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Managed Long-Term Care

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2017 Member Satisfaction Survey Summary Report

April 2018

Executive Summary

Introduction

Methodology

Key Findings

Recommendations

Section 1: Introduction

Background

Objectives

Section 2: Methodology

Survey Instrument

Survey Sample

Composite Measures

Section 3: Results

Response Rates

Respondent Demographics

Plan Evaluation/Rating of Health Plan

Quality of Care

Timeliness of Care

Access to Care

Analysis of Composite Measures and Individual Survey items within Domains

Domain 1: Measures Related to MLTC Plan Evaluation (Table B6)

Domains 2-5: Measures Related to Quality, Timeliness, and Access to Care (Table B6)

Domain 6: Advance Directives (Table B6)

Analysis of Composite Measures and Individual Survey Items by Subgroup

Comparison by Plan Type (Table B7)

Comparison by Gender (Table B8)

Comparison by Race/Ethnicity (Table B9)

Comparison by Education (Table B10)

Comparison by Age (Table B11)

Comparison by Primary Language (Table B12)

Comparison by Self-Reported Health Status (Table B13)

Section 4: Limitations

Section 5: Supplemental Phone Survey

Section 6: Conclusions and Recommendations

Appendix A. Frequency Tables

Appendix B. Aggregate Tables

Appendix C. Survey Tool

Executive Summary

Introduction

The Managed Long-Term Care (MLTC) member satisfaction survey assesses the level of satisfaction of members enrolled in New York State´s Medicaid MLTC plans. The primary purpose of the study is to provide the New York State Department of Health (NYSDOH) with information regarding member satisfaction with the quality, accessibility, and timeliness of services provided by MLTC plans.

At the time of the initiation of the survey in early 2017, within New York Medicaid, there were four models of MLTC plans: 1) Partially capitated MLTC plans, 2) Program of All-Inclusive Care for the Elderly (PACE) plans, 3) Medicaid Advantage Plus (MAP) plans, and 4) Fully Integrated Duals Advantage (FIDA) plans. Partial MLTC plans are capitated for providing care management, community-based long-term care services, and nursing home care. The PACE, MAP, and FIDA benefit packages also include inpatient and outpatient care. The FIDA plan population was not included in the survey this year, as this population is surveyed separately. In view of the continued growth of the MLTC program, the NYSDOH and Island Peer Review Organization (IPRO) considered a satisfaction survey to be warranted. Similar surveys had been conducted in previous years. Results from the 2015 satisfaction survey are cited throughout this report for comparative purposes.

Methodology

The first section of the survey addressed members´ general experience with their MLTC plan. The second section dealt with the quality of specific health care services, where members were asked to rate the quality of these services, whether covered by their plan or not. This section also addressed timeliness of some key long-term care services and access to primary health care services. The third section contained general demographic questions (e.g., age, gender, race, education), living arrangements, whether assistance was provided to complete the survey, and questions regarding the status of members´ advance directives.

The survey was made available in English, Spanish, Russian, and Chinese and was mailed to members based upon the primary language designations provided by the NYSDOH. An English version of the survey was included with every non- English survey upon each mailing. The initial mailing was distributed in April 2017, with a follow up mailing in late June 2017.

Inclusion criteria for the eligible population were as follows:

Continuously enrolled in an MLTC plan for a minimum of 6 months prior to November 30, 2016
MLTC plan enrollees from 45 plans/product lines
- The breakdown by plan type is as follows: PACE-8, Partially Capitated-31, MAP-6

A sample of 600 enrollees from each plan was selected; the entire membership was selected if the plan´s enrollment was less than 600. The final sample was 22,188 enrollees. Exclusions from mailing (e.g., address issues, deceased members) totaled 2,141, yielding an adjusted sample of 20,047 enrollees. Completed and returned surveys totaled 5,559; representing a response rate of 28%. Nearly seventy-three percent (73%) of the responses were returned in English; 53% of the respondents consider English to be their primary language.

Key Findings

MLTC Plan Evaluation: Approximately 88% of respondents rated their plan as good/excellent. The same percentage of members (88%) reported that their plan always/usually explained services clearly. Compared to 2015 survey results, an increased percentage of respondents reported the plan spoke to them about appointing someone to make health care decisions if they are unable to do so. Additionally, of the members who reported having a legal document or advance directive, a larger percentage reported that the plan has a copy of the advance directive on file, when compared to 2015.

Quality of Care: Members´ perception of the quality of care received has remained positive. Eighty-two percent (82%) of respondents for long-term care providers and services (i.e. regular doctor, dentist, eye doctor) rated their quality as good/excellent.

Timeliness of Care: Timeliness of care provided by long-term care providers/services was found to be favorable, with meals on wheels and home delivered meals having the most improvement over 2015. Eighty-two percent (82%) of respondents for long-term care providers and services rated these services to be always/usually timely.

Access to Care: Thirty-seven (37%) of respondents indicated that they are able to get same day urgent appointments with providers, a slight decrease compared to 2015 results (39%). This demonstrates a need for improvement in this area. Nearly 82% of respondents indicated that they are able to get timely regular appointments with providers.

Recommendations

IPRO identified various opportunities for improvement that the health plans should consider, based upon survey outcomes. Recommendations based on these findings are as follows:

The percentage of members rating the quality of medical supplies and equipment as good/excellent, while still high, declined from the 2015 survey. Similarly, declines were also observed with the quality of foot doctors and pharmacy services. It is recommended that plans conduct more in-depth member surveys focused on these services to determine if, in fact, quality issues exist and to determine the nature of these issues. Reviews of complaint and grievance logs may be considered as well, as a means of identifying quality of care issues.
The percentage of respondents rating the quality of dental services as good/excellent, while slightly improved from 2015, continues to be among the lowest of the long-term care services. Member surveys focused on the quality of dental care, and review of dental related complaints and grievances may be warranted.
The percentage of respondents indicating that advance directive discussions have taken place, and the percentage of respondents indicating that they had an advance directive, significantly increased when compared to 2015 results. IPRO recommends continued efforts to conduct advance directive performance improvement projects (PIPs), with interventions focused on language and cultural barriers wherever appropriate.
The percentage of respondents indicating that they had same day urgent access to providers slightly declined when compared to the 2015 results. Plans may wish to investigate access issues through possibly interviewing providers to determine exactly how requests for urgent visits are handled. Plans may also choose to interview a sample of members to obtain more specific information pertaining to how long it takes them to secure an appointment, and who their providers are, in order to conduct targeted outreach to under-performing providers.
The percentage of respondents indicating that family members or caregivers are involved in care planning, while improved over 2015 results, continues to be somewhat low. Family involvement is the member´s choice. However, plans should investigate whether members would like additional family and/or caregiver participation in care planning. Plans may need to consider doing more to foster member and caregiver involvement in care planning. Plans should ensure that, where appropriate and necessary, PIP interventions involve family members and caregivers.
Discussions pertaining to the Consumer Directed Assistance Option, and to Advance Directives, appear to be occurring more often among members with lower education levels than with members with at least a high school education. Plans should ensure that discussions for these important concepts are taking place across all membership groups, regardless of education level.
There were some observed differences in certain ratings when accounting for race/ethnicity of the respondents. These findings may indicate that cultural barriers associated with race, and language barriers, may be playing a role in dissatisfaction with the quality of certain services and with timely access to them. Plans may consider exploring whether or not there is limited access to services across certain ethnic groups.

