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 third quarter of 2013, surveys were mailed to the 434 PCP practices in the AmeriHealth New Jersey network that have 50 or more members; the survey had a 12.7 percent response rate.

PCP satisfaction with discharge summary

(Most or Always) Organizational provider type Receipt of discharge summary Hospital 67.9% Skilled nursing facility 45.8% Emergency room 63.5%

The PCP satisfaction survey reflects that PCPs were most satisfied with the rate of receipt of discharge summaries from hospitals.

PCP satisfaction with exchange of information with organizational providers

(Very satisfied or Satisfied) Organizational provider type Frequency Quality Timeliness Confidentiality Hospital 64.2% 75.5% 69.2% 72.5% Skilled nursing facility 40.4% 47.9% 51.1% 70.2% Emergency room 59.6% 61.5% 68.6% 72.5%

With respect to the flow of information from organizational providers, PCP satisfaction with confidentiality of information exchange was the highest area overall. In general, PCPs were the most satisfied with the frequency, quality, and timeliness of information received from hospitals.

PCPs were the least satisfied with the frequency, quality, timeliness, and confidentiality of information from skilled nursing facilities.

PCP satisfaction with exchange of information with specialists and laboratories

(Very satisfied or Satisfied)

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. Specialist type Frequency Quality Timeliness Confidentiality Cardiology 87.0% 88.9% 82.4% 90.2% Endocrinology 72.2% 79.6% 72.5% 86.3% Allergy/Pulmonary 79.6% 87.0% 76.5% 90.2% Ophthalmology/Optometry 55.6% 75.9% 66.7% 86.3% Laboratory 87.0% 87.0% 88.2% 90.0%

PCP satisfaction with the confidentiality of information exchange with all specialist types and the flow of information from laboratories was the highest category overall. Satisfaction with the quality of information from cardiologists was the highest. Cardiology and laboratory both were rated to have the highest score for the frequency of information received. Laboratories received the highest rate for the timeliness of receipt of information. Opportunities for improvement were noted with respect to PCP satisfaction with the frequency and timeliness of information exchange with endocrinologists and ophthalmologists/optometrists.

PCP satisfaction with the exchange of information with behavioral health practitioners represents an opportunity for improvement for all measures (ranging from 18.0 percent to 28.0 percent).

Continuing efforts

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:

• Members are encouraged 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 behavioral health issues through articles in Partners in Health Update and our website. The PCP to Behavioral Health Provider Communication Form was instituted specifically to promote communication between PCPs and behavioral health practitioners and is also available on our website.

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 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.