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pdfCAHPS Survey for the Medicare Shared Savings
Program and Pioneer Model ACOs
Report for: ACCOUNTABLE CARE ORGANIZATION
Issued September 2013
ACCOUNTABLE CARE ORGANIZATION
Table of Contents
Part 1: Executive Summary ................................................................................................................................................. iii
Part 2: Detailed Results ....................................................................................................................................................... 1
Getting Timely Care, Appointments and Information ............................................................................................................. 2
Getting Appointments for Urgent Care ............................................................................................................................... 2
Getting Appointments for Routine Care .............................................................................................................................. 2
Medical Question Answered After Hours ............................................................................................................................ 3
Getting Seen Within 15 Minutes of Your Appointment....................................................................................................... 3
How Well Providers Communicate .......................................................................................................................................... 4
Providing Clear Explanations ............................................................................................................................................... 4
Listen Carefully .................................................................................................................................................................... 4
Easy to Understand Information.......................................................................................................................................... 5
Showing Respect for What Patients Have to Say ................................................................................................................. 5
Spending Enough Time With Patients ................................................................................................................................. 6
Patient’s Rating of Provider ..................................................................................................................................................... 7
Access to Specialists................................................................................................................................................................. 8
Getting Appointments With Specialists ............................................................................................................................... 8
Specialist Knows Important Medical History ....................................................................................................................... 8
Health Promotion and Education ............................................................................................................................................ 9
General Health Promotion and Education ............................................................................................................................. 10
Told How to Prevent Illness ............................................................................................................................................... 10
Told About Healthy Habits ................................................................................................................................................. 10
Discuss Exercise or Physical Activity .................................................................................................................................. 11
Mental Health Promotion and Education .............................................................................................................................. 12
Asked About Mental Health ............................................................................................................................................... 12
Asked About Stress ............................................................................................................................................................ 12
Shared Decision-Making ........................................................................................................................................................ 13
Making Decisions about Medications .................................................................................................................................... 14
Discuss Reasons for Taking Medicine ................................................................................................................................ 14
Discuss Reasons for Not Taking Medicine ......................................................................................................................... 14
Discuss What is Best .......................................................................................................................................................... 15
Making Decisions about Surgery ........................................................................................................................................... 16
Discuss Reasons for Surgery .............................................................................................................................................. 16
Discuss Reasons for Not Having Surgery............................................................................................................................ 16
Discuss What is Best .......................................................................................................................................................... 17
Sharing Your Health Information ........................................................................................................................................... 18
Extent of Information Shared with Family and Friends ..................................................................................................... 18
Provider Respect Extent of Information Shared ................................................................................................................ 18
CAHPS for the Medicare Shared Savings Program and Pioneer Model ACOs
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Health Status and Functional Status ...................................................................................................................................... 19
Self-rated Health .................................................................................................................................................................... 19
Self-rated Mental Health ....................................................................................................................................................... 19
Cognitive Functioning ............................................................................................................................................................ 20
Beneficiaries without a Chronic Condition ............................................................................................................................ 21
Condition Lasted at Least 3 Months .................................................................................................................................. 21
Taking Medicine to Treat Condition .................................................................................................................................. 21
Beneficiaries’ Functional Status ............................................................................................................................................. 22
Extent Physical Health Interfered with Social Activities .................................................................................................... 22
How Often did Physical Health Interfere with Social Activities ......................................................................................... 22
Difficulty Walking or Climbing Stairs .................................................................................................................................. 23
Difficulty Dressing or Bathing ............................................................................................................................................ 23
Difficulty Performing Errands ............................................................................................................................................ 23
Courteous and Helpful Office Staff ........................................................................................................................................ 24
Office Staff Helpful ............................................................................................................................................................. 24
Office Staff Treat You With Courtesy and Respect ............................................................................................................ 24
Care Coordination .................................................................................................................................................................. 25
Provider Has Medical Records ........................................................................................................................................... 25
Provider Follow Up with Test Results ................................................................................................................................ 25
Health Care Team Discuss Taking Medicines ..................................................................................................................... 26
Between Visit Communication .............................................................................................................................................. 27
Helping You Take Medications as Directed ........................................................................................................................... 28
Provider Gave Instructions for Taking Medicines .............................................................................................................. 28
Written Instructions Easy to Understand .......................................................................................................................... 28
Suggest Ways to Help Remember...................................................................................................................................... 29
Stewardship of Patient Resources ......................................................................................................................................... 30
Frequency Tables (not Case-Mix-Adjusted or Weighted) ...................................................................................................... 31
Part 3: Background and Methodology ............................................................................................................................... 55
CAHPS for the Medicare Shared Savings Program and Pioneer Model ACOs
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Part 1: Executive Summary
Overview
The Affordable Care Act authorized the Centers for Medicare & Medicaid Services (CMS) to establish a Shared Savings
Program to facilitate coordination and cooperation among providers to improve the quality of care delivered to Medicare
Fee-For-Service (FFS) beneficiaries and reduce unnecessary costs. Eligible providers, hospitals, and other suppliers of health
care may participate in the Shared Savings Program by creating or participating in an accountable care organization (ACO).
Under the program, ACOs are financially rewarded to the extent that they lower health care costs while meeting
performance standards on quality of care and putting patients first.
The Affordable Care Act also established a Center for Medicare and Medicaid Innovations (Innovation Center) to test new
models of health care delivery and payment. Working together with the Medicare Shared Savings Program, the Innovation
Center is testing alternative ACO models, including the Pioneer ACO Model. The Pioneer ACO model was designed
specifically for groups of providers with experience working together to coordinate care for patients. It will allow these
groups to move more quickly from a shared savings payment model to a population-based payment model.
Numerous quality measures are used to determine the performance of an ACO. These performance measures include
clinical process and outcome measures as well as patient experience-of-care measures. Of the 33 performance measures
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specified by CMS in its final rules and regulations for the first reporting period of the Shared Savings Program, seven are
measured by a new patient experience survey that is based on the CAHPS Clinician & Group Survey (CG-CAHPS). The
development of this survey, called the CAHPS Survey for the Medicare Shared Savings Program and Pioneer Model ACOs,
included a field test of the survey in the spring of 2012 with the organizations that participated in CMS’ Physician Group
Practice Transition Demonstration.
The first national implementation of the CAHPS Survey for the Medicare Shared Savings Program and Pioneer Model ACOs
was conducted in the first half of 2013 and measured ACO-assigned beneficiaries’ experiences in the ACO over the previous
six months. This report describes the results of that survey.
How This Report Is Organized
This report provides your results from the CAHPS Survey for the Medicare Shared Savings Program and Pioneer Model
ACOs. The remainder of this summary describes the content of the survey, explains the scores included for comparison,
shows your ACO’s performance on several measures derived from the survey, and suggests how to use this report.
Part 2 of the report presents detailed results, including your ACO’s performance on the individual dimensions that make up
the survey measures, and frequency tables that display the unadjusted (i.e., not adjusted for case-mix) and unweighted
responses to all survey questions. Shown first in Part 2 are measures of patient experience on which an ACO’s quality
performance score will be based beginning in 2014 for Pioneer Model ACOs and 2015 for Medicare Shared Savings Program
ACOs (per the MSSP final rule), followed by five additional measures of patient experience that will not factor into an ACO’s
quality performance score but are nonetheless useful to examine as you consider ways to improve your performance.
Part 3 of the report describes sampling and other methodological information and provides additional background about
the survey.
1
The Medicare Shared Savings Program final rule is available at:
http://www.cms.gov/SharedSavingsProgram/30_Statutes_Regulations_Guidance.asp#TopOfPage
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Survey Content
CMS’ 2011 final Federal Rule for the MSSP specifies that the following seven summary survey measures of patient
experience must be included in the CAHPS Survey for the Medicare Shared Savings Program and Pioneer Model ACOs:
1.
2.
3.
4.
5.
6.
7.
Getting Timely Care, Appointments and Information
How Well Your Providers Communicate
Patient’s Rating of Provider
Access to Specialists
Health Promotion and Education
Shared Decision-Making
Health Status and Functional Status
The first six of these summary survey measures are derived from the CG-CAHPS survey. The seventh summary survey
measure consists of questions required by the Affordable Care Act relating to disability status, as well as additional
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questions regarding health and functional status derived from a widely used and well-validated health outcomes survey.
An additional summary survey measure, Courteous and Helpful Office Staff, was included because it is required for all CG3
CAHPS surveys. Finally, a Technical Expert Panel and focus groups with Medicare beneficiaries suggested four additional
summary survey measures for inclusion in the survey: Care Coordination, Between Visit Communication, Education about
Taking Prescription Medications, and Stewardship of Patient Resources. Questions included in these last four summary
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survey measures were adapted from CAHPS supplemental question sets. Part 3 of this report contains a table that shows
the exact wording of the survey questions included in all measures.
How Results Are Adjusted
Analyses of CAHPS data have shown that beneficiaries with certain characteristics tend to report systematically higher or
lower scores. For example, older patients, healthier patients, and less educated patients tend to give higher scores than
younger, sicker and more educated patients. Different ACOs do not have the same distribution (“case mix”) of beneficiaries
with these characteristics, so these tendencies can bias comparisons among ACOs.
We perform a procedure called “case-mix adjustment” to correct for these effects using a statistical model (linear
regression) to estimate the scores that would be obtained by each ACO if every ACO had the same distribution of
beneficiary characteristics, equivalent to the average across all ACOs. Because the overall (national) ACO mean is the same
before and after the adjustment, scores for some ACOs (those with beneficiaries who tend to give more favorable scores)
will be adjusted downwards, and others (those with beneficiaries who tend to give more unfavorable scores) will be
adjusted upwards. A more detailed explanation of these procedures is presented in Part 3 of this report.