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Section 1: Introduction

Background

Managed long-term care (MLTC) is a system that streamlines the delivery of long-term care services to people who are chronically ill or disabled and who wish to stay in their homes and communities. These services, such as home care or adult day care, are provided through managed long-term care plans that are approved by the New York State Department of Health (NYSDOH). The entire array of services to which an enrolled member is entitled can be received through the MLTC plan the member has chosen. Enrollment in an MLTC plan may be mandatory or voluntary, depending on individual circumstances.

Enrollment in an MLTC plan is mandatory for those who:

Are dual eligible (eligible for both Medicaid and Medicare) and equal to or over 21 years of age and need community-based long-term care services for more than 120 days.

Enrollment in an MLTC plan is voluntary for those who:

Are dual eligible and are 18 through 20 years of age and need nursing home level of care and community-based long-term care services for more than 120 days.
Are non-dual eligible and over 18 years of age, are assessed as nursing home eligible and require community based long-term care services for more than 120 days.
Are dual eligible and are 18 years of age and over and were previously determined as permanent placements in a nursing home

Within New York Medicaid, at the time of survey initiation, there were four models of MLTC plans:

Partially capitated MLTC plans,
Program of All-Inclusive Care for the Elderly (PACE) plans,
Medicaid Advantage Plus (MAP) plans, and
Fully Integrated Duals Advantage (FIDA) plans.

Partial MLTC plans are capitated for providing care management, community-based long-term care services, and nursing home care. The PACE, MAP, and FIDA benefit packages also include inpatient and outpatient care. The satisfaction survey addressed only the partially capitated, PACE and MAP plan models, as the FIDA population is surveyed separately.

This study assesses the level of satisfaction of members enrolled in New York State´s Medicaid MLTC plans. The primary purpose of the study is to provide the NYSDOH with information regarding member satisfaction with the quality, accessibility, and timeliness of services provided by MLTC plans.

Satisfaction surveys are a key tool for understanding patient perception of care and improving the delivery of long-term care services, and such surveys are integral to ongoing quality improvement efforts. On both federal and state levels, programs continue to utilize and expand the use of consumer-driven data, based on consumer experiences, to improve the quality of health care delivered to the elderly and, in many cases, chronically ill populations.

At the national level, the Centers for Medicare and Medicaid Services (CMS) has collected information on Medicare managed care enrollee consumer satisfaction and experience with health services through the Consumer Assessment of Health Providers and Systems (CAHPS) survey since 1998. This survey includes the following domains:

Getting Needed Care
Getting Care Quickly
Doctors Who Communicate Well
Flu Shot Rate
Overall Ratings of: Health Care, Health Plan, Doctor, and Specialist

This survey has undergone periodic revisions; in the 2006 survey year for example, data collection was expanded to include satisfaction and experience of members enrolled in a Medicare Advantage Prescription Drug plan. CAHPS surveys are also collected for commercial and Medicaid managed care populations (the NYSDOH administers a biennial Medicaid managed care survey which is largely based on CAHPS).

IPRO observed that while all NYS MLTC plans conduct internal annual member satisfaction surveys, each plan has developed their own individualized surveys. IPRO reviewed a sample of these surveys. Several of them addressed general satisfaction with plan services and covered courtesy and sensitivity, but specific questions relating to the quality of plan services, timeliness, and access to services were often not addressed. Therefore, IPRO, in conjunction with the NYSDOH, conducted the first member satisfaction survey of New York´s MLTC population in 2007, and again in 2011 and on a biennial basis thereafter. Survey results have been positive, with the majority of MLTC respondents satisfied with their health plan. It is anticipated that this survey will continue to be administered every other year going forward.

Objectives

In early 2017, IPRO and the NYSDOH developed a plan to evaluate MLTC member satisfaction with the services provided by their MLTC plan. Specific objectives were to assess whether:

MLTC enrollees are satisfied with:
- quality of health care services;
- access to primary health care services; and
- timeliness of primary health care and long-term care services.
there are differences in care and in satisfaction of care, between three principal MLTC plan models (PACE, partially capitated and MAP plans) and between different age groups, reported state of health, race/ethnicity and primary language;
there has been a change in members´ perception of quality of care and overall satisfaction since the last satisfaction survey in 2015.

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Section 2: Methodology

Survey Instrument

A scannable survey instrument was created to evaluate MLTC member satisfaction with the services provided by their plan. To facilitate comparisons to the 2015 survey, the 2017 survey contained all of the questions from the 2015 survey, with additional verbiage for questions 72 and 73, to clarify the term "legal document" by also including "advance directive."

The survey was comprised of three sections. The first section addressed members´ general experience with their MLTC plan, which included questions on plan of care involvement, courtesy of plan representatives, and timeliness of responses with complaints and grievances. The second section addressed the quality of twenty-two long-term care providers and services (primary care physician, dentist, eye care, foot doctor, home health aide, home health agency, care manager, visiting nurse, covering/on-call nurse, physical therapist, occupational therapist, speech therapist, social worker, medical supplies/equipment, audiology/hearing aids, home delivered meals, meals at Day Heath Center, Day Health Center activities, transportation services, nursing home, pharmacy services, and nutritionist), where members were asked to rate the quality of these providers and services, whether covered by their plan or not. This section also addressed timeliness of some key long-term care services and access to primary health care services. The third section contained general demographic questions (e.g., age, gender, race, and educational attainment). This section also included questions pertaining to living arrangements and whether assistance was provided in completing the survey, as well as questions regarding the status of members´ advance directives.

An English version was prepared and translated into Spanish, Russian, and Chinese, and mailed to members based upon the primary language designations provided by the NYSDOH. An English version of the survey was included with every non-English (Spanish, Russian, Chinese) survey upon each mailing. The initial mailing was distributed in April 2017, with a follow-up mailing in late June 2017.

Survey Sample

To identify the eligible population for the survey, inclusion criteria were as follows:

Continuously enrolled in a MLTC plan for a minimum of 6 months prior to November 30, 2016.
MLTC plan enrollees from 45 plans/product lines. The breakdown by type of MLTC plan is as follows: PACE – 8, Partially Capitated – 31, MAP – 6.

The NYSDOH provided IPRO with the enrollee file for the survey after sampling. A sample of 600 enrollees from each plan had been selected. The entire eligible membership was included for plans with an enrollment of less than 600. The 600-member sample size had been utilized in prior survey years. The final sample for mailing was 22,188 enrollees.

Composite Measures

Composite measures of survey items were computed to obtain a meaningful summary of member responses in each of six domains, which include: MLTC Plan Evaluation, Quality of Providers and Long-Term Care Services, Timeliness of Providers and Long-Term Care Services, Access to Care for Urgent Appointments, Access to Care for Regular Appointments, and Advance Directives. Each domain is comprised of individual survey items, composite measures, or a combination of both. Composite measures were created by combining survey items that measure the same dimension of the health care plans¹.

Using the proportional scoring method, composite scores were computed, representing the average proportion of members responding to the most positive category, or top-box category, for the survey items included in the composite, excluding missing data. For example, for survey items requiring the respondent to answer "Always," "Usually," "Sometimes," or "Never," the calculated score reflects the average proportion of respondents who answered "Always/Usually." For survey items requiring the respondent to answer "Excellent," "Good," "Fair," or "Poor," the calculated score reflects the average proportion of respondents who answered "Excellent/Good." The z-test was used to compare proportions for single survey items year-to-year, and t-tests were used to compare average proportions for composite measures year-to-year. When comparing within subgroups (i.e., plan type, race, gender, educational attainment), chi-square was utilized to compare proportions of single survey items, and the student´s t-test was utilized to compare average proportions for composite measures.

