Patient Satisfaction in Quality of Managed Care Aspect to be compared

Gender and Patient

Satisfaction in Managed Care, etc.

Stakeholder Perceptions of Quality in Managed Care Plans

Two Steps to Enhance Managed Care Quality

Author(s)/Date

Emily Weisman, MS

Martha Romans

Jacobs Institute of Women's Health

Washington, DC

Carolyn M. Clancy, MD

Paul L. Grimaldi, Ph.D.

To determine what the differences are and what variables might affect women patients' perceptions of the quality of managed care

To find out what attributes three different health care stakeholders, physicians, employers and consumers, value most in determining their assessments of the quality of managed care health plans

To explain the ramifications of two developments in managed care: the new application form for MCOs to become Medicare risk contractors, and the National Committee for Quality Assurance plan to begin performance-based accreditation.

Hypotheses

Determining what the differences between men's and women's perceptions of the quality of health care may mean to the outcome of care; hypothesis was that the differences were minor despite women's different patterns of visiting doctors.

The three stakeholder groups view quality differently; consumers want good care and good customer service; physicians want autonomy; employers want value at low cost and good work ethics and so on. Knowing the nature and extent of these differences would help managed care organizations better serve each group.

That the two steps enumerated will cause an increase in health care costs.

Subjects

The subjects were survey respondents of NCQA and contains 97,873 men and women aged 18 and over) who were enrolled in 206 commercial managed care health plans and completed the HEDIS/CAHPS survey administered between February and May 1999.

Focus groups of employees, physicians and consumers were used to develop information, which was followed up by a questionnaire.

None for this article per se; however, he identifies subject groups MCOs might survey vis-a-vis the two factors of managed care he is explaining

Location

Harrisonburg, Va. area

Equipment/Materials

As aggregate data was used from other studies, only computers and other data handling equipment would be needed.

Audiotape machines for the focus groups, as well as some means of transcription, and means of sending out questionnaires.

Virtually none.

Duration

Feb.-May 1999

Several phases, although specific length of time not given.

Procedure

Acquire data set from NQHA; decide which respondents' answers not to use; decide which...

"Second, gender-stratified analyses of the predictors of satisfaction levels are useful for identifying mutable health plan characteristics that are associated with women's satisfaction and can be the focus of quality improvement efforts within health plans.
Third, the study suggests ways in which consumer satisfaction tools may be modified to improve sensitivity to women's health care."

Stakeholders of different groups perceive the attributes of MCO plans differently; the implications of this are that it is incumbent on designers of health plans to be careful to design them with those features most important to the consumers to gain greater acceptance.

The new MCO application form and the performance-based accreditation plan will cause health care costs to rise dramatically.

Authors' suggestions for further study (if any)

Is for-profit health service contradictory to good care or a perception of good care by women?

Additional study of care structure quality and perceptions of stakeholders.

Outline: Comparison of Studies

I. General subject area

A. Gender and Patient Satisfaction in Managed Care: definition

B. Stakeholder Perceptions of Quality in Managed Care Plans: definition

C. Two Steps…