2
The RAND 36-question short-form health survey (SF-36), details of which can be found here:
http://www.rand.org/health/surveys_tools/mos/mos_core_36item.html
3
This panel included representatives of accrediting groups, purchasers and consumers, health care organizations and
providers, as well as experts on survey research and performance measurement and improvement.
4
CAHPS supplemental questions explore topics or domains not covered by core measures (questions that survey sponsors
are required to field to refer to the survey as a CG-CAHPS survey) or that explore core measures in more detail.
CAHPS for the Medicare Shared Savings Program and Pioneer Model ACOs
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Summary Tables
Below is a summary of how your ACO performed on the seven patient experience summary survey measures on which ACO
quality performance scores are based and on the five additional summary survey measures of patient experience that were
assessed by the survey.
Summary Survey Measures To Be Used in Determining an ACO’s Quality Score – Responses to one or more survey
questions were used to create each of the seven summary survey measures listed on the preceding page. Together, these
seven summary survey measures will constitute one-quarter of an ACO’s quality score. For each summary survey measure,
the table below shows the overall mean for the 152 ACOs that participated in the CAHPS Survey for the Medicare Shared
Savings Program and Pioneer Model ACOs and your ACO’s case-mix adjusted mean, both presented on a 0-100 scale.
Information about how summary scores were calculated is presented in Part 3. For detailed results of your ACO’s
performance on these measures, see Part 2.
Table 1. Your ACO’s mean and overall ACO mean scores on the summary survey measures
that will be used to determine an ACO’s quality score in the patient experience domain
Summary Survey Measure
Your
ACO
ACO
Mean
Getting Timely Care, Appointments and Information
82
How Well Providers Communicate
93
Patient’s Rating of Provider*
92
Access to Specialists
85
Health Promotion and Education
57
General Health Promotion and Education
66
Mental Health Promotion and Education
38
Shared Decision-Making
74
Making Decisions about Medications
83
Making Decisions about Surgery
78
Sharing Your Health Information
55
Health Status and Functional Status
70
Self-Rated Health*
52
Self-Rated Mental Health*
64
Cognitive Functioning*
84
Beneficiaries without a Chronic Condition
58
Beneficiaries’ Functional Status
76
* Measure derived from a single survey question
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Additional Summary Measures Derived From the Survey – Responses to individual survey questions were used to derive
five additional summary survey measures of beneficiaries’ experiences with the ACO. Three of these five summary survey
measures were derived from multiple survey questions; two (Between Visit Communication and Stewardship of Patient
Resources) are based on a single survey question. For each of these summary survey measures, the table below shows the
overall mean for the 152 ACOs that participated in the CAHPS Survey for the Medicare Shared Savings Program and Pioneer
Model ACOs and your ACO’s case-mix adjusted mean, both presented on a 0-100 scale. Although these measures will not
be used to determine an ACO’s quality score, they nevertheless capture important dimensions of patient experience and
thus are useful to examine as you consider ways to improve your performance. For detailed information about how your
ACO performed on these measures, see Part 2.
Table 2. Your ACO’s mean and overall ACO mean scores on five additional summary survey
measures of patient experience
Summary Survey Measure
Your
ACO
ACO
Mean
Courteous and Helpful Office Staff
92
Care Coordination
87
Between Visit Communication*
60
Helping You to Take Medications as Directed
77
Stewardship of Patient Resources*
29
*Measure derived from a single survey question
Comparisons and Benchmarks
Throughout the report, comparisons are presented to provide context for your ACO’s scores, and to guide quality
improvement. The overall ACO mean is presented for all summary survey measures, more specific (subsidiary) measures
that compose the summary survey measures, and individual questions. In addition, the mean response of Medicare FFS
beneficiaries (i.e., including both those assigned to ACOs, and those not assigned to ACOs) in your ACO’s geographic service
area is presented for questions that overlap with the FFS Medicare CAHPS survey. We refer to this as the “local FFS mean.”
For information on how your ACO’s geographic service area was determined and how the local FFS mean was computed,
see Part 3.
The number of quality points an ACO will receive in future years will be based on percentile benchmarks that CMS will
publish each year. These benchmarks and resulting quality points will not be established using statistical significance tests.
In an effort to maintain consistency of reports across years, we have not included tests of statistical significance here.
How to Use This Report
ACOs can use the information in this report to identify strengths and opportunities for improvement and to give feedback
to providers about how beneficiaries perceive their experiences with the ACO overall. You may also want to see how your
performance changes over time. You can do so by comparing this year’s survey results to the results of the 2014 national
survey of ACOs, which will assess beneficiaries’ experiences with care during the 2013 reporting period.
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Part 2: Detailed Results
In the following pages, we provide detailed results from the CAHPS Survey for the Medicare Shared Savings Program and
Pioneer Model ACOs, including your performance on the individual performance dimensions that make up each of the
summary survey measures. These results have been case-mix adjusted and weighted. For information on how we
conducted case-mix adjustment and weighting, see Part 3 of this report.
Frequency tables that display unadjusted responses (not case-mix adjusted, not weighted) to all survey questions are also
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shown at the end of this section. Local FFS comparisons are displayed for questions that appear on both the Medicare FFS
Survey and the CAHPS Survey for the Medicare Shared Savings Program and Pioneer Model ACOs. Otherwise, “Comparison
is Not Available” is displayed.
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The “local FFS mean” is the mean response of Medicare FFS beneficiaries (i.e., including both those assigned to ACOs, and
those not assigned to ACOs) in your ACO’s geographic service area. It is presented for questions that overlap with the FFS
Medicare CAHPS survey. For more information on how your ACO’s geographic service area was determined and how the
local FFS mean was computed, see Part 3 of this report.
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Getting Timely Care, Appointments and Information
This graph shows how your ACO performed on the summary survey measure “Getting Timely Care, Appointments and
Information,” which is derived from survey questions 6, 8, 10, 12, and 15. The graph shows the number of respondents who
answered at least one of these questions, the distribution of responses and the mean score. Results for the individual
questions are also shown below.
Mean
Score
Your results
Overall ACO distribution
n=55840
Local FFS distribution
82
COMPARISON NOT AVAILABLE
Getting Appointments for Urgent Care
Q6: In the last 6 months, when you phoned this provider’s office to get an appointment for care you needed right away,
how often did you get an appointment as soon as you needed?
Mean
Score
Your results
Overall ACO distribution
n=25568
88
Local FFS distribution
Getting Appointments for Routine Care
Q8. In the last 6 months, when you made an appointment for a check-up or routine care with this provider, how often did
you get an appointment as soon as you needed?
Mean
Score
Your results
Overall ACO distribution
n=42676
91
Local FFS distribution
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
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Medical Question Answered
Q10. In the last 6 months, when you phoned this provider’s office during regular office hours, how often did you get an
answer to your medical question that same day?
Mean
Score
Your results
Overall ACO distribution
n=23028
Local FFS distribution
84
COMPARISON NOT AVAILABLE
Medical Question Answered After Hours
Q12. In the last 6 months, when you phoned this provider’s office after regular office hours, how often did you get an
answer to your medical question as soon as you needed?
Mean
Score
Your results
Overall ACO distribution
n=4200
Local FFS distribution
80
COMPARISON NOT AVAILABLE
Getting Seen Within 15 Minutes of Your Appointment
Q15. In the last 6 months, how often did you see this provider within 15 minutes of your appointment time?
Mean
Score
Your results
Overall ACO distribution
n=55362
65
Local FFS distribution
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
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How Well Providers Communicate
This graph shows how your ACO performed on the summary survey measure “How Well Providers Communicate,” which is
derived from survey questions 16, 17, 19, 20, 22 and 23. The graph shows the number of respondents who answered at
least one of these questions, the distribution of responses and the mean score. Results for the individual questions are also
shown below.
Mean
Score
Your results
Overall ACO distribution
n=56208
Local FFS distribution
93
COMPARISON NOT AVAILABLE
Providing Clear Explanations
Q16. In the last 6 months, how often did this provider explain things in a way that was easy to understand?
Mean
Score
Your results
Overall ACO distribution
n=55639
93
Local FFS distribution
Listen Carefully
Q17. In the last 6 months, how often did this provider listen carefully to you?
Mean
Score
Your results
Overall ACO distribution
n=55574
93
Local FFS distribution
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
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Easy to Understand Information
Q19. In the last 6 months, how often did this provider give you easy to understand information about these health
questions or concerns?
Mean
Score
Your results
Overall ACO distribution
n=43972
92
Local FFS distribution
Know Important Medical History
Q20. In the last 6 months, how often did this provider seem to know the important information about your medical history?
Mean
Score
Your results
Overall ACO distribution
n=54625
Local FFS distribution
91
COMPARISON NOT AVAILABLE
Showing Respect for What Patients Have to Say
Q22. In the last 6 months, how often did this provider show respect for what you had to say?
Mean
Score
Your results
Overall ACO distribution
n=54910
96
Local FFS distribution
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
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Spending Enough Time With Patients
Q23. In the last 6 months, how often did this provider spend enough time with you?
Mean
Score
Your results
Overall ACO distribution
n=54708
92
Local FFS distribution
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
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Patient’s Rating of Provider
This graph shows how your ACO performed on the summary survey measure “Patient’s Rating of Provider,” which is
derived from a single survey question: 41. The graph shows the number of respondents who answered this question, the
distribution of responses, and the mean score.
Q41: Using any number from 0 to 10, where 0 is the worst provider possible and 10 is the best provider possible, what
number would you use to rate this provider?
Mean
Score
Your results
Overall ACO distribution
n=55306
92
Local FFS distribution
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
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Access to Specialists
This graph shows how your ACO performed on the summary survey measure “Access to Specialists,” which is derived from
survey questions 46 and 47. The graph shows the number of respondents who answered at least one of these questions,
the distribution of responses and the mean score. Results for the individual questions are also shown below.