The six domains are defined as follows:

Domain 1: MLTC Plan Evaluation
Individual item	Q3. The plan always/usually explains all of their services clearly
Composite	My family member (or caregiver) and I are always/usually involved in making decisions about my plan of care Q4. I am always/usually involved in decisions about plan of care Q5. Family member or caregiver always/usually involved in making decisions about plan of care
Composite	The plan always/usually provided helpful, timely, and courteous customer service when I (or my caregiver or family members) have called with a question, needed help, or had a complaint or grievance Q7. I always/usually spoke with a person quickly when I called the plan with a question or for help or with a complaint or grievance Q8. My questions were always/usually answered quickly Q9. I was always/usually able to understand the answers Q10. I was always/usually treated with politeness and respect Q11. I (or my caregiver or family members) called the plan with a complaint or grievance and it was always/usually handled to my satisfaction
Individual item	Q12. Since joining the health plan, someone from the plan has asked to see all of the prescriptions and over the counter medicines I´ve been taking
Individual item	Q13. Since joining the health plan, someone from the plan has explained the Consumer Directed Personal Assistance option
Composite	The plan is excellent/good in assisting my family and I with medication management, managing my illness, helping me when I am sad and lonely, and allowing me to stay in my home instead of a nursing home Q14a. The plan is excellent/good in assisting my family to ensure that I take my medications the way my doctor wants me to Q14b. The plan is excellent/good in assisting my family and I to manage my illness, such as high blood pressure or diabetes Q14c. The plan is excellent/good in assisting my family and I when I am feeling sad and lonely Q14d. The plan is excellent/good in assisting my family and I so that I can stay at home and not have to live in a nursing home
Individual item	Q15. Overall, my MLTC plan is excellent/good

Domain 2: Quality of Providers and Long-Term Care Services
Composite	Excellent/good quality of care provided by long-term care providers and services Q16. Regular doctor Q17. Dentist Q18. Eye Care Q19. Foot Doctor Q20a. Home Health Aide, Personal Care Aide Q20b. Home Health Agency, Personal Care Agency Q21. Care Manager/Case Manager Q22a. Regular Visiting Nurse/Registered Nurse Q22b. Covering/On-call nurse Q23. Physical Therapist Q24. Occupational Therapist Q25. Speech Therapist Q26. Social Worker Q27. Medical Supplies and Equipment Q28. Audiology/Hearing Aids Q29. Home Delivered Meals/Meals on Wheels Q30. Meals served at the Day Health Center Q31. Day Health Center Activities Q32. Transportation Services Q33. Nursing Home Q34. Pharmacy Services Q35. Nutritionist

Domain 3: Timeliness of Providers and Long-Term Care Services
Composite	Timely care always/usually provided by long-term care providers and services Q36. Home Health Aide, Personal Care Aide Q37. Care Manager/Case Manager Q38a. Regular Visiting Nurse/Registered Nurse Q38b. Covering/On-call nurse Q39. Physical Therapist Q40. Occupational Therapist Q41. Speech Therapist Q42. Social Worker Q43. Home Delivered Meals/Meals on Wheels Q44a. Transportation: TO Day Center Q44b. Transportation: FROM Day Center Q44c. Transportation: TO the doctor Q44d. Transportation: FROM the doctor Q45. Medical Supplies and Equipment Q46. Pharmacy Services Q47. Audiology/Hearing Aids

Domain 4: Access to Care for Urgent Appointments
Composite	I was able to get an appointment within the same day to see my provider when I needed care right away in the past 6 months Q48. Regular doctor Q49. Dentist Q50. Eye Care Q51. Foot Doctor Q52. Audiology/Hearing Aids

Domain 5: Access to Care for Regular Appointments
Composite	I was always/usually able to get a regular appointment as soon as I thought I needed one Q53. Regular doctor Q54. Dentist Q55. Eye Care Q56. Foot Doctor Q57. Audiology/Hearing Aids

Domain 6: Advance Directives
Individual item	Q71. The health plan has talked to me about appointing someone to make decisions about my health if I am unable to do so
Individual item	Q72. I have a legal document or advance directive appointing someone to make decisions about my health care if I am unable to do so
Individual item	Q73. The health plan has a copy of this advance directive document

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Section 3: Results

Response Rates

Of the 22,188 surveys that were mailed, 2,141 were returned as undeliverable due to either mailing address issues or death of the member. This yielded an adjusted population of 20,047. A total of 5,559 surveys were completed, with an overall response rate of 28%. In 2015, 4,592 surveys were completed yielding a response rate of 26%.

Table 1 displays the response rates by plan type. The response rates were as follows: PACE (33 %), MAP (34%), and Partially Capitated (26%), with an average response rate of 28%. Table 2a shows the response rates by language. Non- English responses comprised 27% of total responses.

Table 2b provides a summary of all responses per primary language.

Table 3 displays survey responses by individual plan. Response rates differed by plan, ranging from 17% to 50%. Please note that the latter response rate is due to Empire BCBS HealthPlus MAP having one survey respondent from an adjusted population of two members.

Table 1: Survey Responses by Plan Type
	Partially Capitated		PACE		MAP		TOTAL
	N	Percent	N	Percent	N	Percent	N	Percent
Surveys mailed	17,663		2,697		1,828		22,188
Less exclusions:	1,665	9%	339	13%	137	7%	2,141	10%
Address issues	1,555	9%	301	11%	121	7%	1,977	9%
Deceased	82	0.5%	33	1%	8	0.4%	123	0.6%
Other reason	28	0.2%	5	0.2%	8	0.4%	41	0.2%
Adjusted Population	15,998		2,358		1,691		20,047
Total # Surveys Completed	4,203	26%	785	33%	571	34%	5,559	28%

Table 2a: Language Responses by Plan Type
	Partially Capitated		PACE		MAP		TOTAL
	N	Percent	N	Percent	N	Percent	N	Percent
Completed in English	2,971	70.7%	682	86.9%	404	70.8%	4,057	73.0%
Completed in a Language Other Than English	1,232	29.3%	103	13.1%	167	29.2%	1,502	27.0%
Chinese	434	35.2%	26	25.2%	8	4.8%	468	31.2%
Russian	396	32.1%	14	13.6%	3	1.8%	413	27.5%
Spanish	402	32.6%	63	61.2%	156	93.4%	621	41.3%
Total # Surveys Completed	4,203		785		571		5,559

Table 2b: Survey Response Rates by Language
	N	Percent
ENGLISH
English Surveys Mailed	13,948
Less exclusions ¹	1,518	11%
Adjusted English Survey Population	12,430
Completed English Surveys	4,057	33%
SPANISH
Spanish Surveys Mailed	4,068
Less exclusions ²	330	8%
Adjusted Spanish Survey Population	3,738
Completed Spanish Surveys	621	17%
RUSSIAN
Russian Surveys Mailed	1,778
Less exclusions ³	132	7%
Adjusted Russian Survey Population	1,646
Completed Russian Surveys	413	25%
CHINESE
Chinese Surveys Mailed	2,394
Less exclusions ⁴	161	7%
Adjusted Chinese Survey Population	2,233
Completed Chinese Surveys	468	21%

^{1. English exclusions due to address issues (1,381), member deceased (113), member no longer enrolled (4), and other reason (20). 1}
^{2. Spanish exclusions due to address issues (318), member deceased (4), and other reason (8). 2}
^{3. Russian exclusions due to address issues (120), member deceased (5), and other reason (7). 3}
^{4. Chinese exclusions due to address issues (158), member deceased (1), and other reason (2). 4}

