Health Plan For Military Families Achieves Member Satisfaction Rating Among Highest In America

Main Category: Health Insurance / Medical Insurance
Article Date: 05 Dec 2007 - 4:00 PDT

email to a friend   printer friendly   view / write opinions   rate article

Assessed independently with the most widely used set of performance measures in the managed care industry, a community-based healthcare plan for military families has achieved 2007 national member satisfaction ratings among the highest of all managed care organizations (MCOs) in America. The US Family Health Plan, a managed care (TRICARE Prime) option within the government's military health benefits system, was evaluated against a protocol known as the Health Plan Employer Data & Information Set (HEDIS®) through a methodology called the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) 4.0H Survey.

The CAHPS Survey methodology - the most comprehensive tool for measuring consumer satisfaction with health plans - was developed jointly by the Agency for Healthcare Research (AHRQ) and The National Committee for Quality Assurance (NCQA). Designed to produce standardized results, the CAHPS Survey measures the members' experience with health plan care and service over the preceding 12 months.

A random sample of 4,372 US Family Health Plan members, representing all six hospital and physician networks contracted with the Department of Defense (DoD) to deliver care through the Plan, rated their overall satisfaction with the Plan, its customer service and their utilization of its healthcare services. On a scale of 0 to 10 (with 10 as the best possible rating), 87.9 percent of the US Family Health Plan members rated their overall satisfaction with the Plan as an 8, 9 or 10. The national average for member satisfaction with health plans, based on the 251 plans documented by the NCQA in its Quality Compass 2007 Public Report, is 63.2 percent.

"Compared to the Quality Compass benchmark, the US Family Health Plan's national scores significantly exceed the benchmark in all rating areas for the core population, which includes survey respondents of all ages," said David Bahlinger, director of analytics and research for The Myers Group of Snellville, Ga., an NCQA-certified HEDIS survey vendor that administered the study of the US Family Health Plan members. "Additionally, the US Family Health Plan scores for members ages 18-64 are significantly higher in all four rating areas (including the Plan, its health care, its primary care doctors and specialists) and in members' reported ability to get needed care and get care quickly."

The US Family Health Plan members' satisfaction rating for claims processing also significantly surpasses the Quality Compass benchmark. Further, members continue to report strong satisfaction with the Plan's customer service.

Marshall Bolyard, chair of the US Family Health Plan Alliance, said, "For 13 years in a row, independent surveys of US Family Health Plan members have confirmed they are among the most satisfied health plan beneficiaries in America. We will continue to focus on customer service, delivering high-quality care and providing military families with a comprehensive range of benefits - from preventative and wellness programs to intensive case management for members with chronic or multiple health conditions."

The US Family Health Plan is available in DoD-designated regions of the East, Gulf and upper West coasts to military retirees, their eligible family members and eligible family members of active-duty personnel, including Reservists and National Guardsmen. The Plan provides routine, urgent and worldwide emergency care and is distinguished by its thousands of network doctors and hospitals, facilitating easy referrals to specialty care; low cost; low co-payments (and in many cases, no co-payments); no deductibles; after-hours telephone access to healthcare providers in most locations; free preventative pediatric care; and free annual physicals.

Enrollment in the US Family Health Plan, which serves nearly 100,000 members, is offered through the following community-based hospital and physician networks:

- Johns Hopkins Medicine (1-800-801-9322) - serving central Maryland, Washington D.C., and parts of Pennsylvania, Virginia and West Virginia

- Martin's Point Health Care (1-888-241-4556) - serving Maine, Vermont, New Hampshire and northeastern New York

- Brighton Marine Health Center (1-800-818-8589) - serving Massachusetts, including Cape Cod, plus Rhode Island and northern Connecticut

- St. Vincent Catholic Medical Centers (1-800-241-4848) - serving parts of New York, all of New Jersey, eastern Pennsylvania and southern Connecticut

- CHRISTUS Health (1-800-678-7347) - serving southeast Texas and southwest Louisiana

- Pacific Medical Centers (1-888-958-7347) - serving the Puget Sound area of Washington State.

The US Family Health Plan traces its roots back to 1981, when the Omnibus Reconciliation Act designated 10 U.S. Public Health Service Hospitals as U.S. Treatment Facilities (USTFs) to provide care for the uniformed services through an agreement with the DoD. In 1993, that designation grew into a fully at-risk managed healthcare plan known as the US Family Health Plan. The Plan's popularity grew in regions where it was offered and in 1996, the National Defense Authorization Act designated the USTFs as TRICARE Prime Designated Providers and made the US Family Health Plan a permanent part of the military healthcare system.

For more information, visit the US Family Health Plan Web site at US Family Health Plan.

Note: CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).

US Family Health Plan