Mean
Score
Your results
Overall ACO distribution
n=25972
Local FFS distribution
85
COMPARISON NOT AVAILABLE
Getting Appointments With Specialists
Q46. In the last 6 months, how often was it easy to get appointments with specialists?
Mean
Score
Your results
Overall ACO distribution
n=25698
84
Local FFS distribution
Specialist Knows Important Medical History
Q47. In the last 6 months, how often did the specialist you saw most seem to know the important information about your
medical history?
Mean
Score
Your results
Overall ACO distribution
Local FFS distribution
n=25389
86
COMPARISON NOT AVAILABLE
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
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Health Promotion and Education
This graph shows how your ACO performed on the summary survey measure “General Health Promotion and Education.”
This summary survey measure is made up of two more specific measures: “General Health Promotion and Education” and
“Mental Health Promotion and Education,” each of which is derived from multiple survey questions. The graph shows the
number of respondents who answered at least one of the questions from which the “Health Promotion and Education”
summary survey measure was derived, the distribution of responses on that measure and the mean score. Results for the
more specific measures and the individual questions from which they were derived are also shown below.
Mean
Score
Your results
Overall ACO distribution
Local FFS distribution
n=62802
57
COMPARISON NOT AVAILABLE
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
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General Health Promotion and Education
This graph shows how your ACO performed on the measure “General Health Promotion and Education,” which is made up
of survey questions 49, 50, 51, and 52. The graph shows the number of respondents who answered at least one of these
questions, the distribution of responses and the mean score. Results for the individual questions are also shown below.
Mean
Score
Your results
Overall ACO distribution
n=62310
Local FFS distribution
66
COMPARISON NOT AVAILABLE
Told How to Prevent Illness
Q49. Your health care team includes all the doctors, nurses and other people you see for health care. In the last 6 months,
did you and anyone on your health care team talk about specific things you could do to prevent illness?
Mean
Score
Your results
Overall ACO distribution
n=61089
Local FFS distribution
68
COMPARISON NOT AVAILABLE
Told About Healthy Habits
Q50. In the last 6 months, did you and anyone on your health care team talk about a healthy diet and healthy eating habits?
Mean
Score
Your results
Overall ACO distribution
Local FFS distribution
n=61623
62
COMPARISON NOT AVAILABLE
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
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Discuss Exercise or Physical Activity
Q51. In the last 6 months, did you and anyone on your health care team talk about the exercise or physical activity you get?
Mean
Score
Your results
Overall ACO distribution
n=61731
Local FFS distribution
74
COMPARISON NOT AVAILABLE
Discuss Specific Health Goals
Q52. In the last 6 months, did anyone on your health care team talk with you about specific goals for your health?
Mean
Score
Your results
Overall ACO distribution
Local FFS distribution
n=61045
60
COMPARISON NOT AVAILABLE
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
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ACCOUNTABLE CARE ORGANIZATION
Mental Health Promotion and Education
This graph shows how your ACO performed on the measure “Mental Health Promotion and Education,” which is made up of
survey questions 57 and 58. The graph shows the number of respondents who answered at least one of these questions,
the distribution of responses and the mean score. Results for the individual questions are also shown below.
Mean
Score
Your results
Overall ACO distribution
n=61449
Local FFS distribution
38
COMPARISON NOT AVAILABLE
Asked About Mental Health
Q57. In the last 6 months, did anyone on your health care team ask you if there was a period of time when you felt sad,
empty, or depressed?
Mean
Score
Your results
Overall ACO distribution
n=60941
Local FFS distribution
39
COMPARISON NOT AVAILABLE
Asked About Stress
Q58. In the last 6 months, did you and anyone on your health care team talk about things in your life that worry you or
cause you stress?
Mean
Score
Your results
Overall ACO distribution
Local FFS distribution
n=60635
38
COMPARISON NOT AVAILABLE
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
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ACCOUNTABLE CARE ORGANIZATION
Shared Decision-Making
This graph shows how your ACO performed on the summary survey measure “Shared Decision-Making.” This summary
survey measure is made up of three more specific measures, “Making Decisions about Medications,” “Making Decisions
about Surgery” and “Sharing Your Health Information,” each of which is derived from multiple survey questions. The graph
shows the number of respondents who answered at least one of the questions from which the “Shared Decision-Making”
summary survey measure was derived, the distribution of responses on that measure, and the mean score. Results for the
more specific measures and the individual questions from which they were derived are also shown below.
Mean
Score
Your results
Overall ACO distribution
Local FFS distribution
n=53182
74
COMPARISON NOT AVAILABLE
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
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ACCOUNTABLE CARE ORGANIZATION
Making Decisions about Medications
This graph shows how your ACO performed on the measure “Making Decisions About Medications,” which is made up of
survey questions 27, 28 and 29. The graph shows the number of respondents who answered at least one of these
questions, the distribution of responses and the mean score. Results for the individual questions are also shown below.
Mean
Score
Your results
Overall ACO distribution
n=28458
Local FFS distribution
83
COMPARISON NOT AVAILABLE
Discuss Reasons for Taking Medicine
Q27. Did you and this provider talk about the reasons you might want to take a medicine?
Mean
Score
Your results
Overall ACO distribution
n=27916
Local FFS distribution
94
COMPARISON NOT AVAILABLE
Discuss Reasons for Not Taking Medicine
Q28. Did you and this provider talk about the reasons you might not want to take a medicine?
Mean
Score
Your results
Overall ACO distribution
Local FFS distribution
n=28025
76
COMPARISON NOT AVAILABLE
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
14
ACCOUNTABLE CARE ORGANIZATION
Discuss What is Best
Q29. When you and this provider talked about starting or stopping a prescription medicine, did this provider ask what you
thought was best for you?
Mean
Score
Your results
Overall ACO distribution
Local FFS distribution
n=27630
79
COMPARISON NOT AVAILABLE
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
15
ACCOUNTABLE CARE ORGANIZATION
Making Decisions about Surgery
This graph shows how your ACO performed on the measure “Making Decisions About Surgery,” which is made up of survey
questions 36, 37 and 38. The graph shows the number of respondents who answered at least one of these questions, the
distribution of responses and the mean score. Results for the individual questions are also shown below.
Mean
Score
Your results
Overall ACO distribution
n=14493
Local FFS distribution
78
COMPARISON NOT AVAILABLE
Discuss Reasons for Surgery
Q36. Did you and this provider talk about the reasons you might want to have the surgery or procedure?
Mean
Score
Your results
Overall ACO distribution
n=13423
Local FFS distribution
95
COMPARISON NOT AVAILABLE
Discuss Reasons for Not Having Surgery
Q37. Did you and this provider talk about the reasons you might not want to have the surgery or procedure?
Mean
Score
Your results
Overall ACO distribution
Local FFS distribution
n=13284
59
COMPARISON NOT AVAILABLE
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
16
ACCOUNTABLE CARE ORGANIZATION
Discuss What is Best
Q38. When you and this provider talked about having surgery or a procedure, did this provider ask what you thought was
best for you?
Mean
Score
Your results
Overall ACO distribution
Local FFS distribution
n=13953
80
COMPARISON NOT AVAILABLE
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
17
ACCOUNTABLE CARE ORGANIZATION
Sharing Your Health Information
This graph shows how your ACO performed on the measure “Sharing Your Health Information,” which is made up of survey
questions 39 and 40. The graph shows the number of respondents who answered at least one of these questions, the
distribution of responses and the mean score. Results for the individual questions are also shown below.
Mean
Score
Your results
Overall ACO distribution
n=47950
Local FFS distribution
55
COMPARISON NOT AVAILABLE
Extent of Information Shared with Family and Friends
Q39. In the last 6 months, did you and this provider talk about how much of your personal health information you wanted
shared with your family or friends?
Mean
Score
Your results
Overall ACO distribution
n=47427
Local FFS distribution
32
COMPARISON NOT AVAILABLE
Provider Respect Extent of Information Shared
Q40. In the last 6 months, did this provider respect your wishes about how much of your personal health information to
share with your family or friends?
Mean
Score
Your results
Overall ACO distribution
Local FFS distribution
n=43640
77
COMPARISON NOT AVAILABLE
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of
this report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
18
ACCOUNTABLE CARE ORGANIZATION
Health Status and Functional Status
The summary survey measure “Health Status and Functional Status” is made up of five more specific measures, three of
which are derived from a single survey question and two of which are derived from multiple survey questions. The singlequestion measures included in the “Health Status and Functional Status” summary survey measure are “Self-rated Health,”
“Self-rated Mental Health,” and “Cognitive Functioning.” The multi-question measures are “Beneficiaries without a Chronic
Condition” and “Beneficiaries’ Functional Status.” Because the questions that make up this summary survey measure have
different response scales, it is not possible to display a segmented-bar graph for the summary survey measure. Results for
the more specific measures and the individual questions from which they are derived are shown below.
Self-rated Health
Q59. In general, how would you rate your overall health?
Mean
Score
Your results
Overall ACO distribution
n=61329
52
Local FFS distribution
Self-rated Mental Health
Q60. In general, how would you rate your overall mental or emotional health?
Mean
Score
Your results
Overall ACO distribution
n=61446
64
Local FFS distribution
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
19
ACCOUNTABLE CARE ORGANIZATION
Cognitive Functioning
Q75. Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or
making decisions?
Mean
Score
Your results
Overall ACO distribution
Local FFS distribution
n=60579
84
COMPARISON NOT AVAILABLE
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
20
ACCOUNTABLE CARE ORGANIZATION
Beneficiaries without a Chronic Condition
This graph shows how your ACO performed on “Beneficiaries without a Chronic Condition,” a measure comprised of survey
questions 62 and 64. This graph shows the number of respondents who answered “No” to either Q62 or Q64, indicating
that they had NOT seen a provider at least three times in the past 12 months for a condition lasting at least three months or
that they had seen a provider at least three times in the past 12 months for such a condition but did NOT take medicine to
treat that condition. The graph shows the number of respondents who answered both of these questions, the distribution
of responses and the mean score. Results for the individual questions included in this measure are also shown below.
