Survey Brief
The 2018 CHP Patient Satisfaction Survey Measuring quality to demonstrate efficacy
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2018 CHP Patient Satisfaction Survey Brief Now in its 18th year, The CHP Patient Satisfaction Survey (PSS) is an integral part of CHP’s Quality Management program. The primary purpose of the Patient Satisfaction Survey is to measure patient satisfaction with CHP’s high-quality provider network and identify potential opportunities to improve overall patient satisfaction. We have expanded the value of this survey with the inclusion of questions related to achieving the triple aim – better care, smarter spending, and healthier people. As patient experiences have become a key criterion in healthcare quality, these measures reflect patient satisfaction with their providers and demonstrate compliance with treatment and improved health outcomes.1
Survey Methodology & Questions Survey participants included CHP-network chiropractic and naturopathic physicians, licensed acupuncturists and licensed massage therapists. The respondents are a convenience sample of patients seen in the selected provider offices.
With an overall satisfaction score of 98%, there is a high level of patient satisfaction with the CHP network of providers
The PSS includes questions from the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Clinician & Group Survey 3.0. This tool provides standardized survey questions and is recognized by the National Committee for Quality Assurance (NCQA) as an approved tool to assess patient satisfaction. 1 Xin H, Kilgore ML, Sen B. Is access to and use of primary care practices that patients perceive as having essential qualities of a patient-centered medical
home associated with positive patient experience? Empirical evidence from a U.S. nationally representative sample. Journal for Healthcare Quality. 2017; 39(1):4-14.
Complete Survey Averages Results | By Discipline
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# of Provider Participants
# of Respondents
Questions 1-5 & 10 | CAHPS® Average Score
Qustion 6-9 | CHP Average Score
Question 10 | Rate Your Provider
DC
41
135
97%
91%
97%
ND
11
25
98%
93%
96%
LAc
25
94
99%
93%
98%
LM
40
180
98%
94%
98%
Total
117
434
98%
93%
97%
The questions selected for the CHP PSS pertain to: • Appointment accessibility,
• Provider communication including showing respect for what the patient had to say, time spent with them, and providing easy to understand explanations.
• Overall rating of the provider, • The provider’s knowledge of the patient’s medical history,
The responses from these questions provides valuable feedback to clinicians about how well they are performing across a range of important measures as well as specific opportunities for improvement. The survey also includes questions developed by CHP. These questions inquire about respondent’s assessment of providers engaging patients to manage their condition as well as outcomes of the treatment or recommendations. Outcomes are inquired about in general and specifically, including reduced use of opioids/ narcotics and reduced need for other conventional medical care as a result of treatments or recommendations by CHP integrative healthcare (IH) providers.
Survey Results Our 2018 survey results show that patient satisfaction with CHP providers remains at a consistently high level across all categories
CAHPS® Individual Question Survey Results | By Discipline Q1
Q2
Q3
Q4
Q5
Q10
DC
96.7%
99.3%
97.8%
98.3%
95.4%
97.0%
ND
99.0%
100%
99.0%
98.0%
94.0%
96.0%
LAc
98.4%
99.7%
98.7%
99.7%
97.1%
97.9%
LM
97.5%
99.6%
99.6%
99.0%
92.8%
97.6%
Total
97.5%
99.5%
98.8%
98.9%
94.6%
97.4% 2
of providers. This also indicates positive support for all areas representative of CHP’s mission, industry vision, core purpose, vision, and values. The overall CAHPS® score for the 2018 survey was 98%, with an average score for the past ten years of 97%. This year’s scores show remarkable consistency over patient satisfaction over time. All four disciplines performed well on Q10, “Rate Your Provider”, with chiropractic physicians rated at 97.0%, naturopathic physicians rated at 96.0%, licensed acupuncturists rated at 97.9%, and licensed massage therapists rated at 97.6%. These scores have remained at this high level over many years, and demonstrate the patients’ consistently high level of satisfaction with CHP’s network providers. The answers to the CHP questions (6-9) are evidence of high levels of quality as it relates to CHP providers engaging patients in their health care. Specifically, responses show that CHP providers have a positive impact on patients by improving their health, reducing their need for opioid medications, and providing cost offsets in reducing the need for other medical care. In general, the breakdown of responses to Q6-9 have been highly positive year over year, especially when considering combined responses of “Always” and “Usually”. Q8 shows slightly more variation (see table “Question 8 Comparison”); the percentage
Question 6 In the last six months, did this provider talk with you about specific things you can do to manage your condition?
