Medicare
Annual update on Medicare accessibility results
A survey was randomly mailed to a statistically valid sample of family practice, general practice and internal medicine Regence MedAdvantage physician offices. The survey measured a variety of different accessibility standards. Listed below is a brief summary of the results.
Appointment wait times
Emergent Care: The standard
of assessing, treating or referring an emergent patient
within five minutes was met by only 87% of offices surveyed,
rather than the goal of 100%. Most non-compliant respondents
indicated a timeframe of six minutes to half an hour
as the wait time for emergent care.
Urgent, Acute Care: This
standard was not met. Of the offices surveyed,
94%
of offices schedule a patient appointment within 24 hours.
Non-urgent, Symptomatic Care: This
standard was not met. Of the offices surveyed,
94%
were able to schedule a patient appointment within seven
days for non-urgent, symptomatic care.
Non-urgent, Asymptomatic Care: The
standard for an appointment scheduled within 30 calendar
days for non-urgent, asymptomatic care was met.
Preventive Care: This standard, an appointment
scheduled within 42 calendar days for preventive care,
was met.
Planned interventions include letters, visits or phone calls by provider consultants to educate specific offices about these standards and the importance of compliance.
After-hours phone coverage
The standard requires that 100% of family practice, general practice and internal medicine offices have a provision for coverage 24 hours a day, seven days a week. It is important for offices to give complete and clear instructions to patients so they may reach their physician or an on-call provider after hours. A recorded message indicating that the patient should call 911 or go to the emergency room does not meet this standard and is considered only partial compliance.
Ninety-five percent of surveyed offices were in full compliance with this standard. An additional 5% were in partial compliance. One percent of surveyed offices indicated they had no after-hours coverage provisions.
Although our survey measures only primary care offices, we urge all participating physicians and health care professionals to be aware of our standards and make efforts to meet them. These standards can be found in the Medicare Advantage Plans section of our Administrative Manual.