Mean
Score
Your results
Overall ACO distribution
n=61639
58
Local FFS distribution
Condition Lasted at Least 3 Months
Q62. Is this a condition or problem that has lasted for at least 3 months?
Mean
Score
Your results
Overall ACO distribution
n=59239
Local FFS distribution
52
COMPARISON NOT AVAILABLE
Taking Medicine to Treat Condition
Q64. Is this medicine to treat a condition that has lasted for at least 3 months?
Mean
Score
Your results
Overall ACO distribution
Local FFS distribution
n=60441
8
COMPARISON NOT AVAILABLE
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
21
ACCOUNTABLE CARE ORGANIZATION
Beneficiaries’ Functional Status
Beneficiaries’ Functional Status is a measure comprised of survey questions 65, 66, 76, 77, and 78. Because these five
survey questions have different response scales, it is not possible to display a segmented-bar graph for this measure.
Results for the individual questions included in this measure are shown below.
Extent Physical Health Interfered with Social Activities
Q65. During the last 4 weeks, how much did your physical health interfere with your normal social activities with family,
friends, neighbors or groups?
Mean
Score
Your results
Overall ACO distribution
n=61284
Local FFS distribution
72
COMPARISON NOT AVAILABLE
How Often did Physical Health Interfere with Social Activities
Q66. During the last 4 weeks, how much of the time did your physical health interfere with your social activities (like visiting
with friends, relatives, etc.)?
Mean
Score
Your results
Overall ACO distribution
Local FFS distribution
n=61302
73
COMPARISON NOT AVAILABLE
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
22
ACCOUNTABLE CARE ORGANIZATION
Difficulty Walking or Climbing Stairs
Q76. Do you have serious difficulty walking or climbing stairs?
Mean
Score
Your results
Overall ACO distribution
n=60596
Local FFS distribution
65
COMPARISON NOT AVAILABLE
Difficulty Dressing or Bathing
Q77. Do you have difficulty dressing or bathing?
Mean
Score
Your results
Overall ACO distribution
n=60785
Local FFS distribution
88
COMPARISON NOT AVAILABLE
Difficulty Performing Errands
Q78. Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a
doctor’s office or shopping?
Mean
Score
Your results
Overall ACO distribution
Local FFS distribution
n=60616
79
COMPARISON NOT AVAILABLE
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
23
ACCOUNTABLE CARE ORGANIZATION
Courteous and Helpful Office Staff
This graph shows how your ACO performed on the summary survey measure “Courteous and Helpful Office Staff,” which is
derived from survey questions 42 and 43. The graph shows the number of respondents who answered at least one of these
questions, the distribution of responses and the mean score. Results for the individual questions are also shown below.
Mean
Score
Your results
Overall ACO distribution
n=55762
Local FFS distribution
92
COMPARISON NOT AVAILABLE
Office Staff Helpful
Q42. In the last 6 months, how often were clerks and receptionists at this provider’s office as helpful as you thought they
should be?
Mean
Score
Your results
Overall ACO distribution
n=55496
Local FFS distribution
89
COMPARISON NOT AVAILABLE
Office Staff Treat You With Courtesy and Respect
Q43. In the last 6 months, how often did clerks and receptionists at this provider’s office treat you with courtesy and
respect?
Mean
Score
Your results
Overall ACO distribution
Local FFS distribution
n=55463
95
COMPARISON NOT AVAILABLE
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
24
ACCOUNTABLE CARE ORGANIZATION
Care Coordination
This graph shows how your ACO performed on the summary survey measure “Care Coordination,” which is derived from
survey questions 21, 25, and 55. The graph shows the number of respondents who answered at least one of these
questions, the distribution of responses and the mean score. Results for the individual questions are also shown below.
Mean
Score
Your results
Overall ACO distribution
n=62021
Local FFS distribution
87
COMPARISON NOT AVAILABLE
Provider Has Medical Records
Q21. When you visited this provider in the last 6 months, how often did he or she have your medical records?
Mean
Score
Your results
Overall ACO distribution
n=54721
96
Local FFS distribution
Provider Follow Up with Test Results
Q25. In the last 6 months, when this provider ordered a blood test, x-ray, or other test for you, how often did someone
from this provider’s office follow up to give you those results?
Mean
Score
Your results
Overall ACO distribution
n=45161
88
Local FFS distribution
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
25
ACCOUNTABLE CARE ORGANIZATION
Health Care Team Discuss Taking Medicines
Q55. In the last 6 months, how often did you and anyone on your health care team talk about all the prescription medicines
you were taking?
Mean
Score
Your results
Overall ACO distribution
n=58461
77
Local FFS distribution
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
26
ACCOUNTABLE CARE ORGANIZATION
Between Visit Communication
This graph shows how your ACO performed on the summary survey measure “Between Visit Communication,” which is
derived from a single survey question: 14. The graph shows the number of respondents who answered the question, the
distribution of responses and the mean score.
Q14. In the last 6 months, did this provider’s office contact you to remind you to make an appointment for tests or
treatment?
Mean
Score
Your results
Overall ACO distribution
Local FFS distribution
n=34231
60
COMPARISON NOT AVAILABLE
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
27
ACCOUNTABLE CARE ORGANIZATION
Helping You Take Medications as Directed
This graph shows how your ACO performed on the summary survey measure “Helping You Take Medications as Directed,”
which is derived from survey questions 31, 33, and 34. Because these three survey questions have different response
scales, it is not possible to display a segmented-bar graph for the summary survey measure. Results for the individual
questions included in this summary survey measure are shown below.
Provider Gave Instructions for Taking Medicines
Q31. In the last 6 months, how often did this provider give you easy to understand instructions about how to take your
medicines?
Mean
Score
Your results
Overall ACO distribution
n=20431
Local FFS distribution
92
COMPARISON NOT AVAILABLE
Written Instructions Easy to Understand
Q33. Was the written information this provider gave you easy to understand?
Mean
Score
Your results
Overall ACO distribution
Local FFS distribution
n=11374
99
COMPARISON NOT AVAILABLE
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
28
ACCOUNTABLE CARE ORGANIZATION
Suggest Ways to Help Remember
Q34. In the last 6 months, did this provider suggest ways to help you remember to take your medicines?
Mean
Score
Your results
Overall ACO distribution
Local FFS distribution
n=20055
39
COMPARISON NOT AVAILABLE
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
29
ACCOUNTABLE CARE ORGANIZATION
Stewardship of Patient Resources
This graph shows how your ACO performed on the summary survey measure “Stewardship of Patient Resources,” which is
derived from a single survey question: 56. The graph shows the number of respondents who answered the question, the
distribution of responses and the mean score.
Q56. In the last 6 months, did you and anyone on your health care team talk about how much your prescription medicines
cost?
Mean
Score
Your results
Overall ACO distribution
Local FFS distribution
n=58646
29
COMPARISON NOT AVAILABLE
Note: Percentages may not add to 100 due to rounding. For information on how we adjusted for case-mix, see Part 3 of this
report. N/A means too few respondents answered the question to permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
30
ACCOUNTABLE CARE ORGANIZATION
Frequency Tables (not Case-Mix-Adjusted or Weighted)6
Q1. Our records show that you visited the provider named below in the last 6 months. <> Is that right?
Frequency
Percent
Yes
No
Total
Missing
Q2. Is this the provider you usually see if you need a check-up, want advice about a health problem, or get sick or hurt?
Frequency
Percent
Yes
No
Total
Missing
Q3. How long have you been going to this provider?
Frequency
Percent
Less than 6 months
At least 6 months but less than 1 year
At least 1 year but less than 3 years
At least 3 years but less than 5 years
5 years or more
Total
Missing
6
The frequencies shown in this section are not case-mix adjusted or weighted and therefore may not be consistent with means displayed in previous
report sections. In addition, percentages may not add to 100 due to rounding. N/A indicates that too few respondents answered the question to
permit reporting.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
31
ACCOUNTABLE CARE ORGANIZATION
Q4. In the last 6 months, how many times did you visit this provider to get care for yourself?
Frequency
Percent
None
1
2
3
4
5 to 9
10 or more
Total
Missing
Q5. In the last 6 months, did you phone this provider’s office to get an appointment for an illness, injury, or condition that needed care
right away?
Frequency
Percent
Yes
No
Total
Missing
Q6. In the last 6 months, when you phoned this provider’s office to get an appointment for care you needed right away, how often did
you get an appointment as soon as you needed?
Frequency
Percent
Never
Sometimes
Usually
Always
Total
Missing
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
32
ACCOUNTABLE CARE ORGANIZATION
Q7. In the last 6 months, did you make any appointments for a check-up or routine care with this provider?
Frequency
Percent
Yes
No
Total
Missing
Q8. In the last 6 months, when you made an appointment for a check-up or routine care with this provider, how often did you get an
appointment as soon as you needed?
Frequency
Percent
Never
Sometimes
Usually
Always
Total
Missing
Q9. In the last 6 months, did you phone this provider’s office with a medical question during regular office hours?
Frequency
Percent
Yes
No
Total
Missing
Q10. In the last 6 months, when you phoned this provider’s office during regular office hours, how often did you get an answer to your
medical question that same day?
Frequency
Percent
Never
Sometimes
Usually
Always
Total
Missing
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
33
ACCOUNTABLE CARE ORGANIZATION
Q11. In the last 6 months, did you phone this provider’s office with a medical question after regular office hours?
Frequency
Percent
Yes
No
Total
Missing
Q12. In the last 6 months, when you phoned this provider’s office after regular office hours, how often did you get an answer to your
medical question as soon as you needed?
