Testing physician practice protocols to ensure member access
Measuring Provider Access involves determining both appointment availability and after-hours access for members. One way to accurately gauge this factor is to contact providers’ offices during office hours to determine their appointment availability. In addition, the offices are contacted after hours to audit the availability of services or referrals after hours. A second way to measure Provider Access is to survey the members directly to measure their perception of their providers’ appointment availability and after-hours care. The sample consists of members who have recently visited their doctors.

As a result of this study, the health plan gains valuable information from members, which ensures that the plan is meeting internal performance measures regarding Access standards. In addition, this information helps the plan monitor how effectively the network meets the needs and preferences of its membership (QI 4).

Although The Myers Group encourages a customized survey designed to meet the health plan’s internal access standard, the survey tool consists of 20-scaled questions and asks members about:

• Wait times on hold while trying to make an appointment
• Wait times while in the physician’s office
• Ease of accessing physician care
• Length of time to obtain physician care

Administered by phone, the survey takes members about five minutes to complete.