Survey Brief
2019 CHP Patient Satisfaction Survey Measuring quality to demonstrate value
2019 CHP Patient Satisfaction Survey Brief The CHP Patient Satisfaction Survey (PSS) is a key feature of CHP’s Quality Management program. Now in its 19th year, the PSS continues to demonstrate the value of integrative healthcare (IH) and the quality of CHP IH providers. The purpose of the CHP Patient Satisfaction Survey is to measure patient satisfaction with CHP’s high-quality provider network and to identify potential opportunities to improve overall patient satisfaction. This year – as in previous years – CHP expanded the value of the survey with the inclusion of questions related to achieving the triple aim: better care, healthier people, and smarter spending. As patient experiences have become a key criterion in healthcare quality, these measures reflect patient satisfaction with the integrative healthcare provider and demonstrate compliance with treatment and improved health outcomes.1
Survey Methodology & Questions Survey participants included chiropractic and naturopathic physicians, licensed acupuncturists and licensed massage therapists on the CHP provider network. The respondents are a convenience sample of patients seen in the selected provider offices. The PSS includes questions from the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Clinician & Group Survey 3.0. This tool provides standardized survey questions and is recognized by the National Committee for Quality Assurance (NCQA) as an approved tool to assess patient satisfaction. The questions selected for the CHP PSS pertain to:
• Appointment accessibility, • Overall rating of the provider, • The provider’s knowledge of the patient’s medical history, • Provider communication including showing respect for what the patient had to say, time spent with them, and providing easy to understand explanations.
With an overall score of 98%, the CHP network of integrative healthcare providers continues to deliver a high level of patient satisfaction The responses from these questions provides valuable feedback to clinicians about how well they are performing across a range of important measures as well as specific opportunities for improvement. The survey also includes questions developed by CHP. These questions survey the patient’s assessment of providers engaging patients to
1 Xin H, Kilgore ML, Sen B. Is access to and use of primary care practices that patients perceive as having essential qualities of a patient-centered medical
home associated with positive patient experience? Empirical evidence from a U.S. nationally representative sample. Journal for Healthcare Quality. 2017; 39(1):4-14.
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Survey Details
10
200
536
questions
Timeframe
Sept/Oct 2019
provider participants
Number of Respondents by Discipline (Outer Ring) & Number of Providers With Responses By Discipline (Inner Ring) 3 20
patient responses
Chiropractor Naturopathic Physician Acupuncturist
54
10
44
Massage Therapist
2019 Overall Patient Satisfaction Score
98%
12 1
34
97%
0
Ten-Year Average Overall Patient Satisfaction Score
4 16 8
Average Score CAHPSÂŽ Questions 1-5 & 10
Average Score CHP Questions 6-9
Question 10 Rate Your Provider
DC
98%
94%
97%
ND
98%
93%
98%
LAc
98%
93%
98%
LMT
97%
93%
96%
Total
98%
93%
97%
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manage their condition as well as outcomes of the treatment or recommendations. Outcomes are inquired about in general and specifically, including reduced use of opioids/narcotics and reduced need for other conventional medical care as a result of treatments or recommendations by CHP integrative healthcare (IH) providers.
Survey Results Our 2019 survey results continue to show that patient satisfaction with CHP providers is at a high level across all categories of providers with the overall CAHPS® score for the 2019 survey at 98%. The average score for the past ten years is 97%. As in previous years, this year’s scores show remarkable consistency in patient satisfaction over time. The answers to the CHP questions (6-9) are evidence of high levels of quality as it relates to CHP providers engaging patients in their health care. Specifically, responses show that CHP providers have a positive impact on patients by improving their health, reducing their need for
opioid medications, and providing cost offsets in reducing the need for other medical care. In general, the breakdown of responses to Q6-9 have been highly positive year over year, especially when considering combined responses of “Always” and “Usually”. Question 8 shows slightly more variation, as N/A is an option on this questions for patients not taking opioids for their condition. The percentage of respondents that reported “Always” or “Usually” experiencing reduced usage of opioids as a result of the treatment or recommendations received from their CHP provider remains at a high level – 86%. This consistency of positive impact continues to demonstrate the value that our IH providers have on reducing opioid use amongst their patients. The average four-year response rate of 88% evidences the potential role of IH to provide a significant contribution to mitigating the on-going national opioid crisis.