Table 3: Survey Responses by Plan
Health Plan	Adjusted Population	No. of Respondents	Percent
Partially Capitated
AETNA BETTER HEALTH	562	137	24%
AGEWELL NEW YORK	548	159	29%
ALPHACARE	536	107	20%
ARCHCARE COMMUNITY LIFE	525	147	28%
CENTERLIGHT SELECT	550	94	17%
CENTERS PLAN FOR HEALTHY LIVING	555	152	27%
ELDERPLAN dba HOMEFIRST	566	197	35%
ELDERSERVE dba RIVERSPRING	528	136	26%
EMPIRE BCBS HEALTHPLUS MLTC	545	116	21%
EVERCARE CHOICE	543	163	30%
EXTENDED MLTC	563	138	25%
FALLON HEALTH WEINBERG	214	60	28%
FIDELIS CARE AT HOME	542	151	28%
GUILDNET	551	112	20%
HAMASPIK CHOICE	539	187	35%
ICIRCLE	536	157	29%
INDEPENDENCE CARE SYSTEM	553	145	26%
INTEGRA	545	143	26%
KALOS HEALTH	530	169	32%
METROPLUS MLTC	534	136	25%
MONTEFIORE MLTC	557	128	23%
NORTH SHORE-LIJ HEALTH PLAN	547	155	28%
PRIME HEALTH CHOICE	135	30	22%
SENIOR HEALTH PARTNERS	554	128	23%
SENIOR NETWORK HEALTH	395	125	32%
SENIOR WHOLE HEALTH	550	148	27%
UNITED HEALTHCARE PERSONAL ASSIST	537	131	24%
VILLAGECAREMAX	547	121	22%
VNA HOMECARE OPTIONS	519	158	30%
VNS CHOICE MLTC	544	139	26%
WELLCARE ADVOCATE PARTIAL	548	134	24%
TOTAL	15,998	4,203	26%
PACE
ARCHCARE SENIOR LIFE	396	113	29%
CATHOLIC HEALTH-LIFE	173	71	41%
CENTERLIGHT PACE	561	176	31%
COMPLETE SENIOR CARE	103	34	33%
EDDY SENIOR CARE	140	56	40%
ELDERONE	515	147	29%
PACE CNY	374	154	41%
TOTAL SENIOR CARE	96	34	35%
TOTAL	2,358	785	33%
MAP
ELDERPLAN MAP	555	230	41%
EMPIRE BCBS HEALTHPLUS MAP	2	1	50%
FIDELIS MAP	104	24	23%
GUILDNET MAP	394	114	29%
MHI HEALTHFIRST COMPLETE CARE	564	174	31%
VNS CHOICE PLUS MAP	72	28	39%
TOTAL	1,691	571	34%
GRAND TOTAL	20,047	5,559	28%

Respondent Demographics

Unless otherwise indicated, survey demographic results can be found in Appendix A, Table A6.

The demographic profiles of the 2015 and 2017 populations were very similar. About 73% of respondents in 2017 were female (75% in 2015), and 85% were 65 years of age or older (86% in 2015). Approximately half of respondents (2015: 52%, 2017: 53%) had at least a high school diploma.

English was the primary language for 53% of the 2017 respondents (57% in 2015), with Spanish as the next most common language for 19% of the 2017 respondents (18% in 2015). Chinese was the primary language for 11% of the 2017 respondents, (9% in 2015) Russian was the primary language for 9% of the 2017 respondents (11% in 2015) and other languages was reported as the primary language for 8% of the 2017 respondents (6% in 2015). Overall, the percentage of respondents that do not speak English as their primary language was higher in 2017 than in 2015 (47% vs. 43%).

Fifty-nine percent of respondents rated their current state of health as poor/fair (60% in 2015), 25% rated their health as good (25% in 2015), and 16% as very good/excellent (15% in 2015). Sixty percent of the respondents were very much/quite a bit content with their quality of life (62% in 2015).

The vast majority of respondents still live at home, and not in a nursing home, when compared with 2015 rates (95% in 2017 vs. 97% in 2015). This demographic result can be found in Appendix A, Table A1. However, the difference between these rates is statistically significant (see Appendix B, Table B1). Approximately half of respondents live alone (2015: 48%, 2017: 47%). Approximately two-thirds of respondents reported that they received assistance in completing the survey (2015: 65%, 2017: 65%), mostly from family members (2015: 65%, 2017: 64%).

Plan Evaluation/Rating of Health Plan

Section 1 of the survey consisted of questions concerning members´ experience with their MLTC plan.

Full frequency distribution tables can be found in Appendix A (Tables A1-A6), while aggregate tables can be found in Appendix B (Tables B1-B13).

Table B1 compares responses from both survey years, which shows that the level of satisfaction among 2015 and 2017 respondents remained high. Other notable findings from 2017 were as follows:

Ninety-three (93%) of respondents rated their plan as excellent/good at helping them stay at home and not at a nursing home.
Eighty-nine percent (89%) of respondents reported that their plan has been excellent/good at helping them to take medications the way their doctor wants them to, and 74% reported that their plan has been excellent/good at helping when they were feeling sad and lonely. This would appear to demonstrate that the plans have been effective in providing members with self-management support and collaborating with members and their families to improve members´ health.
Eighty-eight percent (88%) of respondents rated their plan as excellent/good.
Seventy-nine percent (79%) of respondents reported that the health plan explained the Consumer Directed Personal Assistance (CDPA) option. This is a significant increase from 75% in 2015.

Quality of Care

In Section 2A of the survey, members were asked to rate the quality of services and supplies they received in the last 6 months. Frequency distributions for the 22 Quality of Care items can be found in Table A2.

Table B2 displays the rank ordered positive (excellent/good) ratings given by members pertaining to quality of care compared by survey year. Members´ perception of the quality of the care they received has remained high in 2017. Other notable findings from this section include:

Overall, the percentage of members who rated the quality of care of the 22 providers as excellent/good increased from the last survey year.
Twelve (12) out of the 22 care providers listed had at least 80% of the respondents giving an excellent/good rating for quality in 2017 (compared to 8 out of 22 in 2015), long-term care providers and services such as primary care physicians (PCPs) (91%); pharmacy services (89%); home health aide (89%); visiting nurse (86%); care manager (85%); eye care professional (83%); foot doctor (82%); and medical supplies/equipment (80%).
In the 2017 survey, Home Health Agency, Personal Care Agency were rated excellent/good by a significantly higher percentage of members (81%) than in the 2015 survey (76%).
Audiology and hearing aids received the lowest quality of care rating in 2017 (73%) and 2015 (68%). Although not statistically significant, the percentage of participants who rated the quality of audiology/hearing aids as excellent/good increased 5 percentage points from 2015 (68%) to 2017 (73%).

Timeliness of Care

In Section 2B of the survey, members were asked to rate how often the services were on time or if they were able to see the provider at the scheduled time in the last six months. Frequency distributions for the 16 items in this section can be found in Table A3. Table B3 displays the rank ordered positive (always/usually) ratings given by members compared by survey year. Other notable findings from this section include:

The percentage of participants rating Home Delivered Meals/Meals on Wheels as always/usually on time was significantly higher in 2017 (79%) than in 2015 (71%).
The majority of members perceived the timeliness of care to be always/usually on time. All care provider types were identified as always/usually on time by at least 63% of participants. Nine (9) of the 16 provider types had at least 80% of respondents giving an always/usually rating for timeliness.
Of the long-term care providers and services, speech therapists were least likely to be rated as always/usually on time, at 63% for 2017. In contrast, pharmacy services were the most likely of the long-term care providers and services to be rated as always/usually on time, at 92% for 2017.