Frequency
Percent
Never
Sometimes
Usually
Always
Total
Missing
Q13. Some offices remind patients about tests, treatment, or appointments in between their visits. In the last 6 months, did you get
any reminders from this provider’s office between visits?
Frequency
Percent
Yes
No
Total
Missing
Q14. In the last 6 months, did this provider’s office contact you to remind you to make an appointment for tests or treatment?
Frequency
Percent
Yes
No
Total
Missing
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
34
ACCOUNTABLE CARE ORGANIZATION
Q15. Wait time includes time spent in the waiting room and exam room. In the last 6 months, how often did you see this provider
within 15 minutes of your appointment time?
Frequency
Percent
Never
Sometimes
Usually
Always
Total
Missing
Q16. In the last 6 months, how often did this provider explain things in a way that was easy to understand?
Frequency
Percent
Never
Sometimes
Usually
Always
Total
Missing
Q17. In the last 6 months, how often did this provider listen carefully to you?
Frequency
Percent
Never
Sometimes
Usually
Always
Total
Missing
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
35
ACCOUNTABLE CARE ORGANIZATION
Q18. In the last 6 months, did you talk with this provider about any health questions or concerns?
Frequency
Percent
Yes
No
Total
Missing
Q19. In the last 6 months, how often did this provider give you easy to understand information about these health questions or
concerns?
Frequency
Percent
Never
Sometimes
Usually
Always
Total
Missing
Q20. In the last 6 months, how often did this provider seem to know the important information about your medical history?
Frequency
Percent
Never
Sometimes
Usually
Always
Total
Missing
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
36
ACCOUNTABLE CARE ORGANIZATION
Q21. When you visited this provider in the last 6 months, how often did he or she have your medical records?
Frequency
Percent
Never
Sometimes
Usually
Always
Total
Missing
Q22. In the last 6 months, how often did this provider show respect for what you had to say?
Frequency
Percent
Never
Sometimes
Usually
Always
Total
Missing
Q23. In the last 6 months, how often did this provider spend enough time with you?
Frequency
Percent
Never
Sometimes
Usually
Always
Total
Missing
Q24. In the last 6 months, did this provider order a blood test, x-ray, or other test for you?
Frequency
Percent
Yes
No
Total
Missing
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
37
ACCOUNTABLE CARE ORGANIZATION
Q25. In the last 6 months, when this provider ordered a blood test, x-ray, or other test for you, how often did someone from this
provider’s office follow up to give you those results?
Frequency
Percent
Never
Sometimes
Usually
Always
Total
Missing
Q26. In the last 6 months, did you and this provider talk about starting or stopping a prescription medicine?
Frequency
Percent
Yes
No
Total
Missing
Q27. Did you and this provider talk about the reasons you might want to take a medicine?
Frequency
Percent
Yes
No
Total
Missing
Q28. Did you and this provider talk about the reasons you might not want to take a medicine?
Frequency
Percent
Yes
No
Total
Missing
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
38
ACCOUNTABLE CARE ORGANIZATION
Q29. When you and this provider talked about starting or stopping a prescription medicine, did this provider ask what you thought
was best for you?
Frequency
Percent
Yes
No
Total
Missing
Q30. After you and this provider talked about starting or stopping a prescription medicine, did you start a prescription medicine?
Frequency
Percent
Yes
No
Total
Missing
Q31. In the last 6 months, how often did this provider give you easy to understand instructions about how to take your medicines?
Frequency
Percent
Never
Sometimes
Usually
Always
Total
Missing
Q32. In the last 6 months, other than a prescription, did this provider give you written information or write down information about
how to take your medicines?
Frequency
Percent
Yes
No
Total
Missing
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
39
ACCOUNTABLE CARE ORGANIZATION
Q33. Was the written information this provider gave you easy to understand?
Frequency
Percent
Yes
No
Total
Missing
Q34. In the last 6 months, did this provider suggest ways to help you remember to take your medicines?
Frequency
Percent
Yes
No
Total
Missing
Q35. In the last 6 months, did you and this provider talk about having surgery or any type of procedure?
Frequency
Percent
Yes
No
Total
Missing
Q36. Did you and this provider talk about the reasons you might want to have the surgery or procedure?
Frequency
Percent
Yes
No
Total
Missing
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
40
ACCOUNTABLE CARE ORGANIZATION
Q37. Did you and this provider talk about the reasons you might not want to have the surgery or procedure?
Frequency
Percent
Yes
No
Total
Missing
Q38. When you and this provider talked about having surgery or a procedure, did this provider ask what you thought was best for
you?
Frequency
Percent
Yes
No
Total
Missing
Q39. In the last 6 months, did you and this provider talk about how much of your personal health information you wanted shared with
your family or friends?
Frequency
Percent
Yes
No
Total
Missing
Q40. In the last 6 months, did this provider respect your wishes about how much of your personal health information to share with
your family or friends?
Frequency
Percent
Yes
No
Total
Missing
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
41
ACCOUNTABLE CARE ORGANIZATION
Q41. Using any number from 0 to 10, where 0 is the worst provider possible and 10 is the best provider possible, what number would
you use to rate this provider?
Frequency
Percent
0: Worst provider possible
1
2
3
4
5
6
7
8
9
10: Best provider possible
Total
Missing
Q42. In the last 6 months, how often were clerks and receptionists at this provider’s office as helpful as you thought they should be?
Frequency
Percent
Never
Sometimes
Usually
Always
Total
Missing
Q43. In the last 6 months, how often did clerks and receptionists at this provider’s office treat you with courtesy and respect?
Frequency
Percent
Never
Sometimes
Usually
Always
Total
Missing
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
42
ACCOUNTABLE CARE ORGANIZATION
Q44. Specialists are doctors like surgeons, heart doctors, allergy doctors, skin doctors, and other doctors who specialize in one area of
health care. Is the provider named in Question 1 of this survey a specialist?
Frequency
Percent
Yes
No
Total
Missing
Q45. In the last 6 months, did you try to make any appointments with specialists?
Frequency
Percent
Yes
No
Total
Missing
Q46. In the last 6 months, how often was it easy to get appointments with specialists?
Frequency
Percent
Never
Sometimes
Usually
Always
Total
Missing
Q47. In the last 6 months, how often did the specialist you saw most seem to know the important information about your medical
history?
Frequency
Percent
Never
Sometimes
Usually
Always
Total
Missing
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
43
ACCOUNTABLE CARE ORGANIZATION
Q48. How many specialists have you seen in the last 6 months?
Frequency
Percent
None
1 specialist
2
3
4
5 or more specialists
Total
Missing
Q49. Your health care team includes all the doctors, nurses, and other people you see for health care. In the last 6 months, did you and
anyone on your health care team talk about specific things you could do to prevent illness?
Frequency
Percent
Yes
No
Total
Missing
Q50. In the last 6 months, did you and anyone on your health care team talk about a healthy diet and healthy eating habits?
Frequency
Percent
Yes
No
Total
Missing
Q51. In the last 6 months, did you and anyone on your health care team talk about the exercise or physical activity you get?
Frequency
Percent
Yes
No
Total
Missing
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
44
ACCOUNTABLE CARE ORGANIZATION
Q52. In the last 6 months, did anyone on your health care team talk with you about specific goals for your health?
Frequency
Percent
Yes
No
Total
Missing
Q53. In the last 6 months, how often was it easy to get the care, tests or treatment you thought you needed?
Frequency
Percent
Never
Sometimes
Usually
Always
Total
Missing
Q54. In the last 6 months, did you take any prescription medicine?
Frequency
Percent
Yes
No
Total
Missing
Q55. In the last 6 months, how often did you and anyone on your health care team talk about all the prescription medicines you were
taking?
Frequency
Percent
Never
Sometimes
Usually
Always
Total
Missing
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
45
ACCOUNTABLE CARE ORGANIZATION
Q56. In the last 6 months, did you and anyone on your health care team talk about how much your prescription medicines cost?
Frequency
Percent
Yes
No
Total
Missing
Q57. In the last 6 months, did anyone on your health care team ask you if there was a period of time when you felt sad, empty, or
depressed?
Frequency
Percent
Yes
No
Total
Missing
Q58. In the last 6 months, did you and anyone on your health care team talk about things in your life that worry you or cause you
stress?
Frequency
Percent
Yes
No
Total
Missing
Q59. In general, how would you rate your overall health?
Frequency
Percent
Excellent
Very good
Good
Fair
Poor
Total
Missing
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
46
ACCOUNTABLE CARE ORGANIZATION, LLC
Q60. In general, how would you rate your overall mental or emotional health?
Frequency
Percent
Excellent
Very good
Good
Fair
Poor
Total
Missing
Q61. In the last 12 months, have you seen a doctor or other health provider 3 or more times for the same condition or problem?
Frequency
Percent
Yes
No
Total
Missing
Q62. Is this a condition or problem that has lasted for at least 3 months?
Frequency
Percent
Yes
No
Total
Missing
Q63. Do you now need or take medicine prescribed by a doctor?
Frequency
Percent
Yes
No
Total
Missing
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
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ACCOUNTABLE CARE ORGANIZATION
Q64. Is this medicine to treat a condition that has lasted for at least 3 months?
Frequency
Percent
Yes
No
Total
Missing
Q65. During the last 4 weeks, how much did your physical health interfere with your normal social activities with family, friends,
neighbors, or groups?
Frequency
Percent
Not at all
Slightly
Moderately
Quite a bit
Extremely
Total
Missing
Q66. During the last 4 weeks, how much of the time did your physical health interfere with your social activities (like visiting with
friends, relatives, etc.)?
Frequency
Percent
All of the time
Most of the time
Some of the time
A little of the time
None of the time
Total
Missing
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
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Q67. What is your age?
Frequency
Percent
Frequency
Percent
18 to 24
25 to 34
35 to 44
45 to 54
55 to 64
65 to 69
70 to 74
75 to 79
80 to 84
85 or older
Total
Missing
Q68. Are you male or female?
