CONSUMER SURVEY: CHD Report Offers Improvement Recommendations

      Consumers say obtaining referrals and prior authorizations to see a specialist are among the most "troublesome" obstacles they encounter in obtaining health care, according to a recent survey conducted by California Health Decisions Inc. Thirty percent of survey respondents said they experienced referral or authorization problems in the past year, including having to wait too long, not understanding the process or feeling like no one was helping them. Furthermore, the participants said they found the process of obtaining care more troublesome than the quality of care delivered. In addition, many consumers said they were frustrated by prescription drug coverage changes, daunting emergency room usage policies; and many said they feel like the traditional doctor-patient relationship is deteriorating. Overall, two-thirds of respondents indicated they were "very" or "somewhat" satisfied with their health care. CHD conducted four years of research comprising in-depth focus group discussions and telephone interviews with nearly 1,000 health plan members and 100 physicians in California. CHD President Ellen Severoni said, "The integration of all these parties -- particularly the inclusion of patients -- offers a unique opportunity to identify the real hopes and concerns consumers have and make improvements that respond to those concerns."

Working Toward Resolution
     The study also allowed participants to propose solutions to the concerns they identified. One solution participants recommended -- already being successfully employed in several health plans -- would allow enrollees to make a single call to resolve billing issues. Another recommendation was to provide educational instruction to pharmacies to enhance their understanding of how changing prescription drug coverage impacts consumers. "It is our hope that other health care organizations and purchasers will pay close attention to what patients are saying," said Severoni. "Addressing these critical issues can go a long way toward solving the problems that plague our health care system," she said. The report, funded by Integrated Healthcare Association, involved four California health care purchasers, 12 provider organizations and four health plans -- Alameda Alliance for Health, Blue Cross of California, Health Net and PacifiCare of California. Information on the report, "Public Values and Perspectives on Managed Care," can be accessed at www.cahd.org, or readers can call (714) 647-4920 to obtain a free copy of the executive summary or order the fall report for $50 (CHD release, 10/1).