Access to Care

In Section 2C of the survey, members were asked to indicate how long they generally had to wait for urgent and regular appointments for long-term care providers and services in the last 6 months. Tables A4 and A5 provide frequency distributions for these survey items.

Timely access to regular appointments was defined as obtaining an appointment with a provider as soon as a member felt they needed an appointment. Timely access to urgent appointments was defined as obtaining an appointment on the same day that the member needed care. Tables B4 and B5 display the rank ordered results for timely access to urgent and regular appointments compared by survey year.

Access to urgent and regular appointments was similar in 2017 and 2015.

Table B4 shows that for urgent appointments, nearly half of the respondents were able to obtain a same day appointment with their primary care physician (PCP) (2017: 49%, 2015: 50%).
Timely access to urgent appointments was even less likely than primary care physicians for foot doctors (2017: 32%, 2015: 34%), audiologists (2017: 32%, 2015: 32%), eye care (2017: 31%, 2015: 33%), and dentists (2017: 29%, 2015: 29%).
As demonstrated in Table B5, a similar percentage of participants in 2017 and 2015 reported that they always/usually have timely access to regular appointments as soon as the member felt they needed one: PCPs (2017: 89%, 2015: 88%), eye care (2017: 79%, 2015: 79%), foot doctors (2017: 78%, 2015: 80%), dentists (2017: 75%, 2015: 73%), and audiologists (2017: 70%, 2015: 68%).

Analysis of Composite Measures and Individual Survey items within Domains

Composite measures of survey items were computed, in addition to individual survey items, to obtain a meaningful summary of member responses in each of the following six domains:

Domain 1 – MLTC Plan Evaluation: Consists of a combination of four (4) individual survey items and three (3) composite measures and includes questions 3-5 and 7-15. Questions 4 and 5 were combined to create a composite measure (Composite 1a), as were Questions 7-11 (Composite 1b) and Questions 14a-14d (Composite 1c). All other questions in this group were reported as individual survey items. Collectively, these composite measures, as well as the individual survey items, assess the members´ general experience with the care plan, including plan of care involvement, and courtesy and timeliness of responses of plan representatives when members called the plan. For Composite 1a and Composite 1b, the score represents the average proportion of respondents who answered "Always/Usually", and for Composite 1c, the score represents the average proportion of respondents who answered "Excellent/Good."
Domain 2 – Quality of Providers and Long-Term Care Services: Consists of one composite measure and includes questions 16-35. This domain evaluates the quality of care provided by long-term care providers and services and consists of 22 provider and service types. The composite score for this domain reflects the average proportion of respondents who rated the quality of long-term care providers and services and services as excellent/good.
Domain 3 – Timeliness of Providers and Long-Term Care Services: Consists of one composite measure including questions 36-47 and evaluates the timeliness of care provided by long-term care providers and services. This composite consists of 16 provider and service types. The composite score for this domain reflects the average proportion of respondents who rated the timeliness of the providers and services as always/usually timely.
Domain 4 – Access to Care for Urgent Appointments: Consists of one composite measure, which assesses the respondents´ ability to get an appointment within the same day when care was needed right away. There are five (5) measures within the composite representing five (5) provider types: PCP, dentist, eye care, foot doctor, and audiology. The composite score reflects the average proportion of respondents who reported that they always/usually could get an appointment within the same day.
Domain 5 – Access to Care for Regular Appointments: Consists of one composite measure assessing the ability of respondents to get a regular appointment as soon as they thought they needed one. There are five (5) measures included in the composite which represent five (5) provider types: PCP, dentist, eye care, foot doctor, and audiology. The composite score reflects the average proportion of respondents who reported that they always/usually were able to get a regular appointment as soon as they thought they needed one.
Domain 6 – Advance Directives: Consists of three single survey items, which includes questions 71-73. This domain evaluates whether or not members have appointed someone to make decisions about their health if they are unable to do so, if they have a legal document or advance directive in place, and if the MLTC plan has a copy of that advance directive document on file.

Domain 1: Measures Related to MLTC Plan Evaluation (Table B6)

Eighty-eight percent of members reported that the plan always/usually explained services clearly and 94% said the plan had asked to see all prescriptions and medications.
In 2017, 72% of respondents said they, along with family members or caregivers, were always/usually involved in making decisions about their plan of care, a slight increase from 2015 (70%).
Seventy-nine percent (79%) reported that they always/usually received helpful, timely, and courteous customer assistance when they called the plan with a question or complaint, unchanged compared to 2015.
Seventy-nine percent of members (79%) said the plan had explained the Consumer Directed Personal Assistance (CDPA) option, a significantly higher rate than in 2015 (75%).
Eighty-five percent (85%) reported that the plan was excellent/good in helping members with managing medications and illnesses, as well as feeling sad or lonely and helping members remain in their homes as opposed to a nursing home.
Overall, 88% rated the health plan as excellent/good in 2017, a one percentage point increase from 2015 (87%).

Figure 1 displays the rates for each measure as compared to 2015.

Figure 1: MLTC Plan Evaluation (Domain 1)

* Indicates a rate significantly higher than 2015. p<.001.
1 Indicates a single survey item. Significance testing for single items was done using a z-test.
2 Indicates a composite measure. Significance testing for composite measures was done using the Student´s t-test.

Domains 2-5: Measures Related to Quality, Timeliness, and Access to Care (Table B6)

About 82% of respondents rated the quality of providers and services as excellent/good, a one percentage point increase from 2015.
About 82% of respondents rated the overall timeliness of care as always/usually timely, unchanged from 2015.
About 37% of respondents reported that they were always/usually able to get an appointment within the same day in 2017, which decreased slightly from 2015 (39%).
Additionally, 82% of respondents were always/usually able to get a regular appointment with their doctor, representing a slight increase from 2015 (81%).

Figure 2 displays the rates for Domains 2-5 as compared to 2015.

Figure 2: Quality, Timeliness, and Access to Care (Domains 2-5)

Domain 6: Advance Directives (Table B6)

Advance directives are considered an important component in the overall care of the managed long-term care population.
Significantly more members in 2017 (75%) reported that their health plan has talked to them about appointing someone to make health care decisions for them if they are unable to do so, compared to 2015 (67%).
Sixty-eight (68%) percent of members reported having a legal document or advance directive appointing someone to make health care decisions on their behalf in the event that they are unable to do so, a significant increase from 2015 (58%).
Of individuals with an advanced directive, 84% of members said that their health plan has retained a copy of the document, a significantly higher rate than 2015 (79%).
It should be noted that the questions on advance directives were re-worded in 2017 to include the word "advance directive." Participants may have responded differently to these items in 2017 due to this clarification, and thus may explain the significant increase of positive responses.

Figure 3 displays the rates for each measure as compared to 2015.

Figure 3: Advance Directives (Domain 6)

* Indicates a rate significantly higher than 2015. p<.001.

Analysis of Composite Measures and Individual Survey Items by Subgroup

Comparisons between subgroups were also performed on the individual survey items and composite measures that comprise each domain to determine which subgroups of the managed long-term care population were most or least satisfied with the quality, timeliness, and access to care in 2017. The subgroups included: plan type, gender, race/ethnicity, educational attainment, age, primary language spoken, and self-reported health status.