Male
Female
Total
Missing
Q69. What is the highest grade or level of school that you have completed?
Frequency
Percent
8th grade or less
Some high school,but did not graduate
High school graduate or GED
Some college or 2-year degree
4-year college graduate
More than 4-year college degree
Total
Missing
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
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Q70. How well do you speak English?
Frequency
Percent
Very well
Well
Not well
Not at all
Total
Missing
Q71. Do you speak a language other than English at home?
Frequency
Percent
Yes
No
Total
Missing
Q72. What is the language you speak at home?
Frequency
Percent
Spanish
Chinese
Korean
Russian
Vietnamese
Some other language
Total
Missing
Q73. Are you deaf or do you have serious difficulty hearing?
Frequency
Percent
Yes
No
Total
Missing
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
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Q74. Are you blind or do you have serious difficulty seeing, even when wearing glasses?
Frequency
Percent
Yes
No
Total
Missing
Q75. Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making
decisions?
Frequency
Percent
Yes
No
Total
Missing
Q76. Do you have serious difficulty walking or climbing stairs?
Frequency
Percent
Yes
No
Total
Missing
Q77. Do you have difficulty dressing or bathing?
Frequency
Percent
Yes
No
Total
Missing
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
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Q78. Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a doctor’s office
or shopping?
Frequency
Percent
Yes
No
Total
Missing
Q79. Are you of Hispanic, Latino, or Spanish origin?
Frequency
Percent
Yes, Hispanic, Latino, or Spanish
No, not Hispanic, Latino, or Spanish
Total
Missing
Q80. Which group best describes you?
Frequency
Percent
Mexican, Mexican-American, Chicano
Puerto Rican
Cuban
Another Hispanic, Latino, or Spanish origin
Total
Missing
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
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Q81. What is your race? Mark one or more.
Frequency
Percent
White
Black or African American
American Indian or Alaska Native
Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
Other Asian
Native Hawaiian
Guamanian or Chamorro
Samoan
Other Pacific Islander
Total
Missing
Q82. Did someone help you complete this survey?
Frequency
Percent
Yes
No
Total
Missing
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
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Q83. How did that person help you? Mark one or more.
Frequency
Percent
Read the questions to me
Wrote down the answers I gave
Answered the questions for me
Translated the questions into my language
Helped in some other way
Total
Missing
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
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Part 3: Background and Methodology
Methodology
The CAHPS Survey for the Medicare Shared Savings Program and Pioneer Model ACOs assesses Medicare Fee-For-Service
beneficiaries’ experiences with care in ACOs participating in the Medicare Shared Savings Program and Pioneer Model
ACOs. A version of this survey was field tested in 2012 with Medicare Fee-For-Service beneficiaries receiving care from
providers participating in the Medicare Physician Group Practice Demonstration Leading Quality Group. The first national
implementation of the survey occurred in the first half of 2013. This final section of the report provides additional
information about the content of the survey, data collection, and how the data were analyzed.
The Survey Instrument
The CAHPS Survey for the Medicare Shared Savings Program and Pioneer Model ACOs contained 83 questions, organized
into the following sections: Your Provider (3 questions), Your Care From This Provider in the Last 6 Months (38 questions),
Clerks and Receptionists at This Provider’s Office (2 questions), Your Care from Specialists in the Last 6 Months (5
questions), All Your Care in the Last 6 Months (10 questions), and About You (25 questions).
Many of the evaluative questions included in the survey are preceded by screener questions, so that only those
beneficiaries for whom the question is relevant (i.e., those with applicable needs or experiences) are asked to answer the
evaluative questions.
From the evaluative questions, we derived 12 summary survey measures for reporting. Three of the 12 summary survey
measures are comprised of multiple more specific (subsidiary) measures. For example, the summary survey measure
“Shared Decision-Making” is made up of three subsidiary measures, “Making Decisions about Medications,” “Making
Decisions about Surgery,” and “Sharing Your Health Information.” In most cases, the measures—whether summary survey
measures or their subsidiaries—are made up of multiple survey questions. Measures that will contribute to an ACO’s quality
score are identified and listed before measures that will not contribute to an ACO’s quality score.
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Table 1. CAHPS Survey for the Medicare Shared Savings Program and Pioneer Model ACOs – Summary Survey
Measures and Survey Questions
Summary Survey
Measure
Question(s) Included in the Measure
Measure Used
to Determine
ACO’s Quality
Score?
In the last 6 months, when you phoned this provider’s office to get an
appointment for care you needed right away, how often did you get an
appointment as soon as you needed?
In the last 6 months, when you made an appointment for a check-up or
routine care with this provider, how often did you get an appointment as
soon as you needed?
Getting Timely
Care,
Appointments
and Information
In the last 6 months, when you phoned this provider’s office during regular
office hours, how often did you get an answer to your medical question that
same day?
Yes
In the last 6 months, when you phoned this provider’s office after regular
office hours, how often did you get an answer to your medical question as
soon as you needed?
Wait time includes time spent in the waiting room and exam room. In the
last 6 months, how often did you see this provider within 15 minutes of your
appointment time?
In the last 6 months, how often did this provider explain things in a way that
was easy to understand?
In the last 6 months, how often did this provider listen carefully to you?
How Well
Providers
Communicate
In the last 6 months, how often did this provider give you easy to
understand information about these health questions or concerns?
In the last 6 months, how often did this provider seem to know the
important information about your medical history?
Yes
In the last 6 months, how often did this provider show respect for what you
had to say?
In the last 6 months, how often did this provider spend enough time with
you?
Patient’s Rating
of Provider
Using any number from 0 to 10, where 0 is the worst provider possible and
10 is the best provider possible, what number would you use to rate this
provider?
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
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Table 1. CAHPS Survey for the Medicare Shared Savings Program and Pioneer Model ACOs – Summary Survey
Measures and Survey Questions (continued)
Summary Survey
Measure
Access to
Specialists
Question(s) Included in the Measure
Measure Used
to Determine
ACO’s Quality
Score?
In the last 6 months, how often was it easy to get appointments with
specialists?
Yes
In the last 6 months, how often did the specialist you saw most seem to
know the important information about your medical history?
General Health Promotion and Education
In the last 6 months, did you and anyone on your health care team talk
about specific things you could do to prevent illness?
In the last 6 months, did you and anyone on your health care team talk
about a healthy diet and healthy eating habits?
Health
Promotion and
Education
Yes
In the last 6 months, did you and anyone on your health care team talk
about the exercise or physical activity you get?
In the last 6 months, did anyone on your health care team talk with you
about specific goals for your health?
Mental Health Promotion and Education
In the last 6 months, did anyone on your health care team ask you if there
was a period of time when you felt sad, empty, or depressed?
Yes
In the last 6 months, did you and anyone on your health care team talk
about things in your life that worry you or cause you stress?
Making Decisions about Medications
Did you and this provider talk about the reasons you might want to take a
medicine?
Did you and this provider talk about the reasons you might not want to take
a medicine?
Shared DecisionMaking
Yes
When you and this provider talked about starting or stopping a prescription
medicine, did this provider ask what you thought was best for you?
Making Decisions about Surgery
Did you and this provider talk about the reasons you might want to have the
surgery or procedure?
Did you and this provider talk about the reasons you might not want to have
the surgery or procedure?
Yes
When you and this provider talked about having surgery or a procedure, did
this provider ask what you thought was best for you?
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Table 1. CAHPS Survey for the Medicare Shared Savings Program and Pioneer Model ACOs – Summary Survey
Measures and Survey Questions (continued)
Patient
Experience
Domain
Shared DecisionMaking
Questions(s) Included in the Measure
Sharing Your Health Information
In the last 6 months, did you and this provider talk about how much of your
personal health information you wanted shared with your family or friends?
Measure Used
to Determine
ACO’s Quality
Score?
Yes
In the last 6 months, did this provider respect your wishes about how much
of your personal health information to share with your family or friends?
Self-Rated Health
In general, how would you rate your overall health?
Yes
Self-Rated Mental Health
In general, how would you rate your overall mental or emotional health?
Yes
Cognitive Functioning
Because of a physical, mental, or emotional condition, do you have serious
difficulty concentrating, remembering, or making decisions?
Yes
Beneficiaries without a Chronic Condition
In the past 12 months, have you seen a provider 3 or more times for
condition or problem that has lasted for at least 3 months?
Health Status
and Functional
Status
Yes
Do you need or take medicine to treat the condition?
Beneficiaries’ Functional Status
During the last 4 weeks, how much did your physical health interfere with
your normal social activities with family, friends, neighbors or groups?
During the last 4 weeks, how much of the time did your physical health
interfere with your social activities (like visiting with friends, relatives, etc.)?
Yes
Do you have serious difficulty walking or climbing stairs?
Do you have difficulty dressing or bathing?
Because of a physical, mental, or emotional condition, do you have difficulty
doing errands alone such as visiting a doctor’s office or shopping?
Courteous and
Helpful Office
Staff
In the last 6 months, how often were clerks and receptionists at this
provider’s office as helpful as you thought they should be?
No
In the last 6 months, how often did clerks and receptionists at this provider’s
office treat you with courtesy and respect?
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Table 1. CAHPS Survey for the Medicare Shared Savings Program and Pioneer Model ACOs – Summary Survey
Measures and Survey Questions (continued)
Patient
Experience
Domain
Question(s) Included in the Measure
Measure Used
to Determine
ACO’s Quality
Score?
When you visited this provider in the last 6 months, how often did he or she
have your medical records?
Care
Coordination
In the last 6 months, when this provider ordered a blood test, x-ray, or other
test for you, how often did someone from this provider’s office follow up to
give you those results?
No
In the last 6 months, how often did you and anyone on your health care
team talk about all the prescription medicines you were taking?
