November 14, 2013
This is installment #19 in a continuing series of Access to Care Reports.
Access to care is often as seen in the “eye of the individual”.
How motivated an individual is to seek out care depends on financial arrangements and on a wide range of other objective and subjective factors.
One of the best ways to determine the satisfaction of the public with the Affordable Care Act (ACA) is to ask some of those involved about their experiences, impressions and reactions.
As described in final regulations in the Federal Register (dated October 30, 2013, p. 65105) the Department of Health and Human Services (HHS) is in the early stages of setting up such satisfaction surveys to check on how enrollees in Qualified Health Plans (QHPs) feel about insurance company activities.
For those with an interest in the ACA, now is the time to become involved in helping determine how such evaluations will be designed and applied.
The eventual results of such evaluations may have significant impact on future evolution of the ACA, as well as Medicare and Medicaid.
HHS is to approve the selection of “enrollee satisfaction survey vendors” to administer surveys to QHP enrollees.
The approval of vendors will be on a year-to-year basis.
Vendor staff must participate in training and complete a “post-training certification exercise”.
Survey protocols and specifications will be set by HHS.
Vendors must develop quality assurance plans.
And the accuracy of the survey results will be monitored by HHS.
A list of approved vendors is to be published online by HHS.
Early involvement in this survey strategy may enable interested groups to help set the scope, content and procedures for these studies.
Suggestions made to HHS at this stage may be able to affect the final survey designs and methods for processing data.
Many private companies that often enter into evaluation contracts with HHS may have only a limited appreciation for the ways in which the ACA relates to insurance companies, and of the multiple factors that enter into company operations.
Those groups with experience in preparing and conducting surveys may also have developed certain “ways of doing things” with HHS, that may not fit well with surveys of enrollees in this situation.
Attorneys who are involved in representing insurance companies and various health care groups and organizations may find it useful to suggest involvement in this evaluation process to their clients. Long-range organizational interests may be served by trying to contribute to these design activities during the early stages of development.
More on related ACA and access to care topics may be found in a recent book by the authors that describes implementation of the ACA, and in a new Practice Guide by the authors that addresses funding and access issues in health care.