March 1, 2017
Premera conducts annual research with our customers and providers about access to practitioner appointments as part of our commitment to healthcare safety and quality.
This research focuses on the customers' ability to access appointments. We have a documented Practitioner Accessibility of Services policy to ensure our networks include sufficient numbers and types of primary care, behavioral healthcare, and specialty care practitioners to meet our customers' needs.
Read more about access to different types of practitioners.
Primary Care Practitioners
As part of our research, we review data from the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) conducted by the federal government.
The 2016 CAHPS survey of our customers showed satisfaction with access to primary care practitioners (PCPs) (in all service areas) was just one-half percent below the 83 percent national average for access to a routine care appointment. Customer satisfaction regarding access to a PCP for urgent care was 86 percent, 2 percent below the national average and a 3 percent decrease from 2015.
Behavioral Healthcare Practitioners
We captured behavioral healthcare practitioner (BHP) information through a telephone survey with a random sample of practitioners in Washington and Alaska. Among all BHPs, 89 percent reported they were available to clients within 10 business days for a routine care appointment, while 85 percent were available for follow-up care appointments. For urgent care appointments, 77 percent of Washington BHPs were available to clients within 48 hours, and 67 percent of Alaska BHPs had an available appointment open for urgent care.
For the majority of BHPs, it was challenging to provide access to care within 6 hours for a non-life-threatening emergency. Among the BHPs surveyed, 48 percent of Washington practitioners and 35 percent of Alaska practitioners stated they were available to clients within 6 hours for a non-life-threatening emergency.
Specialty Care Practitioners
Washington
In Washington, Premera has an extensive commercial market share. The network is robust, with more than 90 percent of the state's physicians contracted. New in 2017, specific specialty care practitioner (SCP) CP types will be identified and surveyed as high-volume or high-impact specialists.
Alaska
The Alaska market poses unique challenges to practitioner contracting and member access to appointments. Although Alaska specialists also had gaps in appointment availability, Alaska members were very satisfied with their ability to get a specialist appointment when needed. The 2016 CAHPS survey results showed an overall improvement of 10.4 percent in member satisfaction from the previous year.
An important commitment
By evaluating how well our customers can access appointments, Premera can better support customer safety and improve customer satisfaction with practitioners and the health plan.