1. Coverage for special concerns of the elderly: prescriptions, foot care, home care, long-term care, other supplemental coverage.

QUALITY (Accreditation and Survey-Based Information)

  1. Accreditation status
  2. Percentage of board-certified physicians
  3. Patient reports and ratings of care for all members and for members over age 65:
    1. Member services:
      1. member support
      2. prior approval process
      3. restrictions on referrals for specialty care, special services
    1. Access:
      1. appointment waiting times
      2. visit waiting times
      3. choice of primary care physicians and specialists
    1. Communication and interpersonal skills
    2. Coordination of care
    3. Information and education
    4. Respect for patient preferences
    5. Emotional support
  1. HEDIS and other technical measures appropriate for a Medicare population.

Finally, we recommend that AHCPR's Consumer Assessment of Health Plans Survey project incorporate the informational needs of Medicare beneficiaries into the design of surveys and report formats. This effort to collect national comparative data for all other consumers could serve as the vehicle for capturing and presenting information to the Medicare population in the future. As all consumers become familiar and accustomed to using these kinds of data and information, there is no justification for recommending that they or the providers of care switch to a different survey or report format for the Medicare population. As we lay the foundation for collecting and disseminating consumer feedback now, we should develop a system that works for everyone. More important, why would we ask the Medicare population to shift to new surveys and report card formats at a time when it is most important for information to be clear and comprehensible?



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