Comparison tables can be found in Appendix B, Tables B7-B13. Statistically significant differences in each subgroup are noted as follows:

Comparison by Plan Type (Table B7)

Partially Capitated and MAP members were more likely to report that someone at the plan had explained the Consumer Directed Personal Assistance (CDPA) option to them since joining the plan compared to PACE members (Partially Capitated: 81%, MAP: 84% vs. PACE: 61%).
PACE and MAP members were more likely to report that the plan had talked to them about appointing someone to make decisions about their health care if they are unable to compared to Partially Capitated members (PACE: 82%, MAP: 80% vs. Partially Capitated: 73%).
PACE plan members were more likely to report having a legal document or advance directive appointing someone to make health care decisions for them, compared to MAP and Partially Capitated members (PACE: 85% vs. MAP: 69%, Partially Capitated: 65%).
PACE members were more likely to report that the health plan had a copy of the legal document or advance directive (PACE: 97% vs. Partially Capitated: 80%, MAP: 83%).

Comparison by Gender (Table B8)

Seventy-one percent (71%) of male respondents reported that someone from the health plan had talked to them about appointing someone to make health care decisions for them if they are unable to do so, significantly lower than female respondents (77%).
In addition, male respondents were less likely than female respondents to report having a legal document or advance directive appointing someone to make health care decisions if they are unable to do so (64% vs. 70%).

Comparison by Race/Ethnicity (Table B9)

Eighty-five percent (85%) of Asian respondents indicated someone from the plan explained the CDPA Option, significantly higher than any other race category (White: 76%, Black: 80%, Other: 70%).
Overall, 85% of white respondents rated the quality of care they received from long-term care providers and services as excellent/good, a rate significantly higher than black and Asian respondents (78% and 80%, respectively).
In addition, 86% of white respondents rated the timeliness of care as excellent/good, while 79% of black respondents and 82% of Asian respondents rated the timeliness as excellent/good. The rate for white respondents was significantly higher than the rates for black and Asian respondents.
Eighty-six percent (86%) of white respondents reported that they were always/usually able to get a regular appointment with their doctors as soon as they thought they needed one. This rate is significantly higher than both black and Asian respondents (79% and 77%, respectively).
Of Asian respondents, 51% reported that they had legal documentation or advance directive appointing someone to make health care decisions if they are unable to, significantly lower than any other race category (White: 73%, Black: 71%, Other: 79%).

Comparison by Education (Table B10)

Respondents with a level of education less than high school were more likely to report that the plan had explained the CDPA option than respondents with at least a high school diploma (83% vs. 76%).
Respondents with an education level of less than high school were less likely to indicate they always/usually get timely regular appointments with long-term care providers (80% vs. 84%).
Additionally, 78% of respondents with a level of education less than high school reported that the plan had talked to them about appointing someone to make health care decisions if they are unable to do so, significantly higher than respondents with at least a high school diploma (73%).

Comparison by Age (Table B11)

Respondents ages 18-64 were less likely to report that their family members or caregivers were involved in making decisions about their health care than respondents over the age of 65 (67% vs. 73%).
Additionally, respondents ages 18-64 were less likely to have a legal document or advance directive appointing someone to make health care decisions if they are unable to do so (62% vs. 69%).

Comparison by Primary Language (Table B12)

English-speaking respondents were less likely to report that the health plan had explained the CDPA option as compared to non-English speaking respondents (73% vs. 85%).
Thirty-three percent (33%) of English-speaking respondents reported that they could get urgent appointments with their doctors the same day, significantly lower than non-English speaking respondents (43%).
When asked if members had a legal document or advance directive appointing someone to make health care decisions for them, 78% of English speaking respondents reported they did have an advance directive, while 56% of non-English speaking respondents reported they had an advance directive. The rate for English speaking respondents was significantly higher than non-English respondents.

Comparison by Self-Reported Health Status (Table B13)

Eighty-four percent (84%) of respondents who rated their current state of health as good/fair/poor reported that the health plan always/usually explained all of their services clearly, significantly lower than respondents who rated their current state of health as excellent/very good (92%).
When asked if their family members, caregivers, or they were involved in making health care decisions, respondents who rated their current state of health as good/fair/poor were less likely to respond positively (always/usually) than respondents who rated their current state of health as excellent/very good (70% vs. 75%).
In regard to receiving helpful, timely, and courteous customer service when members called the plan with a question, complaint, or grievance, 75% of respondents who rated their current state of health as good/fair/poor reported they always/usually received helpful, timely, and courteous customer service while 84% of respondents who rated their current state of health as excellent/very good reported the same. The rate for respondents with good/fair/poor health was significantly lower.
Eighty-one percent (81%) of respondents who rated their current state of health as good/fair/poor reported the plan was excellent/good at helping them with medication management, managing illnesses, feeling sad and lonely, and staying in their own home as opposed to a nursing home. Comparatively, 91% of respondents who reported their health status as excellent/very good responded to these survey items with an excellent/good rating. The rate for respondents who rated their health as good/fair/poor was significantly lower.
Overall, 84% of respondents who rated their current state of health as good/fair/poor rated their MLTC plan as excellent/good while 93% of respondents who rated their current state of health as excellent/very good rated their MLTC plan as excellent/very good. The rate for respondents who rated their current state of health as good/fair/poor was significantly lower than the rate for respondents who rated their current state of health as excellent/very good.
In regard to quality of care provided by long-term care providers and services, 79% of respondents who rated their current state of health as good/fair/poor rated quality as excellent/good, significantly lower than respondents who rated their current state of health as excellent/very good (87%).
Eighty percent (80%) of respondents who rated their current state of health as good/fair/poor reported that long-term care providers and services were always/usually on time, significantly lower than respondents who rated their current state of health as excellent/very good (87%).
Respondents who rated their current state of health as good/fair/poor were less likely to report always/usually being able to get regular appointments with long-term care providers and services as soon as they thought they needed it (80% vs. 84%).
Respondents who rated their current state of health as good/fair/poor were less likely than respondents who rated their current state of health as excellent/very good to report that they had a legal document or advance directive appointing someone to make health care decisions if they are unable to do so (64% vs. 74%).

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Section 4: Limitations

As with any survey that relies on self-reported responses, there is the possibility of recall bias, since some questions require the member to answer questions based on a time period within six months. Limitations that may affect response rates of plans were most notable. Throughout the year that the survey was conducted, a few MLTC plans have ceased operations and/or sold their product line(s) to existing MLTC plans. For example, GuildNet MLTC plan ceased operations in Nassau, Suffolk and Westchester Counties. The members affected by this change were absorbed by other MLTC plans. In another instance, CenterLight Select eliminated its MLTC product line. The majority of these members were transitioned to Centers Plan for Healthy Living. As a result of this change, the response rate for CenterLight Select decreased and the response rate for Centers Plan for Healthy Living increased. It should also be noted that participants may have rated their plan unfavorably after being moved to a new MLTC plan.

IPRO was made aware that a few MLTC plans had communicated with members via postcards, calls or other means to encourage members to complete the survey, which could have affected response rates. Other limitations observed by IPRO included the Medicare member satisfaction survey, which was being conducted in the same general timeframe as the IPRO/NYSDOH member satisfaction survey. Some members in MLTC plans that are also Medicare beneficiaries may have received this survey, which may have caused confusion among those members, given the similarity of the items on both surveys.

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Section 5: Supplemental Phone Survey

IPRO conducted an abbreviated phone survey in follow up to the mailed survey. The purpose of the phone survey was to investigate possible bias that may have occurred due to MLTC care managers assisting members in completing the mailed survey, specifically with regard to care manager and plan-related survey items. In light of this potential issue, IPRO and the NYSDOH thought it necessary to conduct a study to compare responses between members completing the phone survey and members who completed the mailed survey. During the course of the survey response period, IPRO became aware of the possibility that care managers from several plans had intervened with members in completing the survey. Therefore, there was added interest in learning whether or not responses among members from these plans differed from other plans. An abbreviated phone survey consisting of 16 questions from the original survey was crafted and was conducted across a random sample of members from all of the MLTC plans, with an oversample of members drawn from selected plans with a notably higher level of care manager assistance in completing the survey (Question 69). The random sample for the phone survey consisted of 1,150 members. IPRO was successful in completing the phone survey with 112 members in the sample. In every instance, IPRO completed the survey with the members directly, or with a family member, to eliminate the possibility of health aides and care managers answering questions on the members´ behalf.

