Medicare Releases Positive Results On Provider Satisfaction With Fee-For-Service Contractors, USA

Main Category: Medicare / Medicaid / SCHIP
Article Date: 31 Jul 2007 - 1:00 PDT

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Most Medicare health care providers continue to be satisfied with services provided by Medicare fee-for-service contractors, the Centers for Medicare & Medicaid Services (CMS) reported last week.

The Medicare Contractor Provider Satisfaction Survey (MCPSS), conducted by CMS for the second year, is designed to garner objective, quantifiable data on provider satisfaction with the fee-for-service contractors that process and pay Medicare claims. Sixty-five percent of those who were surveyed responded. The survey revealed that for the second consecutive year, 85 percent of respondents rated their contractors between 4 and 6 on a 6-point scale.

The survey was sent early this year to more than 36,000 randomly selected providers, including physicians, suppliers, health care practitioners and institutional facilities that serve Medicare beneficiaries across the country. The survey was expanded this year to include hospices and federally qualified health centers.

The survey, which will be administered annually to measure satisfaction with key services performed by Medicare fee-for-service contractors, focused on the seven business functions of the provider-contractor relationship -- provider communications, provider inquiries, claims processing, appeals, provider enrollment, medical review, and provider audit and reimbursement. Respondents were asked to rate their contractors using a scale of 1 to 6 on each of the business functions, with "1" representing "not at all satisfied" and "6" representing "completely satisfied." Contractors received an overall composite score as well as a score on each function.

"The 2007 MCPSS results, when coupled with the initial 2006 results, enable CMS to begin establishing provider satisfaction performance standards for its contractors, who process more than $280 billion in Medicare claims each year," said CMS Acting Deputy Administrator Herb Kuhn. "The significant level of participation on the part of providers indicates they are comfortable with the survey instrument and confident that it is an effective way to convey their viewpoints to CMS.

"In addition, for fee-for-service contractors, the survey results provide a tangible benchmark they can use to improve their processes," Kuhn added. "Over time, this increased awareness and accountability will lead to an overall strengthening of the Medicare program." The survey is one of the tools CMS uses to measure provider satisfaction levels, as required in the Medicare Modernization Act of 2003. It was developed with extensive input from providers, and information about the survey has been disseminated to providers through a variety of channels.

For all contractor types, the key predictor of a provider's satisfaction is the contractor's handling of provider inquiries. This indicates a shift from 2006, when the strongest predictor was claims processing. Claims processing is the second strongest predictor in 2007.

"This finding reveals the high value providers place on responsiveness from their Medicare contractors," Kuhn said. "This year, CMS, with contractor input, improved reporting to enable contractors to more easily identify areas for process improvement activities."

CMS has posted findings to the CMS Web site detailing results such as provider satisfaction by contractor type; by provider types; and business function scores by contractor type.

For more information, visit http://www.cms.hhs.gov/MCPSS.