January 4, 2018
Appointment access is an important aspect of patient safety and satisfaction with practitioners and with the health plan. Premera has a Practitioner Accessibility of Services Policy that documents appointment accessibility expectations for primary care practitioners (PCPs), behavioral healthcare practitioners (BHPs), and specialty care practitioners (SCPs).
To maintain adequate networks and meet the needs and preferences of our membership, we annually collect and evaluate appointment accessibility data. We use a practitioner self-reported survey and the Consumer Assessment of Healthcare Providers and Systems (CAHPS) member satisfaction survey.
PCPs
The 2017 CAHPS survey showed member satisfaction with access to PCPs (in all service areas) was just 1.5 percentage points below the 83 percent national average for access to a routine care appointment. Member satisfaction regarding access to a PCP for urgent care was 88 percent, 1 percentage point below the national average.
BHPs
The BHP self-reported telephone survey used a random sample of practitioners in Washington and Alaska. Among those surveyed, 75 percent of all BHPs reported they were available to clients within 10 business days for a routine care appointment, and 80 percent were available for follow-up care appointments. For urgent care, 90 percent of Washington and 80 percent of Alaska BHPs were available to clients within 48 hours. Access to a BHP for a non-life threatening emergency within 6 hours is the most challenging for BHPs. In Washington, 64 percent of BHPs stated they were available to clients within 6 hours for a non-life threatening emergency, while only 48 percent of Alaska BHPs were similarly available.
SCPs
In Washington, only 48 percent of surveyed obstetricians/gynecologists (ob/gyn), and 40 percent of surveyed dermatologists had an open appointment within 15 business days. Oncologists had 89 percent availability, exceeding the 75 percent company goal, while orthopedic surgeons just fell short at 71 percent.
In Alaska, 84 percent of surveyed ob/gyms had an open appointment within 15 business days. With 73 percent availability, the orthopedic surgeons again just fell short of the 75 percent company goal for accessibility. Among surveyed oncologists, 80 percent were accessible within 15 business days, while only 33 percent of cardiologists surveyed had an open appointment within 15 business days.