Patients LOVE Their Doctors
Implications for Employer-Sponsored Health Plans
By Dr Eric Bricker, Medical Director at Coupe Health
Patients love their doctors. The largest survey of patient satisfaction is run by a company called Press Ganey. Press Ganey is a company based in South Bend, IN that has been conducting patient surveys for 38 years.
Over 50% of US hospital systems use Press Ganey to survey their patients to measure satisfaction –including satisfaction with their doctors.
Doctors are measured on 10 questions ranging from empathy to communication skills, to if the patient would recommend the doctor to another person. Each question is on a 5-point scale with 5 being the best. Only answers of 5 are counted toward the doctor’s score; 1, 2, 3 and 4 don’t count.
The final score is the percent of answers that had a score of 5.
Amazingly, the bottom 10% of physicians score 70% of ALL Responses as 5’s. The top 10% of physicians score 91% of ALL Responses as 5’s. The median score is 82% of ALL Responses as 5’s.
In other words, patients are HIGHLY satisfied with almost ALL doctors. There is minimal difference between the patient satisfaction of doctors at the ‘bottom’ vs. doctors at the ‘top.’
What This Means for Employer-Sponsored Health Plans
When it comes to gaining trust, improving healthcare quality and lower healthcare cost, the doctor is king. Not the insurance carrier. Not the employer. Not the plan design. Not the hospital system. It is the doctor.
Therefore, the key to improving employer-sponsored health plan performance is steering members to the right doctor for them. Plan design should focus on steering plan members to the right doctor. Financial incentives should focus on steering to the right doctor. Doctor search tools should focus on steering to the right doctor. Navigation and customer service should focus on steering to the right doctor.
Conversely, the main priority of employer-sponsored health plan steerage should not be to a specific hospital system. Not a specific test. Not a treatment plan. Not a specific medication. In other words, an employer-sponsored health plan should not be micromanaging which patients a doctor can see.
Unfortunately, the majority of employer-sponsored health plans use the latter approach and not the former. With large PPO networks, they let plan members choose almost any doctor they like and then act as a ‘busybody,’ telling that doctor what they can and cannot do through prior authorization, step therapy, and other ‘smart sounding’ solutions.
The plan member doesn’t like it and the doctor doesn’t like it either. It creates animosity toward the insurance carrier and toward the employer.
The Path Forward
Smart employers are putting in value-based plan designs that create copay differentials and doctor search tools to steer plan members to the right doctors—lower dollar copays for high-quality, low-cost doctors; and high dollar copays for low-quality, high-cost doctors.
One of the largest retailers in America told me, ‘We gave up traditional deductibles and co-insurance years ago and have been using copays ever since.’
Total change does not happen overnight, and many employers maintain prior authorization and tiered formularies with these value-based plan designs.
However, there is a movement of ‘gold-carding’ high-value doctors who have displayed the ability to follow evidence-based guidelines and freeing them from prior authorization requirements. In other words, they do the right thing already and don’t need to be micromanaged by the insurance carrier.
Employers can set plan members up for success in their health by steering them to the doctor that’s right for them. A successful health plan member equals a successful health plan.