Attachment V -- Response to Public Comments from the ANA and HPNA

August 26, 2009

Mary Jean Schumann, MSN, MBA, RN, CPNP

Chief Programs Officer

American Nurses Association

Dear Ms. Schumann,

Thank you for your letter of August 21, 2009 and your support of the proposed research project titled, “Study of Factors Influencing Consumer Choices Among Health Plans and Clinicians”.

We absolutely agree that non-physician providers play a critical role in health care delivery and there is a need to provide information about quality and choice across the full range of health care professionals.

We believe that the findings from Phase I of the proposed doctor choice experiment regarding factors influencing choice will be applicable to other, non-physician health care providers. For example, understanding the relative importance of technical quality measures versus service quality measures, and the role of patient comments, will help in the design of reporting systems comparing performance information among not just doctors of medicine (MDs) and osteopathy (DOs), but advanced practice registered nurses (APRNs) such as nurse practitioners (NPs), certified nurse midwives (CNMs), clinical nurse specialists, and other health care professionals.

Following Phase I, we plan to conduct a second round of experiments that will incorporate the findings from the first phase testing on health plan and doctor choice.   While our focus will continue to be on primary care providers, we will consider strategies for including other health care professionals in this second round of testing, as you have suggested.

Thank you again for your helpful comments and suggestions. We look forward to exploring ways to include these critical health care professionals in our future research.

Sincerely,

Christine Crofton, PhD

CAHPS Team Lead

Meg Campbell, RN, PhD, FAAN

President, Hospice and Palliative Nurses Association

Dear Dr. Campbell,

Thank you for your letter of August 12, 2009 and your support of the proposed research project titled, “Study of Factors Influencing Consumer Choices Among Health Plans and Clinicians”.

We agree that non-physician providers play an important role in health care delivery and there is a need to provide information about quality and choice across the full range of health care professionals.

We believe that the findings from Phase I of the proposed doctor choice experiment regarding factors influencing choice will be applicable to other, non-physician health care providers. For example, understanding the relative importance of technical quality measures versus service quality measures, and the role of patient comments, will help in the design of reporting systems comparing performance information among not just doctors of medicine (MDs) and osteopathy (DOs), but nurse practitioners, clinical nurse specialists, psychologists, certified nurse midwives, naturopathic physicians, and other health care professionals.

Following Phase I, we plan to conduct a second round of experiments that will incorporate the findings from the first phase testing on health plan and doctor choice.   While our focus will continue to be on primary care providers, we will consider strategies for including other health care professionals in this second round of testing.

Thank you again for your helpful comments and suggestions. We look forward to exploring ways to include these critical health care professionals in our future research.

Sincerely,

Christine Crofton, PhD

CAHPS Team Lead