Oregon’s CCOs: A Deep Look at Patients’ Take on AllCare

This is the first story in a new Lund Report series, which will examine the results of in-depth surveys among members of the state’s coordinated care organizations

Patients of Grants Pass-based AllCare Health, one of Oregon’s 16 Medicaid-funded coordinated care organizations, are demographically different: they are more likely to be men, less likely to hold a post-graduate degree, and whiter than CCO members as a whole, across the state.

But according to an in-depth survey aimed at understanding how well the state’s CCOs are serving patients, AllCare delivers quality at a similar rate to the other plans under the Oregon Health Plan umbrella, according to its “Banner Book,” the label given to a series of 340-page documents that assesses the state’s CCOs. Commissioned by the Oregon Health Authority, these documents were created after 12 weeks of surveys conducted earlier this year, offered in both English and Spanish that attempted to sample 900 members of each CCO.

This week, The Lund Report launches an examination of the survey results, by looking at how adult members of AllCare say their health insurance measures up. In the coming weeks, we’ll look at the same surveys at the state’s other CCOs, and we will conclude this series by comparing their performance to see if some CCOs rate considerably better or worse than others.

Data on CCOs is plentiful, and The Lund Report has reported in the past on profits and revenue at these organizations and membership growth. But the Banner Books take a different approach, asking members if they received the care they needed, whether care was available quickly, how well doctors communicated with them, how well each health plan’s customer service works, and how much input patients had into decision making.

On most metrics, AllCare’s members reported experiences similar to patients at other CCOs across the state: Less than 1 percent said the care they received was the worst imaginable, virtually identical to the overall view of all Oregon Health Plan members; 69 percent of AllCare members said on a scale of zero to 10, they’d rate the quality of care they receive at 8 or higher – while 67 percent of all CCO members in Oregon feel the same way.

AllCare was also virtually identical to the Oregon Health Plan average on survey results about how easy it is for people to access care (79 percent said it was usually or always easy), how well doctors explained things (91 percent explanations were always or usually easy to understand), on how easy it was to fill out CCO paperwork (93 percent said it is usually or always easy to fill out).

But there were a few areas where AllCare was different than the average of all CCOs in the state, according to the results reported by survey company DataStat Inc, which ultimately received 350 responses from AllCare’s members, after reaching out to 900 people. A comparison of AllCare’s sickest and healthiest members shows that not everyone in the CCO feels the same way about the care and service they receive.

Where AllCare is different than other CCOS

When seeking special therapy, such as physical, occupational or speech therapy, AllCare patients reported that they had a harder time accessing care than patients of CCOs in general. About 32 percent of those who sought special therapy said it was never easy to get services compared to 23 percent of all Oregon Health Plan patients. And 50 percent of AllCare members said it was always or usually easy to access special therapy – compared to 60 percent of all Oregon Health Plan patients.

Also, AllCare members were less likely to have received a flu shot or nasal spray compared to those in other CCOs, with 29 percent saying they were inoculated, compared to 37 percent of CCO patients overall.

But AllCare’s medical providers were more likely than their peers across the state to put in a lot of effort, according to patient assessments:

  • 70 percent said a lot of effort was made to help them understand their health issue, compared to 64 percent of all CCO members.
  • 68 percent said a lot of effort was made to listen to the things that matter most to them, compare to 63 percent of all CCO members.
  • 64 percent said a lot of effort was made to including what matters most to them in choosing how to proceed with care, compared to 58 percent of all CCO patients.

AllCare’s dental services ranked higher than the statewide average as well, with 53 percent of its members saying they could usually or always see a dentist right away after an emergency (and 25 percent not getting dental care in that situation), compared with 44 percent of all CCO members who said they could usually or always seeing a dentist right away after an emergency (and 37 percent not getting dental care in such a situation).

Sicker patients less satisfied than healthier ones

Survey results also looked at how AllCare’s healthiest members answered questions differently than those who had more chronic conditions. Perhaps unsurprisingly, those whose health is generally good, and need less care, reported having a better experience navigating the system.

Among AllCare members who were in good or excellent health, 94 percent said they always have enough time with their doctors; but only 54 percent of people in fair or poor health had such an experience.

Of patients in good or excellent health, 84 percent said they have one of the best possible doctors – ranking eight or higher on a scale of zero to 10 – while only 67 percent of people in fair or poor health agreed.

About 62 percent of people in good or excellent health said they always got an appointment to see a specialist as soon as needed; 42 percent of people in fair or poor health said the same.

How often do AllCare providers make it easy to ask questions or raise concerns? Always, according to 62 percent of people in good or excellent health; only 47 percent of people in fair and poor health say it’s always easy to ask questions or raise concerns.

Of people in good or excellent health, 73 percent say they can definitely trust their doctor or provider; but only 58 percent of people in fair or poor health agreed,

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Courtney Sherwood investigates public records and digs into data for The Lund Report. Reach her at [email protected], or follow her on Twitter at @csherwood.

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