OPERATIONS UPDATE
"Survey conducted for RBHA contracted providers in Arizona to assess satisfaction levels with claims processing, resolution, timeliness, customer service, and more. Results and comparisons among Mercy Maricopa Integrated Care, Cenpatico Integrated Care, and Health Choice Integrated Care providers."
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Presentation Transcript
OPERATIONS UPDATE AHCCCS RBHA Provider Survey 2016 Reaching across Arizona to provide comprehensive quality health care for those in need 1
RBHA Provider Survey Survey was developed using web-based provider of survey solutions, Survey Monkey Survey for all RBHA contracted providers RBHAs disseminated survey to providers. Also available on the AHCCCS website 10/1/16 10/31/16 Reaching across Arizona to provide comprehensive quality health care for those in need 2
Survey Questions How satisfied are you with this RBHAs processing of your initial claims? How satisfied are you with this RBHAs resolution of your claims issues? How satisfied are you with this RBHAs timeliness of resolution of your claims issues? How satisfied are you with this RBHAs claims customer service department? How satisfied are you with this RBHAs provider services staff? How satisfied are you with this RBHAs credentialing process? Reaching across Arizona to provide comprehensive quality health care for those in need 3
Survey Response AHCCCS received a total of 308 responses: # of Contracted Survey Respondents who Completed the Survey RBHA Mercy Maricopa Integrated Care 113 Cenpatico Integrated Care 122 Health Choice Integrated Care 73 Reaching across Arizona to provide comprehensive quality health care for those in need 4
How RBHAs Compare How satisfied are you with the RBHA'sprocessing of your initial claims? 100% 18% 90% 31% 80% 42% 70% 60% Dissatisfied 50% 82% 40% Satisfied 69% 30% 58% 20% 10% 0% Mercy Maricopa Integrated Care Cenpatico Integrated Care Health Choice Integrated Care Reaching across Arizona to provide comprehensive quality health care for those in need 5
How RBHAs Compare How satisfied are you with the RBHA's resolution of your claims issues? 100% 19% 90% 39% 80% 43% 70% 60% Dissatisfied 50% Satisfied 81% 40% 61% 30% 57% 20% 10% 0% Mercy Maricopa Integrated Care Cenpatico Integrated Care Health Choice Integrated Care Reaching across Arizona to provide comprehensive quality health care for those in need 6
How RBHAs Compare How satisfied are you with the RBHA's timeliness of resolution of your claims issues? 100% 90% 22% 80% 44% 55% 70% 60% Dissatisfied 50% Satisfied 40% 78% 30% 56% 45% 20% 10% 0% Mercy Maricopa Integrated Care Cenpatico Integrated Care Health Choice Integrated Care Reaching across Arizona to provide comprehensive quality health care for those in need 7
How RBHAs Compare How satisfied are you with the RBHA'sClaims Customer Service? 100% 18% 90% 38% 80% 42% 70% 60% Dissatisfied 50% 82% 40% Satisfied 62% 30% 58% 20% 10% 0% Mercy Maricopa Integrated Care Cenpatico Integrated Care Health Choice Integrated Care Reaching across Arizona to provide comprehensive quality health care for those in need 8
How RBHAs Compare How satisfied are you with the RBHA's Provider Service Staff? 100% 90% 21% 28% 80% 43% 70% 60% Dissatisfied 50% Satisfied 40% 79% 72% 30% 57% 20% 10% 0% Mercy Maricopa Integrated Care Cenpatico Integrated Care Health Choice Integrated Care Reaching across Arizona to provide comprehensive quality health care for those in need 9
How RBHAs Compare How satisfied are you with the RBHA's credentialing process? 100% 90% 23% 39% 39% 80% 70% 60% 50% Dissatisfied 40% 77% Satisfied 62% 61% 30% 20% 10% 0% Mercy Maricopa Integrated Care Cenpatico Integrated Care Health Choice Integrated Care Reaching across Arizona to provide comprehensive quality health care for those in need 10
Overall Findings Most satisfaction o RBHA performance with processing of initial claims and provider services staff. Comments o 105 total comments across all RBHAs Provider satisfaction 2016: 30.1% Provider dissatisfaction 2016: 69.9% Most dissatisfaction o RBHA performance with resolution of claims issues,timeliness of resolution of claims issues and credentialing. o Dissatisfied responses indicate a desire for RBHA improvement in the efficiency and responsiveness of resolution of claims issues, particularly related to timeliness of resolution, subsequent payment, and efficient and responsive customer service. Reaching across Arizona to provide comprehensive quality health care for those in need 11
Follow-up Actions & Expectations RBHAs o Discuss the survey results at your Quarterly Health Plan Update meeting with the Director. Planned course of action to address needed improvements Strengths and challenges Correlation of implemented strategies to results 12
Follow-up Actions & Expectations AHCCCS Survey Report posted to the AHCCCS web in February / March 2017 Individual RBHA reports to be issued to RBHAs three weeks prior to Quarterly Health Plan Update meeting with AHCCCS Director. Reaching across Arizona to provide comprehensive quality health care for those in need 13
Questions? Reaching across Arizona to provide comprehensive quality health care for those in need 14
