CareOregon's coordinated care organizations may all be administered by a single nonprofit, but their members report very different experiences.
Patients covered by Jackson Care Connect had an easier time accessing care through their health plan than people enrolled in other CCOs across the state. At Columbia Pacific CCO, members had a harder-than-average time getting in to see a specialist. And Yamhill Community Care members said they had a harder time accessing special therapy, like occupational or physical therapy. (Yamhill's plans are administered by CareOregon, but not owned by it.)
Those are among the experience revealed by CareOregon’s three CCO's “Banner Books,” the label given to a series of 340-page documents that assesses the state of Oregon’s Medicaid-funded health plans. 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 and seeking to sample 900 members of each CCO.
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.
In this the second story in a The Lund Report examination of the survey results, we are looking at how adult members of three Care Oregon CCOs say their health insurance measures up. A fourth CCO affiliated with Care Oregon, Health Share, will be reviewed in a future story. We started the series with a look at AllCare Health.
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.
Columbia Pacific CCO
Columbia Pacific CCO serves Columbia, Clatsop and Tillamook counties.
On most metrics, Columbia Pacific’s members reported experiences similar to patients at other CCOs across the state:
- 81 percent said it was usually or always easy to get the care, tests or treatment they needed.
- 94 percent said their doctor usually or always explained things in a way that was easy to understand.
- 90 percent said the health plan’s customer service treated them with courtesy and respect.
But there were a few areas where Columbia Pacific was different than the average of all CCOs in the state, according to the results reported by survey company DataStat Inc.:
- Worse than average: 64 percent of its members said they usually or always could see a specialist as soon as they needed, compared to a statewide average of 75 percent.
- Better than average: 73 percent of Columbia Pacific’s members said that it was easy to get specialized therapy, such as physical, occupational or speech therapy, compared to a statewide average of 73 percent; tobacco users were slightly more likely to be encouraged to quit (55 percent within the plan, compared to 50 percent statewide); 73 percent said they could usually or always get the medical equipment they needed, compared to 63 percent statewide.
As with other CCOs, its members reported discrepancy in how they were treated depending on how healthy they were when they sought care.
Of those in good health, 79 percent said their doctor always explained things in a way that was easy to understand; 96 percent said their doctor always or usually listened carefully; and 91 percent said their doctor never used a condescending, rude or sarcastic tone. Among people in fair or poor health, 62 percent said that their doctor always explained things in a way that was easy to understand; 84 percent said their doctor always or usually listened carefully; and 76 percent said their doctor never used a condescending, rude or sarcastic tone.
Men and women also reported statistically significant differences in how they responded to some questions. Men said their doctor always or usually explained things in a way that was easy to understand about 98 percent of the time, compared to 92 percent of the time for women.
On another question, patients were asked, “Using any number from 0 to 10, 0 is worst and 10 is best, what number would you use to rate your personal doctor?” Men gave a top score, of 8, 9 or 10, 84 percent of the time. Women gave a top score of 8, 9 or 10 only 77 percent of the time.
Jackson Care Connect
Jackson Care Connect serves Jackson County.
On most metrics, Jackson Care’s members reported experiences similar to patients at other CCOs across the state. For example:
- 95 percent said their doctor usually or always explained things in a way that was easy to understand.
- 79 percent said the health plan’s customer service treated them with courtesy and respect.
But there were a few areas where it was different than the average of all CCOs in the state, with Jackson Care doing better than average nearly every time:
- 87 percent said it was usually or always easy to get the care, tests or treatment they needed, compared to a statewide average of 80 percent of CCO members
- 94 percent said their doctor usually or always spent enough time with them, compared to a statewide average of 87 percent
- 89 percent said their doctor seemed informed and up-to-date, compared to 79 percent statewide.
- Asked to rank their doctor on a scale of 0 to 10, 84 percent of Jackson Care members gave their providers a top score of 8, 9 or 10 – while only 76 percent of all CCO members statewide ranked their doctors that high.
In only one area did Jackson Care lag behind: flu inoculation. Only 27 percent of its members said they had received either a flu shot or flu nasal spray in the previous six months, compared to a statewide average of 37 percent.
Of members in good health, 98 percent said their doctor explained things in a way that was easy to understand; 92 percent said their doctor made a lot of effort or some effort to listen to the things that matter most about their health.
Of members in fair or poor health, 90 percent said their doctor explained things in a way that was easy to understand; 76 percent said their doctor made a lot of effort or some effort to listen to the things that matter most about their health.
When asked how easy their medical provider made it to ask questions or raise concerns, 76 percent of men answered always or usually, compared to 87 percent of women.
However, on a number of survey questions it was not possible to draw a statistically meaningful conclusion about how well this CCO served healthier or sicker members, or how women or men responded differently to the same question, because not enough people responded to the survey.
Yamhill Community Care
Yamhill Community Care has members in Yamhill County as well as in parts of Clackamas, Washington, Polk, Marion and Tillamook counties. Though it is administered by CareOregon, Yamhill is not owned by the larger organization.
On most metrics, Yamhill’s members reported experiences similar to patients at other CCOs across the state. For example:
- 81 percent said it was usually or always easy to get the care, tests or treatment they needed.
- 81 percent said their doctor usually or always explained things in a way that was easy to understand.
- 72 percent said the health plan’s customer service treated them with courtesy and respect.
But there were two areas where it lagged behind the average of all CCOs in the state:
- 36 percent of Yamhill CCO members said it was never easy to get the special therapy, such as physical, occupational or speech therapy, they needed, compared to a statewide average of 23 percent.
- 29 percent of its members said they had received either a flu shot or flu nasal spray in the previous six months, compared to a statewide average of 37 percent.
Of members in good health, when asked to rate the quality of their health care on a scale of 0 to 10, 74 percent gave a top score of 8, 9 or 10; 70 percent said their doctor always spent enough time with them;
84 percent said their own personal doctor would rate a top score; 97 percent said forms related to the plan were easy to fill out; 68 percent gave the total health plan a top score; 53 percent said it was easy to ask questions or raise a concern with their provider; 71 percent said they definitely trust their health provider with their care.
Of members in fair or poor health, when asked to rate the quality of their health care on a scale of 0 to 10, 50 percent gave a top score of 8, 9 or 10; 50 percent said their doctor always spent enough time with them; 64 percent said their own personal doctor would rate a top score; 88 percent said forms related to the plan were easy to fill out; 40 percent gave the total plan a top score; 37 percent said it was easy to ask questions or raise a concern with their provider; 48 percent said they definitely trust their health provider with their care.
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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.
