Haviland AM,Slaughter ME,Heller A

doi

10.1111/j.1475-6773.2011.01279.x

subject

Has Abstract

pub_date

2011-10-01 00:00:00

pages

1646-62

issue

5

eissn

0017-9124

issn

1475-6773

journal_volume

46

pub_type

杂志文章

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