Between Visit
Communication
Helping You
Take
Medications as
Directed
Stewardship of
Patient
Resources
In the last 6 months, did this provider’s office contact you to remind you to
make an appointment for tests or treatment?
No
In the last 6 months, how often did this provider give you easy to
understand instructions about how to take your medicines?
Was the written information this provider gave you easy to understand?
No
In the last 6 months, did this provider suggest ways to help you remember to
take your medicines?
In the last 6 months, did you and anyone on your health care team talk
about how much your prescription medicines cost?
No
Data Collection
Data collection was conducted by CMS’ contractor for the national implementation of the CAHPS Survey for the Medicare
Shared Savings Program and Pioneer Model ACOs.
Sample Selection and Eligibility Criteria. CMS’ contractor selected a sample of 117,800 beneficiaries receiving primary care
in the prior 12 months. For each ACO, a random sample of 775 beneficiaries was drawn, 194 drawn from the top 10% of
users and 581 drawn from the remaining 90% of users. The top 10% of users in each ACO was defined as beneficiaries who
ranked within the top 10% by their total value of primary care claims. The top 10% of utilizers were oversampled (1) to
increase the likelihood that the survey questions that measure less common experiences would receive adequate numbers
of responses; and (2) because one of the goals of the Medicare Shared Savings Program and the Pioneer Model ACOs is to
incentivize high quality and efficient service delivery, making it particularly useful to capture the patient experiences of
those with high levels of health care utilization.
Survey Implementation. The survey was conducted between January 31 and April 15, 2013, and asked about beneficiaries’
experiences with care received in the previous 6 months. The survey referenced (by name) the provider who delivered the
plurality of the beneficiary’s primary care in the prior 12 months. The data collection protocol included mailing of a prenotification letter, up to two mailings of paper surveys, and telephone interviews with beneficiaries who did not respond to
the mail survey. The mail survey and telephone interviews were available in English, Spanish, Cantonese, Korean, Mandarin,
Russian, and Vietnamese.
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Table 2. Implementation Timeline for the CAHPS Survey for the Medicare Shared Savings Program and Pioneer
Model ACOs.
Task
Dates
Pre-notification letters sent to sample beneficiaries
January 23, 2013
Surveys mailed to sample beneficiaries
January 31, 2013
Follow-up surveys mailed to non-respondents
Follow-up calls made to non-respondents
February 25, 2013
March 18-April 15, 2013
Sample Disposition. The sample disposition and response rates for the survey are presented in Table 3. Of the 117,800
beneficiaries in the sample, 208 (0.18%) were classified as ineligible because they were institutionalized, deceased, had a
language barrier that prevented them from participating in the survey, were mentally or physically incapable of responding,
or were excluded from data collection for some other reason. The adjusted response rate, after excluding all dispositions
under the ineligible category below was 53.9% (62,483 completed surveys plus 932 partially completed surveys divided by
117,592 eligible sample beneficiaries).
Table 3. Sample Disposition, CAHPS Survey for the Medicare Shared Savings Program and Pioneer Model
ACOs.
Disposition
Completed survey
Overall
Sample
Beneficiary
Count*
Overall
Percentage
of Sample
62,483
53.04%
Partially completed survey
932
0.79%
Ineligible
208
0.18%
7
0.01%
155
0.13%
3
0.00%
39
0.03%
4
0.00%
54,177
45.99%
117,800
100%
Institutionalized
Deceased
Language Barrier
Mentally or physically unable to respond
Other excluded from survey
Non-respondents
Total sample
Beneficiary
Count for
Your ACO
Percentage
of Sample for
Your ACO
* Across all 152 ACOs
Response Weights. Data from the CAHPS Survey for the Medicare Shared Savings Program and Pioneer Model ACOs were
weighted to account for sampling design and nonresponse. Weighting is necessary so that statistics computed from the
survey data are representative of your ACO’s population of FFS beneficiaries. Sampling weights compensate for the
oversampling of high utilizers. Nonresponse weights compensate for the fact that not all sampled beneficiaries actually
respond.
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Defining an ACO’s Geographic Service Area/Local FFS Mean
For those survey questions that overlap with the content of the FFS Medicare CAHPS Survey, this report provides a
comparison between the response of beneficiaries in your ACO and the average response of FFS Medicare beneficiaries in
your ACO’s geographic survey area (the local FFS mean). To determine your ACO’s geographic service area, we identified
7
the states or substate areas in which at least 0.5% of your ACO’s assigned beneficiaries reside . For your ACO, those include
XXX. This area covers XX% of your ACO’s beneficiaries. To calculate a comparable “local” FFS mean response for your
ACO, we weighted the mean response of FFS beneficiaries in each of your ACO’s identified
state/substate areas to reflect the proportion of your ACO’s beneficiaries residing in each of those areas.
Data Analysis
CMS’ contractor analyzed the data to produce summary statistics for this report. The sections below describe the major
analysis steps.
Derivation of Summary Survey Measures. Summary survey measures consist of one or more survey questions. For
measures consisting of multiple survey questions, we typically gave questions equal weight in calculating a score on the
measure. Two exceptions are the measure of functional status and the percent of beneficiaries without a chronic condition.
For the measure of functional status, responses to the two questions about participation in social activities were summed
and this sum was then averaged with the other three questions in the measure. Beneficiaries were counted as not having a
chronic condition if they reported that they had NOT seen a provider three or more times in the past 12 months for a
condition lasting at least three months or that they had seen a provider at least three times in the past 12 months for such a
condition but did NOT take medicine to treat that condition. All summary survey measures were transformed linearly to a
0-100 possible range, as were more specific (subsidiary) measures and individual questions.
Case-Mix Adjustment. Certain Medicare beneficiary characteristics, such as age, health status, and education, are not
within the control of an ACO, but are associated with beneficiaries’ survey responses. To ensure that comparisons among
ACOs reflect differences in performance rather than differences in case-mix, it is necessary to adjust for these respondent
characteristics prior to making comparisons. Linear regression models were developed in which the dependent variable was
the response on a particular survey question and the independent variables were case-mix adjustors. First, respondent
characteristics significantly associated with reports and ratings of care were identified. Next, how much ACOs differed on
these variables was used to determine which adjustors would have the greatest impact on the dependent variables. Table 4
shows the variables used in the final case-mix adjustment models. All variables were used in all models with the exception
of Self-Rated Health and Self-Rated Mental Health and Proxy Assistance, which were not used in predicting measures in the
Health Status & Functional Status summary survey measure. In addition, Proxy Assistance was not used in predicting
measures in the Sharing Your Health Information composite.
Reliability of Scores. Reliability of items was assessed and will potentially inform decisions regarding calculation of an ACO’s
quality points in the future. Although other reports of CAHPS surveys results often suppress and/or flag measures with low
reliability in public reporting. There is no public reporting of ACO CAHPS data at this time and thus suppression/flagging of
measures is not necessary.
7
Substate areas are used for populous states in which regional variation in CAHPS responses has been observed. These
states are Texas, Pennsylvania, California, Florida, Illinois, and New York.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
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Table 4. Case-Mix Adjustment Variables, CAHPS Survey for the Medicare Shared Savings Program and Pioneer
Model ACOs.
Case-Mix Variable
Survey Question
Variable Coding
What is your age?
1)
2)
3)
4)
5)
6)
64 or younger
65 to 69
70 to 74
75 to 79
80 to 84
85 or older
What is the highest grade or level
of school that you have
completed?
1)
2)
3)
4)
5)
6)
8th grade or less
Some high school, but did not graduate
High school graduate or GED
Some college or 2-year degree
4-year college graduate
More than 4-year college degree
Self-Rated Health
In general, how would you rate
your overall health?
1)
2)
3)
4)
5)
Poor
Fair
Good
Very good
Excellent
Self-Rated Mental Health
In general, how would you rate
your overall mental or emotional
health?
1)
2)
3)
4)
5)
Poor
Fair
Good
Very good
Excellent
Medicaid dual eligibility
[From enrollment file]
1) Not Medicaid eligible
2) Medicaid eligible
Low income subsidy
eligibility
[From enrollment file]
1) Not eligible
2) Eligible
Proxy Assistance
Did someone help you complete
this survey? If “yes,” how did that
person help you?
1) No assistance on survey
2) Proxy assistance (someone helped but
did not answer for respondent)
3) Proxy response (someone answered for
respondent)
Use of Asian language
(Cantonese, Korean,
Mandarin, or Vietnamese)
survey
[Survey administration]
1) Did not use Asian language survey
2) Did use Asian language survey
Age
Education
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Table 5 shows the F-statistic for each nominal predictor, with significance tests. The “signs” in the table entries are
synthetic as the F-statistic is always positive. These signs indicate the direction of the linear trend in the coefficients from
8
the “lowest” category (youngest , least education, worst health, not eligible for Medicaid or a low income subsidy, no proxy
assistance, and non-use of the Asian language survey) to the “highest.” Thus, a positive value indicates that higher
categories gave more favorable responses, and a negative value indicates that higher categories gave less favorable
responses. An example of how to interpret Table 5 is located below the table itself.
Age, education, self-rated health status, self-rated mental health status, Medicaid dual eligibility, low income subsidy
eligibility, receipt of proxy assistance, and use of an Asian language survey accounted for a considerable amount of
variation among ACOs on the dependent variables. Not every variable was important in every model, but each predictor
was important in at least some of the models. The more striking patterns tend to be consistent across questions within a
more specific measure. For example, self-rated mental health has a strong positive association with reported quality of
provider communication. Age has a strong negative association with each question in the General and Mental Health
Promotion and Education measures, as does self-rated health. Better mental health is positively associated with advice
discussions for non-mental health problems; the opposite holds for discussions regarding mental health problems,
suggesting that mental health discussions might displace other health discussions for those in poor mental health. In
addition, not surprisingly, age and Medicaid dual eligibility have a strong negative association with each question regarding
functional status meaning that olders respondents and respodents who are eligible for Medicaid tend to respond more
negatively to questions about their functional status.
