Implications of Variation in the Relationships between Beneficiary Characteristics and Medicare Advantage <scp>CAHPS</scp> Measures

Hatfield, Laura A.; Zaslavsky, Alan M.

doi:10.1111/1475-6773.12544

Cited by 7 publications

(10 citation statements)

References 30 publications

(48 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 11 , 12 For example, health organizations that use the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey to assess patient-reported satisfaction commonly adjust for a patient’s general and mental health status and educational level. 5 However, the association between race/ethnicity and patient satisfaction scores—and the consequent need to make statistical adjustments for patient race/ethnicity—remains uncertain. Many previous studies have examined differences in the patient satisfaction scores of black or African American and Hispanic patients relative to non-Hispanic white patients (hereafter simply referred to as white patients).…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] Furthermore, a growing body of literature has demonstrated that immutable, patient-level characteristics, such as age, overall health status, educational level, and race/ethnicity, serve as important determinants of patient-reported satisfaction. [4][5][6][7][8][9][10] To avoid possible measurement bias, health organizations adjust patient satisfaction scores for various characteristics, including age, sex, and health status. 11,12 For example, health organizations that use the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey to assess patient-reported satisfaction commonly adjust for a patient's general and mental health status and educational level.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of Outpatient Satisfaction Survey Scores for Asian Physicians and Non-Hispanic White Physicians

et al. 2019

View full text Add to dashboard Cite

Importance Patient satisfaction scores are used to inform decisions about physician compensation, and there remains a lack of consensus regarding the need to adjust scores for patient race/ethnicity. Previous research suggests that patients prefer physicians of the same race/ethnicity as themselves and that Asian patients provide lower satisfaction scores than non-Hispanic white patients. Objective To examine whether Asian physicians receive less favorable patient satisfaction scores relative to non-Hispanic white physicians. Design, Setting, and Participants This population-based survey study used data from Press Ganey Outpatient Medical Practice Surveys collected from December 1, 2010, to November 30, 2014, which included 149 775 patient survey responses for 962 physicians. Every month, 5 patients per physician were randomly selected to complete a satisfaction survey after an outpatient visit. Hierarchical multivariable logistic regression was used to examine the association between Asian race/ethnicity of the physician and racial/ethnic concordance of the patient with the probability of receiving the highest score on the survey item rating the likelihood to recommend the physician. Statistical analysis was performed from April 2 to August 27, 2018. Exposures Physician characteristics included race/ethnicity, sex, years in practice, and proportion of Asian patient responders. Patient characteristics included race/ethnicity, sex, age, and language spoken. Main Outcomes and Measures The highest score (a score of 5 on a 1-5 Likert scale, where 1 indicates very poor and 5 indicates very good) on the survey item rating the likelihood to recommend the physician on the Press Ganey Outpatient Medical Practice Survey. Results Of the 962 physicians in this study, 515 (53.5%) were women; physicians had a mean (SD) of 19.9 (9.1) years of experience since graduating medical school; 573 (59.6%) were white, and 350 (36.4%) were Asian. In unadjusted analyses, the odds of receiving the highest score on the survey item rating the likelihood to recommend the physician were lower for Asian physicians compared with non-Hispanic white physicians (odds ratio, 0.78; 95% CI, 0.72-0.84; P < .001). This association was not significant after adjusting for patient characteristics, including patient race/ethnicity. However, Asian patients were less likely to give the highest scores relative to non-Hispanic white patients (odds ratio, 0.56; 95% CI, 0.54-0.58; P < .001), regardless of physician race/ethnicity. Conclusions and Relevance This study suggests that Asian physicians may be more likely to receive lower patient satisfaction scores because they serve a greater proportion of Asian patients. Patient satisfaction scores should be adjusted for patient race/ethnicity.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of Outpatient Satisfaction Survey Scores for Asian Physicians and Non-Hispanic White Physicians

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Potential case-mix variables for analysis of the Field Trial data will be selected based on theoretical notions and empirical evidence. [35][36][37][38][39][40] Depending on the data analysis of the Field Trial, the case-mix adjustment in the analyses of the Main Survey data may be modified.…”

Section: Methodsmentioning

confidence: 99%

“…Case-mix variables are variables that may hamper a fair comparison of patient-reported indicators between countries or regions. Potential case-mix variables for analysis of the Field Trial data will be selected based on theoretical notions and empirical evidence 35–40. Depending on the data analysis of the Field Trial, the case-mix adjustment in the analyses of the Main Survey data may be modified.…”