83% stated always 14% stated usually 3% stated sometimes 0% stated never
Question 7 Has the treatment or recommendation you have received from this provider helped you?
84% stated always 15% stated usually 1% stated sometimes 0% stated never
Question 8 Comparison | 2016-2018 Has the treatment or recommendation you have received from this provider reduced your use of opiate/ narcotic pain medications, for example: oxycodone, Vicodin?
2017
2018
(32% or 261/829 answered w/out N/A)
(34% or 224/668 answered w/out N/A)
(22% or 95/434 answered w/out N/A)
Always
63% 22% 8% 7%
73% 19% 5% 3%
62% 24% 9% 5%
Usually Sometimes Never
3
2016
Response
Question 8
62% stated always
of respondents that reported “Always” or “Usually” experiencing reduced usage of opioids as a result of the treatment or recommendations received from their CHP provider remains at a high level – 86%. (The 3-year average of 88% over the three years this question has been included.) This consistency of positive impact continues to demonstrate the value that our IH providers have on reducing opioid use amongst their patients. This response evidences the potential role of IH to provide a significant contribution to mitigating the national opioid crisis.
24% stated usually
Benchmark Comparison – IH vs. Conventional Care
Has the treatment or recommendation you have received from this provider reduced your use of opiate/ narcotic pain medications, for example: oxycodone, Vicodin?
9% stated sometimes 5% stated never
Question 9 Has the treatment or recommendation you have received from this provider reduced your use of other medical care for this problem?
58% stated always
The 2017 CAHPS® Clinician & Group Survey (CG-CAHPS) Database Chartbook2 includes a total of 366,994 patient experience survey responses submitted voluntarily by 3,443 conventional medical practices across the US. There are five core measures included in the survey that address the following key areas: • Access: getting timely appointments, care, and information • Provider communication: how well providers communicate with patients • Office staff: helpful, courteous, and respectful
35% stated usually
• Care coordination: providers’ use of information to coordinate patient care
6% stated sometimes
• Rating of provider
1% stated never
The table below presents comparative data of the Patients’ Rating 2 Data collected January 2017 through March 2018.
Comparison of CAHPS® Adult Survey 3.0 Overall Rating of Provider, by Physician Specialty, and CHP Combined Scores | 2017
Patients rating the providers 9 or 10 where 10 is “Most satisfied”
CAHPS® DB Overall
Family Practice
Internal Medicine
Orthopedics
CHP Providers
80%
79%
80%
81%
94%
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of the Provider from the Adult Survey 3.0 CAHPS database overall. It also compares several medical specialties with CHP providers. Comparing last year’s scores in this category, the benchmark scores decreased by 1-3% while CHP’s score decreased by just 1%. Additionally, CHP’s overall score of 94% is 14% greater than the benchmark overall score. Comparing the overall average of last year’s outcomes to the current year in the access and provider communication categories, CHP provider scores remained at the same high level. This contrasts against the benchmark for overall average scores, which decreased by 1.5%. CHP provider’s overall average score, as well, is 11.25% higher than the benchmark average. CHP providers demonstrate higher levels of performance when benchmarked against the CAHPS® database in all three areas where we measure performance, i.e. access, provider communication, and provider rating.
Conclusion Our high patient satisfaction scores demonstrate our providers engagement in achieving the Triple Aim: • Better care (patient experience: access, communication, overall quality of provider) • Healthier people (patient engagement, outcomes, reduction in opioid usage) • Smarter spending (reduction of other medical care) At CHP, we are excited to be a part of the healthcare revolution that is focused on patient-centered care and demonstrates the efficacy of integrative healthcare. Evidence combined with patient satisfaction shows the value of IH for conditions that may have previously required expensive imaging or even an opioid prescription. The reduction in use of these costly and potentially addictive interventions shows that IH can offer effective, evidence-based alternatives for treatment that can deliver cost savings and safer alternatives for patients and payers alike.
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