Survey of Californians finds that a range of changes in the delivery of care significantly improves patient satisfaction
San Francisco, CA (February 11, 2015) – More than half of low-income Californians now rate their quality of care as excellent or very good, according to a new report released today by Blue Shield of California Foundation. After four years of concerted effort among California’s healthcare facilities serving low-income patients, patient satisfaction has increased in key measures, including continuity of care, waiting times, availability of appointments, courtesy, cleanliness and other factors.
“As both the recipients and drivers of our evolving safety-net healthcare system, patients’ voices matter,” said Peter V. Long, Ph.D., the Foundation’s president and CEO. “Clinics listened to what patients were saying about their care experience and made improvements to care delivery, and now we see increased satisfaction among patients. Given the uncertainty spurred by passage of the Affordable Care Act (ACA), and the influx of newly insured patients, this progress is particularly remarkable.”
Since 2011, Blue Shield of California Foundation has conducted a series of surveys on the impact of health reform on low-income Californians. Findings from previous surveys encouraged California’s safety-net providers to adopt new strategies to improve care delivery by offering alternative care models such as team-based care, healthcare coaches, and “patient navigators” to steer families through complicated health systems. The surveys found that patients who could email or text-message their providers were more likely to rate their care positively, so clinics have also made efforts to expand these capabilities.
The 120-page report, “Delivering on a Promise: Advances and Opportunities in Health Care for Low-Income Californians,” compared survey results from 2011 and 2014 and found notable improvement overall, with 31% of patients now rating their care as excellent and 22% rating it very good, totaling 53%. That represents a five percentage-point increase over 2011.
Comparing the 2014 survey results with 2011, the percentage of community health center and public clinic patients giving excellent or very good ratings to their providers rose in nine key areas, including:
- 45% of patients were highly satisfied with their ability to see the same provider, up from 36% in 2011. Seeing the same provider significantly enhances the patients’ continuity of care, a key driver in their overall engagement.
46% gave top marks on the ability to get timely appointments, a nine-point increase.
On waiting times, 34% of patients gave top ratings, compared with 23% in 2011.
Staff courtesy ratings increased 13 points, with 62% of patients calling it excellent or very good, compared with 49% in 2011.
Many clinics have worked to remove cultural and language barriers, and patients reported feeling significantly more welcomed, with 58% reporting high satisfaction, a 10-point jump.
Rating the cleanliness of their care facility, 60% of patients gave top marks, compared with 52% in 2011.
While these increases show important progress among California‘s safety-net providers, the report said, there are still areas for improvement: Access to mental health and substance abuse services continues to fall short of demand, and waiting times, though improved, remain the most widespread complaint.
“There are no easy fixes in the healthcare system,” Dr. Long said. “Change takes time, and now that we have a better understanding of where we are going and how to get there, we must continue to take deliberate steps forward. We are confident that lessons learned in California can be applied to a range of care settings across the country.”
In addition to increases in patient satisfaction, the report also indicates that the number of low-income Californians who lack health insurance has fallen dramatically, from 30 percent in 2013 to 15 percent after the ACA’s first enrollment period. Notably, this increase is not limited to the low-income population. A separate sample of higher-earning residents shows that the uninsured rate has fallen in this group as well, from 10 to 5 percent in a single year.
The full findings and recommendations of this report are available here.
About the Survey
This survey was conducted August 14 to October 5, 2014, via telephone interviews with a representative statewide sample of 1,568 Californians between the ages of 19 and 64, including 1,033 with household family incomes below 200 percent of the federal poverty level (FPL) and 513 with household incomes at 200 percent of the FPL or more. The sample was composed of 723 landline and 845 cell phone interviews, with 1,172 interviews conducted all or mostly in English and 396 in Spanish. The survey was produced, managed, and analyzed by Langer Research Associates of New York, N.Y., with sampling, fieldwork and data tabulation by SSRS of Media, PA.
About Blue Shield of California Foundation
Blue Shield of California Foundation is one of the state’s largest and most trusted grantmaking organizations. Our mission is to improve the lives of all Californians, particularly the underserved, by making health care accessible, effective, and affordable, and by ending domestic violence. For more information, visit www.blueshieldcafoundation.org.