Section: Methodsmentioning

confidence: 99%

Assessing the outcomes and experiences of care from the perspective of people living with chronic conditions, to support countries in developing people-centred policies and practices: study protocol of the International Survey of People Living with Chronic Conditions (PaRIS survey)

et al. 2022

View full text Add to dashboard Cite

IntroductionIn view of growing populations with chronic conditions, many countries are redesigning their health systems. However, little information is available about how health systems perform from the perspective of people living with chronic conditions. The Organisation for Economic Co-operation and Development (OECD) Member States therefore mandated the OECD to initiate the International Survey of People Living with Chronic Conditions (PaRIS survey), which aims to provide insight in outcomes and experiences of care as reported by people living with chronic conditions. The PaRIS-SUR consortium has been tasked by the OECD to support the development and implementation of the survey.Methods and analysisAs primary care services play a pivotal role in the management of chronic conditions, the PaRIS survey will be implemented in the primary care setting. Data will be collected with a survey among users of primary care services aged 45 years or older, of whom many have chronic conditions. An additional survey is conducted among their primary care providers. The nested study design will allow analysis of the patient-reported data in relation to characteristics of and care provided by primary care providers within and across countries. In 2022, the survey will be tested in a Field Trial in participating countries. Data for cross-country comparison will be collected by the Main Survey in 2023.Ethics and disseminationInformed consent will be obtained from primary care providers and service users. National Project Managers search ethical approval of the survey in their country, if required. Reporting by the OECD will focus on questions for international comparison. A secured information technology platform will be developed for participants and stakeholders in countries to receive feedback and answer their own questions. Findings will also be disseminated through an international OECD flagship report, conferences, scientific papers and policy briefs, to inform strategies to improve care for people living with chronic conditions throughout the world.

show abstract

“…Uniformity of relationship between the candidate case-mix adjustor and a patient experience measure over strata (case-mix model coefficients; (Elliott et al 2001;Zaslavsky et al 2000)). Analysis of the Medicare CAHPS data found evidence of variation in case-mix adjustment coefficients across plans, but its effect on comparative scores was minimal (Hatfield and Zaslavsky 2017).…”

Section: Selection Of Case-mix Adjustment Variablesmentioning

confidence: 98%

Development, methodology, and adaptation of the Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS®) patient experience survey, 2007–2019

Orr

Zaslavsky

Cleary

et al. 2022

Health Serv Outcomes Res Method

Self Cite

View full text Add to dashboard Cite

The Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS®) surveys collect standardized information about patient experiences of care from nationally representative samples of people with Medicare to support consumers’ enrollment choices and enable the Centers for Medicare & Medicaid Services to monitor care quality and incentivize high quality patient-centered care. Since 2007, protocols for data collection, analysis, and reporting have evolved to address expanded Medicare coverage options and a shift from a single survey vendor to a model in which health plans hire approved vendors to administer the survey. During that time, response rates for all types of surveys have declined; increasing effort has gone toward increasing survey participation, especially among people whose preferred language is not English. In this paper, we describe the history, goals, and current use of the Medicare CAHPS surveys. We also summarize key methodological issues, such as sample design, field implementation and data cleaning, adjustment, scoring, and report production. Additionally, we discuss issues that may arise more generally in managing a large, annual national survey that has direct impact on policy, and consider how a long-running survey of this nature may need to evolve to reflect changes in health care delivery and promote standardization in survey administration while maintaining survey content.

show abstract

Implications of Variation in the Relationships between Beneficiary Characteristics and Medicare Advantage CAHPS Measures

Abstract: Customized reporting may help consumers select the best Medicare Advantage plan, but policies should protect against unintended consequences.

Cited by 7 publications

References 30 publications

Comparison of Outpatient Satisfaction Survey Scores for Asian Physicians and Non-Hispanic White Physicians

Comparison of Outpatient Satisfaction Survey Scores for Asian Physicians and Non-Hispanic White Physicians

Assessing the outcomes and experiences of care from the perspective of people living with chronic conditions, to support countries in developing people-centred policies and practices: study protocol of the International Survey of People Living with Chronic Conditions (PaRIS survey)

Development, methodology, and adaptation of the Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS®) patient experience survey, 2007–2019

Contact Info

Product

Resources

About