Benchmark Comparison – IH vs. Conventional Care The 2018 CAHPS® Clinician & Group Survey
Question 8 Comparison | 2016-2019 Has the treatment or recommendation you have received from this provider reduced your use of opiate/ narcotic pain medications, for example: oxycodone, Vicodin?
2017
2018
2019
(32% or 261/829 answered w/out N/A)
(34% or 224/668 answered w/out N/A)
(22% or 95/434 answered w/out N/A)
(22% or 115/536 answer w/out N/A)
Always
63% 22% 8% 7%
73% 19% 5% 3%
62% 24% 9% 5%
66% 23% 5% 6%
Usually Sometimes Never
3
2016
Response
CHP Survey Question Details
Question 6 In the last six months, did this provider talk with you about specific things you can do to manage your condition?
86% stated always 12% stated usually 2% stated sometimes 0% stated never
Question 7 Has the treatment or recommendation you have received from this provider helped you?
83% stated always 16% stated usually 1% stated sometimes 0% stated never
Question 8 Has the treatment or recommendation you have received from this provider reduced your use of opiate/narcotic pain medications, for example: oxycodone, Vicodin?
66% stated always
Has the treatment or recommendation you have received from this provider reduced your use of other medical care for this condition?
59% stated always
23% stated usually 5% stated sometimes 6% stated never
Question 9 35% stated usually 4% stated sometimes 2% stated never
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(CG-CAHPS) Database Chartbook2 includes a total of 313,706 patient experience survey responses submitted voluntarily by 2,024 conventional medical practices across the US. There are five core measures included in the survey that address the following key areas:
level. Additionally, CHP’s overall score is 11.75% greater than the benchmark overall score. CHP providers also demonstrate higher levels of performance when benchmarked against the CAHPS® database in all three areas where we measure performance: access, provider communication, and provider rating.
• Access: getting timely appointments, care, and information
All four CHP disciplines performed well on Q10, “Rate Your Provider”, with chiropractic physicians rated at 97%, naturopathic physicians rated at 98%, licensed acupuncturists rated at 98%, and licensed massage therapists rated at 97%. These scores have remained at this high level over many years, and demonstrate patients’ consistently high level of satisfaction with CHP’s network providers.
• Provider communication: how well providers communicate with patients • Office staff: helpful, courteous, and respectful • Care coordination: providers’ use of information to coordinate patient care • Rating of provider The table below presents comparative data of the Patients’ Rating of the Provider from the Adult Survey 3.0 CAHPS database overall. It also compares several medical specialties with CHP providers. Comparing last year’s scores in this category, the benchmark scores decreased by 1-3% while CHP’s score remained at the same
2 Data collected January through December 2018.
Comparison of CAHPS® Adult Survey 3.0 Overall Rating of Provider, by Physician Specialty (2018) and CHP Combined Scores (2019) Patients rating the providers 9 or 10 where 10 is “Most satisfied” CAHPS® Internal Database Family Practice Orthopedics CHP Providers Medicine Overall 80%
5
77%
79%
78%
94%
Looking Forward The high patient satisfaction scores received by CHP network providers demonstrate our engagement in achieving the Triple Aim in healthcare: better care, healthier people, and smarter spending. At CHP, we are excited to be a part of the healthcare revolution that is focused on patient-centered care and demonstrates the value of integrative healthcare. There is increasing research evidence, that, when combined with patient satisfaction scores, shows the value of IH for conditions such as low back pain. These conditions may have previously required expensive imaging or even an opioid prescription and now are effectively treated with IH reducing the use of costly and potentially addictive interventions. This combination of research and patient satisfaction survey data shows that integrative healthcare can offer effective, evidence-based alternatives for treatment that delivers cost savings and safer alternatives for patients and payers alike.
The Triple Aim Better care
Improving the patient experience through better access, clearer communication, and the overall quality of the provider-patient interaction
Healthier people
Improving patient engagement with treatment recommendations, improvement of treatment outcomes, and a reduction in opioid usage
Smarter spending
Reduction of the cost of medical care including a reduction in the usage of low-value treatment options
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