8
The under-65 age category is excluded from this calculation because of that category of respondents’ distinctive selection
for Medicare based on a disability.
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
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Table 5. F-Statistics for Case-mix Associations (“Signs” Added to Indicate Directions of Association)
Summary Measure
Getting Timely Care,
Appointments, and
Information
How Well Providers
Communicate
Patient’s Rating of
Provider
Access to Specialists
General Health
Promotion and
Education
Questions
Getting Appointments for
Urgent Care
Getting Appointments for
Routine Care
Medical Question Answered
Medical Question Answered
After Hours
Getting Seen Within 15
Minutes of Your Appointment
Providing Clear Explanations
Listen Carefully
Easy to Understand
Information
Know Important Medical
History
Showing Respect for What
Patients Have to Say
Spending Enough Time With
Patients
Patient’s Rating of Provider
Getting Appointments With
Specialists
Specialist Know Important
Medical History
Told How to Prevent Illness
Told About Healthy Habits
Discuss Exercise or Physical
Activity
Discuss Specific Health Goals
Mental
Health
Status
Medicaid
Dual
Eligibility
Low
Income
Subsidy
Eigibility
Proxy
Assistance
Use of
Asian
Language
Survey
Age
Education
General
Health
Status
-1.38
-2.15
18.49***
29.29***
-47.46***
-0.25
3.33*
-5.79*
2.06
-1.47
17.93***
65.29***
-65.6***
-0.30
13.82***
-17.88***
-3.31**
-6.70***
6.09***
29.42***
-2.32
3.24
0.35
-6.43*
-1.12
1.47
-0.87
12.87***
-1.89
-0.35
-0.04
-1.92
-6.45***
1.19
47.69***
33.49***
-5.87*
0.01
-5.46**
-6.09*
-11.06***
-0.97
4.37***
-2.43*
13.02***
18.29***
109.05***
102.25***
-41.11***
-23.26***
1.61
0
3.30*
2.98
0.07
-4.55*
-4.01**
-1.50
32.27***
106.1***
-7.4**
2.82
6.26**
-2.57
1.87
-3.06**
20.12***
98.05***
-40.23***
1.79
8.55***
1.86
-3.02**
-1.52
15.71***
69.42***
-47.86***
0
7.20***
-2.21
-10.28***
-4.54***
32.42***
120.31***
-39.34***
-0.51
19.83***
-0.29
4.34***
-16.28***
42.42***
104.97***
-20.74***
0
1.11
15.99***
-1.08
-9.80***
20.54***
63.24***
-10.79**
-0.29
2.93
0.25
-2.73*
-9.31***
-5.64***
88.05***
-32.19***
0.01
7.57***
1.29
-181.24***
-238.39***
71.29***
9.26***
-59.63***
-68.69***
33.68***
25.25***
-10.52**
0.47
-2.03
1.98
152.21***
132.35***
1.02
11.75***
-154.35***
58.62***
-22.67***
22.95***
-11.77***
-3.18
87.25***
7.18**
-173.53***
25.31***
-86.6***
38.59***
2.04
0.04
137.09***
8.95**
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
64
ACCOUNTABLE CARE ORGANIZATION
Table 5. F-Statistics for Case-mix Associations (“Signs” Added to Indicate Directions of Association) continued
Summary Measure
Mental Health
Promotion and
Education
Making Decisions
about Medications
Making Decisions
about Surgery
Sharing Your Health
Information
Cognitive Functioning
Beneficiaries with a
Chronic Condition
Age
Education
General
Health
Status
Asked About Mental Health
-174.8***
6.11***
-26.20***
-179.61***
13.14***
Low
Income
Subsidy
Eigibility
1.32
Asked About Stress
-215.8***
37.76***
-3.57**
-226.71***
11.89***
-16.65***
3.63**
-0.50
2.18
-17.93***
11.8***
-1.31
-14.66***
-4.99***
-2.08
10.58***
5.78***
Questions
Discuss Reasons for Taking
Medicine
Discuss Reasons for NOT Taking
Medicine
Discuss What is Best (medicine)
Discuss Reasons for Surgery
Discuss Reasons for NOT
Having Surgery
Discuss What is Best (surgery)
Extent of Information Shared
with Family and Friends
Provider Respect Extent of
Information Shared
Difficulty concentrating,
remembering, or making
decisions
Saw provider 3 or more times
for condition lasting at least 3
months AND took medication
to treat the condition
118.56***
Use of
Asian
Language
Survey
-4.69*
0.36
111.91***
-5.72*
-6.41*
2.51
10.50***
-0.35
-0.56
-6.02*
-6.89**
45.3***
4.60*
7.74***
-1.08
4.09**
7.10***
8.81**
-2.11
0
0.06
14.04***
4.02*
0.75
-55.93***
30.21***
-3.93**
3.31*
2.56
1.01
25.61***
-10.10**
-2.91*
3.83**
3.28*
6.61***
10.14**
0.06
15.13***
-3.35
-8.64***
-22.18***
-8.25***
7.73***
38.85***
0.77
--
7.25**
-90.68***
55.69***
1.34
29.95***
-29.80***
-1.28
--
25.12***
-807.38***
102.88***
--
--
-499.18***
-43.72***
--
5.78*
193.60***
-18.18***
--
--
-47.67***
-5.42*
--
-49.76***
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
Mental
Health
Status
Medicaid
Dual
Eligibility
65
Proxy
Assistance
ACCOUNTABLE CARE ORGANIZATION
Table 5. F-Statistics for Case-mix Associations (“Signs” Added to Indicate Directions of Association) continued
Summary Measure
Beneficiaries’
Functional Status
Courteous and
Helpful Office Staff
Care Coordination
Between Visit
Communication
Helping You Take
Medications as
Directed
Stewardship of
Patient Resources
Mental
Health
Status
Medicaid
Dual
Eligibility
Low
Income
Subsidy
Eligibility
Use of
Asian
Language
Survey
Age
Education
General
Health
Status
-672.85***
36.11***
--
--
-330.22***
-49.47***
--
3.53
-591.87***
45.64***
--
--
-472.51***
-53.20***
--
1.30
-600.5***
130.75***
--
--
-596.68***
-96.78***
--
10.87***
Difficulty Dressing or Bathing
-387.89***
42.58***
--
--
-609.05***
-39.92***
--
-0.35
Difficulty Performing Errands
-996.44***
112.02***
--
--
-946.36***
-61.16***
--
3.55
Office Staff Helpful
Office Staff Treat You With
Courtesy and Respect
Provider Has Medical Records
Provider Follow Up with Test
Results
Health Care Team Discuss
Taking Medicines
Providers office contacted you
to make appointment
Provider Give Instructions for
Taking Medicines
Written Instructions Easy to
Understand
Suggest Ways to Help
Remember
Health care team talked about
how much medicines cost
17.37***
-32.37***
19.58***
87.20***
-9.46**
-1.30
-9.12***
-0.01
25.24***
-6.41***
9.83***
75.62***
-16.78***
0
-20.65***
2.32
0.52
-1.68
3.09*
49.22***
-45.9***
3.82
5.41**
-6.74**
-3.27**
-5.96***
16.98***
49***
-10.02**
-1.60
1.83
-0.55
-81.44***
8.48***
5.94***
70.47***
-6.53*
-7.10**
84.16***
10.48**
1.31
-6.96***
-6.61***
-2.25
62.38***
0.64
-10.46***
2.82
-9.39***
-6.94***
4.80***
28.39***
0.53
-1.14
7.40***
-17.6***
0.71
0.86
-0.35
4.18**
0
0.08
-0.69
-16.43***
4.53***
-63.57***
9.15***
-3.19*
120.43***
6.61*
-7.41***
2.45
-51.32***
-6.36***
-16.96***
3.02*
-91.41***
-8.76**
-22.75***
-0.21
Questions
Extent Physical Health
Interfered with Social Activities
How Often did Physical Health
Interfere with Social Activities
Difficulty Walking or Climbing
Stairs
* p<0.05; ** p<0.01; *** p<0.001
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
66
Proxy
Assistance
ACCOUNTABLE CARE ORGANIZATION
Interpretation of Table 5: The sixth row of Table 5, (labeled “Providing Clear Explanations”) indicates that beneficiaries’
age, education, self-rated health, self-rated mental health, Medicaid eligibility and receipt of proxy assistance were
statistically significantly associated with their response to the survey question about how often their provider gave easy-tounderstand explanations. Statistical significance is indicated by the asterisks to the right of the values -11.06, 4.37,13.02,
109.05,-41.11, and 3.3 . Because the sign of the value in the “Age” column is negative (-11.06), the interpretation is that
older beneficiaries said their providers gave easy-to-understand explanations less often than did younger beneficiaries.
Similarly, because the sign of the value in the “Medicaid dual eligibility” column is negative (-41.11), the interpretation is
that beneficiaries who are eligible for Medicaid said their providers gave easy-to-understand explanations less often than
did those that are not eligible for Medicaid. Because the sign of the value in the “Mental Health Status” column is positive
(109.05), the interpretation is that beneficiaries with better mental health said that their providers gave easy-to-understand
explanations more often than did beneficiaries with worse mental health. Similarly, because the sign of the value in the
“Education” column is positive (4.37), the interpretation is that beneficiaries with higher education said that their providers
gave easy-to-understand explanations more often than did beneficiaries with less education. As the other two values in that
row, 1.61 and 0.07, do not have asterisks beside them, the associations that they signify are not statistically significant (i.e.,
not reliably distinguishable from zero).
CAHPS for the Medicare Shared Savings Program and Pioneer ACOs
67
| File Type | application/pdf |
| File Modified | 2013-11-13 |
| File Created | 2013-09-18 |