Washington Health Alliance survey finds provider’s knowledge of the patient and effective communication are most critical elements of the patient’s experience


Patient experience survey sent to more than 181,000 patients in 14 Washington counties finds some improvement over previous surveys, but Washington state is still lagging behind national benchmarks

SEATTLE, February 25, 2016 – Many patients are having a hard time getting timely appointments, care and information. By contrast, patients say provider communication is improving.  Overall, providers are not reaching national quality benchmarks.

These are some of the key findings of a survey that measures patients’ experiences with Washington state primary care providers, an initiative called Your Voice Matters. This is the third time that the Washington Health Alliance (Alliance) has administered this nationally developed and standardized patient experience survey, and the survey has grown in size each time. The Alliance is the only organization in Washington state to systematically ask patients about their primary care experience and make comparable results publicly available.

Patient experience is an important element of overall care. Research shows that, in addition to improved clinical outcomes, excellent patient experience is an outcome unto itself, and one that is highly valued by patients. Patients want to be respected, feel heard, get the care that they feel they need when they need it, and understand their health conditions.

“Creating a pattern of positive patient experience is very important,” said Susie Dade, deputy director of the Alliance. “Reliably knowing what to expect from your provider when you seek care creates trust and lays the foundation for improving the health and well-being of the patient.”

Patient experience is also an important component of health care value―high-quality care and good patient experience delivered for a fair price. Value in health care has become a top priority of both health care leaders and consumers and there is a heightened market focus on patient experience. In 2014, through an effort led by the Governor’s Office and the Washington State Health Care Authority, Washington State adopted a Common Measure Set for Health Care Quality and Cost. Measures of patient experience are included in this measure set – both for hospitals and physician practices. The Common Measure Set is being used to evaluate performance and to support value-based purchasing, where health care provider payment is linked to performance.

The survey results are summarized in five categories: getting timely appointments, care and information; how well providers communicate with patients; how well providers use information to coordinate care; helpful, courteous and respectful office staff; and the patient’s overall rating of the provider. The performance results reflect the “top box” score, the percentage of patients whose responses indicate high performance for a given measure.

Four medical groups scored above the state average in all five categories: Center for Women’s Health at Evergreen, Hall Health Primary Care Center, Minor & James Medical and The Polyclinic.

Among the survey’s highlights:

  • Variation among medical groups and clinics continues to be an issue.
  • Getting timely appointments, care and information is what the state needs to improve the most.
  • Provider communication has improved, but helpfulness and courteousness of office staff as well as patient’s overall rating of the provider has not changed significantly since the last survey.
  • 30% of patients visited an ER for care they felt they needed right away and 26% of these patients did so because they could not get the care they needed from their primary care provider.
  • 30% of patients said their primary care provider never talked with them about a healthy diet and healthy eating habits and 19% of patients said their primary care provider never talked with them about exercise or physical activity
  • 63% of patients said that no one in their primary care provider’s office talked with them about alcohol or drug use
  • 85% of survey respondents indicated that their provider did not discuss the cost of care with them. However, only 12% of survey respondents indicated that they asked their provider or someone in the provider’s office how much they would have to pay for a health care service.

Nine variables explain 83 percent of the variation in the overall provider ratings

The Alliance conducted a key driver analysis based on results from this patient experience survey to understand what elements of the patient experience most highly correlate with the overall rating of care; in other words, what matters most to patients. The results show that nine variables, all concerning different aspects of effective provider communication and care coordination, explain 83 percent of the variation in the overall provider ratings. The results are very similar to those from the 2011 and 2013 patient experience surveys.

“Provider communication is paramount in affirming the patient’s experience of care. This is not to say that timely access to care and information is not important – it is.  And it’s very important as we work to reduce avoidable emergency room visits and hospital admissions,” said Ms. Dade. “But without that meaningful and positive relationship between the provider and patient, patients do not learn to trust and rely upon their primary care provider and his/her team.”

The Alliance survey was based on the nationally recognized Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Clinician & Group 12-Month Survey, also known as the CG-CAHPS Survey. CAHPS was introduced by the federal Agency for Healthcare Research and Quality (AHRQ) and has undergone rigorous scientific development and testing to ensure validity and reliability.

The survey was sent to approximately 181,000 adults in 14 counties in Washington (Benton, Chelan, Douglas, Franklin, King, Kitsap, Kittitas, Pierce, Skagit, Snohomish, Spokane, Thurston, Whatcom and Yakima). The patient sample was drawn from samples provided by Aetna, Cigna, Group Health Cooperative, Premera Blue Cross, Regence Blue Shield, UnitedHealthcare and the Washington State Health Care Authority (Medicaid). The Center for the Study of Services (CSS) fielded the survey on behalf of the Alliance.

Patients receiving the survey were asked to report their experiences with their health care provider and the provider’s staff over the last 12 months. Individual patient responses were kept absolutely confidential and were not seen by the patient’s provider, health plan or the Alliance. Scores are publicly reported for medical groups and clinics only if they meet a predetermined threshold for reliability.

In 2017, the Washington Health Alliance plans to conduct a patient experience survey for primary care medical groups and clinics of four or more providers throughout Washington’s 39 counties.

Media Contact:

John Gallagher, Director of Communication and Development
Washington Health Alliance

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