[
AmeriHealth New Jersey monitors and
takes appropriate action to improve the continuity and coordination of care
between primary care physicians (PCPs), specialists, and organizational
providers (hospitals, skilled nursing facilities, and emergency rooms). The PCP
satisfaction survey is used to assess satisfaction with the rate of receipt and
exchange of information between PCPs and specialists, as well as between PCPs
and these three organizational provider types. In the fourth quarter of 2012,
surveys were mailed to all 417 PCP practices in the AmeriHealth New Jersey
network with 50 or more members; the survey had a 22.3 percent response rate.
Receipt of discharge summary
(Most/Always)
|
|
|
|
Hospital
|
59.3%
|
|
Skilled nursing facility
|
51.2%
|
|
Emergency room
|
60.4%
|
The PCP satisfaction survey reflects
that PCPs were most satisfied with the rate of receipt of discharge summaries
from emergency rooms.
PCP satisfaction with exchange of
information with organizational providers
(Very satisfied/Satisfied)
|
|
|
|
|
|
|
Hospital
|
51.6%
|
62.0%
|
45.6%
|
82.0%
|
|
Skilled nursing facility
|
43.5%
|
46.5%
|
38.1%
|
73.5%
|
|
Emergency room
|
56.5%
|
59.8%
|
52.2%
|
82.2%
|
With respect to the flow of information
from organizational providers, PCP satisfaction with confidentiality of
information exchange was the highest area overall. PCPs were most satisfied
with the frequency and timeliness of the information from emergency rooms. For
quality, PCPs were the most satisfied with hospitals. PCPs were the least
satisfied with the frequency, quality, timeliness, and confidentiality of
information from skilled nursing facilities.
PCPs were also asked to assess their
satisfaction with the exchange of information with select high-volume
specialists and laboratories to ensure continuity and coordination of care in
the management of patients with chronic conditions such as diabetes, asthma,
and coronary artery disease.
PCP satisfaction with exchange of
information with specialists and laboratories
(Very satisfied/Satisfied)
|
|
|
|
|
|
|
Cardiology
|
87.6%
|
91.1%
|
83.5%
|
92.3%
|
|
Endocrinology
|
74.2%
|
83.3%
|
83.5%
|
90.0%
|
|
Allergy/Pulmonary
|
84.3%
|
88.9%
|
73.6%
|
91.2%
|
|
Ophthalmology/Optometry
|
71.9%
|
83.3%
|
69.2%
|
88.8%
|
|
Laboratories
|
90.8%
|
88.2%
|
91.2%
|
91.1%
|
PCP satisfaction with the
confidentiality of information exchange with all specialist types (except
ophthalmology/optometry) and the flow of information from laboratories was
above 90 percent. Satisfaction with the quality of information from cardiology
and the frequency and timeliness of information exchange from laboratories was
also above 90 percent. Opportunities for improvement were noted with respect to
PCP satisfaction with the frequency of information exchange with endocrinology
and ophthalmology/optometry and timeliness of information exchange with
allergy/pulmonary and ophthalmology/optometry.
PCP satisfaction with the exchange of
information with behavioral health practitioners represents an opportunity for
improvement for all measures (ranging from 18.2 percent to 40 percent).
AmeriHealth New Jersey
continues its efforts to promote communication between practitioners and
organizational providers in order to enhance the continuity, coordination,
quality, and safety of patient care including, but not limited to:
- Member publications encourage
members to take an active role in their care and to advise their PCP or
personal physician of any urgent/emergent or inpatient care received, to allow
for coordination of follow-up care.
- Efforts to improve
coordination of care between behavioral health providers and PCPs are ongoing
and include the availability of overview guides on substance-use, depression,
and suicide, which are available under Worksheets,
Forms, and Guides within the Resources for Patient Management section of
our website. The PCP to Behavioral Health Provider
Communication Form, also available on our website, was instituted
specifically to promote communication between PCPs and behavioral health
providers.
In addition, AmeriHealth New Jersey
will take steps to reinforce the importance of timely and appropriate
dissemination of discharge information by participating organizational
providers. We also encourage PCPs and specialists to ensure the exchange of
information and to provide feedback to facilities, as appropriate, regarding
the frequency, quality, timeliness, and confidentiality of information received
from organizational providers. Our goal is to facilitate coordination of care
management and to ensure the healthiest outcomes for our members.
Thank you to those providers who
participated in the 2012 survey.
]