Responses to both versions of the survey (phone and mail) indicated that members are satisfied with the services they receive from their care manager, health aide, and health plan. There were no significant differences between the two survey groups with regard to questions related to plan rating and quality of services provided by care managers. IPRO´s phone survey results therefore support the credibility of the mail survey responses.

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Section 6: Conclusions and Recommendations

Overall survey findings were favorable. The tables presented in this report indicate that the majority of MLTC respondents are satisfied with their MLTC plan. The majority of members rated the quality of MLTC services to be good or excellent, and the majority of members indicated that providers and services are always or usually on time. It is encouraging to see continued high satisfaction rates for such critical long-term care services as visiting nurses and care managers. Survey results also indicate that certain services reflected notable quality improvement ratings as compared to the 2015 survey, among these were home delivered meals and home health and personal care agencies.

Significant improvements have been made in advance care planning from the last survey year to the current survey year. A larger percentage of members indicated that someone from the plan spoke to them about appointing someone to make decisions about their plan of care if they are unable to do so. Further, a larger percentage of members indicated that they have a legal document or advance directive appointing someone to make decisions if they are unable to do so. Members also indicated that the plan has a copy of the legal document or advance directive, which underscores the increased efforts made by plans to ensure members are thinking about advance care planning through the performance improvement projects (PIPs) being conducted.

Specific observations and recommendations were as follows:

IPRO observed that the percentage of members rating the quality of medical supplies and equipment as good/excellent, while still high, declined slightly from the 2015 survey (82% to 80% - Table B2).

Plans may choose to conduct more in-depth member surveys focused on this service to determine if, in fact, quality issues exist and to determine the nature of these issues. These surveys can be used as baseline data to determine if PIPs focusing on this service are warranted. Reviews of complaint and grievance logs may be considered as well, as a means of identifying quality of care issues.
The percentage of respondents rating the quality of dental services as good/excellent, while slightly improved from 2015 (73% to 75%), continues to be among the lowest of the long-term care providers and services (Table B2).

Member surveys focused on the quality of dental care may be warranted, to identify issues, and to determine if there are access issues with these providers as well. Reviews of complaint and grievance logs may also be considered as a means of identifying problems with dental networks. Plans conducting dental preventive screening PIPs may wish to include this as part of their interventions and process measures, as issues with access to dental services may yield lower dental exam rates.
Audiology/hearing aids, while improved from the 2015 survey, had the lowest good/excellent quality of care ratings, at 73%, versus 68% in 2015 (Table B2).

As with dental services, member surveys focused on the quality of these services may be warranted, as are reviews of complaints and grievances involving audiology services, to assist in determining if outreach to these providers is necessary. Plans pursuing hearing exams as a topic for their preventive screening PIP should consider interventions that address these survey results, as well as any findings from complaint/grievance logs pertaining to dissatisfaction with audiology services.
The percentage of respondents indicating that the health plan spoke to them about appointing someone to make decisions about their health if they are unable to do so, and the percentage of respondents indicating that they have a legal document or advance directive in place, significantly increased from 2015 to 2017 (Table B1). PACE and MAP plans continue to exhibit higher rates of these discussions and advance directive procurement than partially capitated plans (Tables A6, B7). Whites, blacks, and respondents who identified as "other" reported higher rates of advance directives in place than Asians (Table B9).

As noted in prior survey findings, a number of partially capitated plans have been addressing advance directives over the years by undertaking PIPs which focus on advance directive discussion as well as procurement. Project interventions have included:
1. Increased social worker and care management involvement (language and culture specific where applicable)
2. Language and culture specific member education materials
3. Advance directive discussions at start of enrollment processes
4. Advance directive discussions during clinical re-assessment visits
5. Increased telephone follow-up initiatives
Some improvement in advance directive procurement rates have been observed with these interventions. IPRO recommends continued efforts in these areas and recommended advance directives as a PIP topic option for the 2017-2018-year PIPs. This will benefit partially capitated plans in particular, due to the continued lower rates of advance directive discussion and procurement of partially capitated plans compared to MAP and PACE plans. Language and culture-specific interventions, wherever possible and applicable, would appear to be a key to this undertaking.
The percentage of respondents indicating that they had same day urgent access to providers has declined since the last survey year and continues to be low. The highest percentage was reported for PCPs (49%), with same day urgent access for foot doctors, eye care, audiology, and dentists notably lower (Table B4).

IPRO continues to acknowledge that outpatient services are not in the benefit package of the partially capitated plans. However, all plans may wish to investigate access issues through possibly interviewing providers to determine exactly how urgent visits are handled. Plans may also choose to interview samples of members to obtain time intervals for urgent appointments, in order to provide outreach to certain providers.
The percentage of respondents indicating that family members or caregivers are involved in care planning, while slightly improved over 2015 results, still indicates room for improvement (Table B1, 66%).

Family involvement is the member´s choice; therefore, plans should investigate whether members would like additional family and/or caregiver participation in care planning. Plans may need to possibly consider doing more to foster member and caregiver involvement in care planning, either through care manager education (e.g. in-service training) or through outreach to vendors involved in care planning. An initial step might be a survey to a sample of members addressing whether these members would like to see family members involved in care planning or service determination discussions, and if members want family members/caregivers to receive copies of their care plans. These surveys should also address if members and/ or caregivers are not satisfied with their care plans because they do not include all of the relevant issues that they perceive to be important.
Respondents with a level of education less than high school were more likely to report that the plan had explained the CDPA option than respondents with at least a high school diploma (83% vs. 76%) (Table B10). It should be noted that this difference is statistically significant. Additionally, 78% of respondents with a level of education less than high school reported that the plan had talked to them about appointing someone to make health care decisions if they are unable to do so, which was significantly higher than respondents with at least a high school diploma (73%) (Table B10).

These results may be indicating that verbal discussions may be limited to members with an obvious inability to understand these concepts. While it is encouraging to see that discussions are taking place with these members, plans should take steps to ensure that discussions are occurring across all membership groups. Members with a high school education or better may also have difficulty understanding these concepts and should not be overlooked.
Similar to last year, there were some observed race/ethnicity differences with some ratings. White respondents were more likely to report that their family members or caregivers were always/usually involved in making decisions about health care and were more likely to report always/usually receiving helpful, timely and courteous service when calling the plan. White respondents were also more likely to rate their quality of care as good/excellent and were more likely to rate that they were always/usually able to get a regular appointment with their doctors as soon as they thought they needed one. A significantly lower rate of Asian respondents reported having advance directives in place than all other respondents. Also, a significantly higher percentage of English-speaking respondents reported having these documents in place, as compared to non-English speaking respondents (Tables B9, B12).

These results may indicate that cultural barriers associated with race, and language barriers, may be playing a role in members not being satisfied with certain services and with timely access to them.

This may be another area for plans to explore, if there is limited access to services across certain ethnic groups. Cultural competency training for plan staff may also be warranted, as well as increased use of language line services if a language barrier exists.

