Patient Satisfaction Among Low-Income Patients on the Rise, Survey Says

More than half of Medi-Cal and other low-income patients rated their care as very good or excellent, a gain of about five percentage points from 2011 to 2014, according to a survey released Wednesday by the Blue Shield of California Foundation.
The gain in patient satisfaction is more significant given the upheaval in the medical system from adding millions of lower-income Californians to coverage through Covered California and Medi-Cal expansion, according to Peter Long, President and CEO of Blue Shield of California Foundation.
“The prevailing wisdom is, we’ve brought all these people into coverage, but don’t have the resources to care for them,” Long said. “This survey frankly surprised me, with the kind of across-the-board numbers we’re seeing. It’s pleasantly surprising that … in this turbulent environment, we actually improved [care beyond] patient expectations.”
The survey comparing data from a similar survey in 2011 to data collected in 2014 found increases in a number of key performance measures, Long said — including continuity of care, waiting times, availability of appointments and courtesy of staff members.
According to the survey data:

  • About 31% of patients in 2014 rated their care as excellent and an additional 22% pegged it as very good, for a total favorable rating of 53%, compared to a total rating of 48% in 2011;
  • 45% of patients in 2014 were highly satisfied with their ability to see the same provider, up from 36% in 2011;
  • 46% of patients said they were highly satisfied with their ability to get timely appointments, compared to 37% in 2011;
  • High satisfaction with waiting times hit 34%, up from 23% in 2011; and
  • Courtesy of staff members was rated highly by 62% of patients in 2014, compared to 49% in 2011.

Part of the rise in patient satisfaction with quality of care may be related to millions of newly enrolled Californians, both in Medi-Cal and through Covered California, being happy to finally get coverage and regular health care, Long said.
“There could be that halo effect,” Long said. “I think part of the explanation is that people are getting care they wouldn’t have had before.”
But Long said it’s also a strong statement about the quality of care and access to care that can be delivered to lower-income Californians by managed care plans.
When you look at all of the gains in satisfaction, including such things as cleanliness or courtesy, “That’s getting at something more structural,” Long said. “I think things have changed.”
Many care centers have made concerted efforts to improve quality metrics, Long said.
“That appears to be working,” he said. “Across the board, you’re seeing it. When people [at community health centers] understand there’s a choice for patients, they want to be the provider of choice, not the provider of last resort.”
All of those positive numbers are a signal to lawmakers and providers that, contrary to the many concerns aired about quality and access, things are going pretty well so far with the expansion of coverage, Long said.
“The first take-home message is, don’t let the negative reviews sway you,” Long said. “The safety-net providers can provide good care. Not only are they providing high-quality service technically, but patients are happy to see them. And that’s an important piece of the equation.”
And the second thing to keep in mind, Long said, is that lawmakers in Sacramento might want to focus on getting patients’ input into their oversight of managed care and Medi-Cal.
“To get a clear picture, I think policy makers [responsible for] managed care oversight should bring more patients’ voices into the process when you’re looking at the oversight and measuring progress in the Medi-Cal expansion,” Long said.