Winter 2016/2017
Results of our Provider Satisfaction Survey completed in July 2016 indicate that overall satisfaction with Neighborhood declined, however not significantly, from 64% in 2015 to 55% in 2016.
Surveying provider satisfaction annually allows Neighborhood to gauge its network providers’ satisfaction with services performed by the Plan. An external survey vendor, Symphony Performance Health Analytics (SPHA), administered the survey and ensured a confidential mechanism for providers to report their experiences with Neighborhood.
Similar to 2015, we surveyed 922 network PCPs and medical specialists between May and July 2016, and 25% responded via mail, telephone or the Internet. Respondents were asked to rate Neighborhood compared to other health plans they work with on a five-point scale: Well below average, Somewhat below average, Average, Somewhat above average or Well above average.
The survey results reveal strengths and some areas for improvement:
- Three-quarters of responding providers (75%) said they would recommend the health plan to other physician’s practices.
- Provider satisfaction remains highest with ease of reaching health plan call center staff over the phone with over half (54%) rating Neighborhood above average, exceeding the SPHA Medicaid benchmark significantly (p < 0.05).
- Providers rating the Provider Services Specialist’s ability to answer questions and resolve problems as above average improved substantially from 32% in 2015 to 46% in 2016.
- Neighborhood was rated as average by a majority of responding providers on all six items related to utilization and quality management.
- Providers were least satisfied with aspects of Neighborhood’s formulary with four in ten (40%) rating the variety of branded drugs on the formulary as below average when compared to other health plans.
- Opportunities for improvement exist in the following areas: pharmacy, behavioral health, claims processing and reimbursement.
Some of the interventions implemented in 2016 to improve provider satisfaction include:
- Neighborhood and its behavioral health partner, Beacon Health Strategies, meeting with high-volume primary care sites to educate staff about available behavioral health resources.
- A streamlined mail room process implemented in Q1 2016 in Providence and then in May 2016 in the Plan’s new Smithfield location facilitates timely identification and routing of claims problems requiring resolution and reduces claims processing turn-around times.
- Neighborhood implemented a reimbursement increase for Exchange membership in September 2016.
Neighborhood’s next Provider Satisfaction Survey will be administered in the spring of 2017.