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Appendix A. Frequency Tables

Table A1: MLTC Plan Evaluation
	All respondents	Partial Cap 2015		Partial CAP 2017		PACE 2015		PACE 2017		MAP 2015		MAP 2017		Statewide 2015		Statewide 2017
Item	Description	N	%	N	%	N	%	N	%	N	%	N	%	N	%	N	%
Section 1: MLTC Plan Evaluation
1a	Our records indicate that you are a member of [HEALTH PLAN]. Is this correct?
	Yes	2,965	96	3,685	96	542	98	725	99	632	98	482	96	4,139	97	4,892	96
	No	112	4	160	4	9	2	7	1	16	2	20	4	137	3	187	4
	TOTAL	3,077		3,845		551		732		648		502		4,276		5,079
2a	Where do you live?
	At home	2,964	98	3,580	94	493	93	657	93	637	99	486	98	4,094	97	4,723	95
	Nursing home	68	2	209	6	37	7	49	7	8	1	8	2	113	3	266	5
	TOTAL	3,032		3,789		530		706		645		494		4,207		4,989
3	MLTC plan explains services clearly?
	Always	1,507	56	1,831	55	222	51	307	51	353	60	289	64	2,082	56	2,427	56
	Usually	823	30	1,061	32	150	34	211	35	155	26	112	25	1,128	30	1,384	32
	Sometimes	318	12	342	10	56	13	73	12	70	12	42	9	444	12	457	11
	Never	61	2	67	2	10	2	11	2	13	2	6	1	84	2	84	2
	TOTAL	2,709		3,301		438		602		591		449		3,738		4,352
	Don´t know or not sure	134		154		31		27		28		17		193		198
4	Are you involved in making decisions about plan of care?
	Always	1,394	52	1,793	55	207	46	286	48	321	54	236	52	1,922	52	2,315	53
	Usually	659	25	828	25	144	32	160	27	127	21	98	22	930	25	1,086	25
	Sometimes	392	15	408	12	64	14	111	19	95	16	79	17	551	15	598	14
	Never	223	8	252	8	33	7	38	6	51	9	40	9	307	8	330	8
	TOTAL	2,668		3,281		448		595		594		453		3,710		4,329
	Don´t know or not sure	168		163		25		33		26		19		219		215
5	Is your family/caregiver involved in making decisions about plan of care?
	Always	1,247	46	1,529	46	226	48	311	51	308	51	213	47	1,781	47	2,053	47
	Usually	478	18	662	20	101	22	109	18	70	12	71	16	649	17	842	19
	Sometimes	494	18	573	17	77	16	99	16	108	18	89	19	679	18	761	17
	Never	467	17	565	17	65	14	96	16	117	19	84	18	649	17	745	17
	TOTAL	2,686		3,329		469		615		603		457		3,758		4,401
	Don´t know or not sure	142		115		10		14		17		13		169		142
6	Called the plan for help or a complaint/grievance?
	Yes	1,312	47	1,675	50	246	54	343	56	290	48	232	51	1,848	48	2,250	51
	No	1,451	53	1,697	50	211	46	274	44	315	52	225	49	1,977	52	2,196	49
	TOTAL	2,763		3,372		457		617		605		457		3,825		4,446
7 ♦	Speak with a person quickly?
	Always	479	38	587	36	80	33	112	33	92	32	82	36	651	36	781	36
	Usually	482	38	610	37	108	45	127	38	93	33	90	39	683	38	827	38
	Sometimes	255	20	366	22	50	21	88	26	82	29	48	21	387	22	502	23
	Never	57	4	71	4	3	1	8	2	19	7	8	4	79	4	87	4
	TOTAL	1,273		1,634		241		335		286		228		1,800		2,197
	Don´t know or not sure	11		16		0		3		0		1		11		20
8 ♦	Were questions answered quickly?
	Always	501	39	636	39	80	33	102	31	100	35	88	38	681	38	826	38
	Usually	470	37	604	37	99	41	131	39	97	34	79	35	666	37	814	37
	Sometimes	246	19	337	21	56	23	87	26	74	26	58	25	376	21	482	22
	Never	60	5	62	4	5	2	14	4	13	5	4	2	78	4	80	4
	TOTAL	1,277		1,639		240		334		284		229		1,801		2,202
	Don´t know or not sure	11		18		1		6		3		0		15		24
9 ♦	Were you able to understand the answers?
	Always	664	52	805	49	114	48	158	47	122	43	112	50	900	50	1,075	49
	Usually	379	30	552	34	92	38	126	38	92	32	74	33	563	31	752	34
	Sometimes	202	16	245	15	29	12	45	14	64	22	37	16	295	16	327	15
	Never	20	2	28	2	5	2	4	1	8	3	2	1	33	2	34	2
	TOTAL	1,265		1,630		240		333		286		225		1,791		2,188
	Don´t know or not sure	18		20		2		6		1		3		21		29
10 ♦	Were you treated with politeness and respect?
	Always	919	72	1,136	70	164	68	232	69	200	70	164	72	1,283	71	1,532	70
	Usually	274	21	380	23	58	24	79	24	55	19	48	21	387	21	507	23
	Sometimes	75	6	102	6	17	7	24	7	28	10	16	7	120	7	142	6
	Never	16	1	16	1	1	0	1	0	2	1	1	0	19	1	18	1
	TOTAL	1,284		1,634		240		336		285		229		1,809		2,199
	Don´t know or not sure	2		12		2		1		2		0		6		13
11 ♦	Complaint or grievance handled to satisfaction?
	Always	378	39	460	36	58	31	87	31	75	33	80	41	511	37	627	36
	Usually	292	30	410	32	72	38	92	33	70	31	50	26	434	31	552	31
	Sometimes	205	21	273	21	48	25	87	31	63	28	43	22	316	23	403	23
	Never	104	11	138	11	12	6	15	5	20	9	23	12	136	10	176	10
	TOTAL	979		1,281		190		281		228		196		1,397		1,758
	I did not call the plan with a complaint	307		367		53		57		53		34		413		458
12	Has asked to see all of the prescriptions/over the counter medicines?
	Yes	2,520	94	3,101	95	397	92	549	93	566	95	434	95	3,483	94	4,084	94
	No	157	6	176	5	35	8	41	7	27	5	25	5	219	6	242	6
	TOTAL	2,677		3,277		432		590		593		459		3,702		4,326
	Don´t know or not sure	174		179		41		35		26		17		241		231
13	Explain the CDPA option?
	Yes	1,413	77	1,920	81	156	58	222	61	292	74	264	84	1,861	75	2,406	79
	No	418	23	439	19	111	42	140	39	105	26	52	16	634	25	631	21
	TOTAL	1,831		2,359		267		362		397		316		2,495		3,037
	Don´t know or not sure	1,002		1,061		201		257		211		151		1,414		1,469
14a	Take meds the way your doctor wants you to
	Excellent	1,114	51	1,414	53	236	55	324	58	273	53	205	53	1,623	52	1,943	54
	Good	817	37	970	36	156	36	187	34	185	36	141	37	1,158	37	1,298	36
	Fair	189	9	204	8	28	7	35	6	36	7	24	6	253	8	263	7
	Poor	74	3	96	4	10	2	12	2	20	4	15	4	104	3	123	3
	TOTAL	2,194		2,684		430		558		514		385		3,138		3,627
	Not Applicable	529		620		38		51		85		71		652		742
14b	Manage your illness
	Excellent	913	44	1,159	46	205	50	286	52	239	47	180	48	1,357	46	1,625	47
	Good	823	40	1,005	40	167	40	206	37	197	39	138	37	1,187	40	1,349	39
	Fair	236	11	258	10	32	8	48	9	47	9	44	12	315	11	350	10
	Poor	89	4	115	5	10	2	11	2	23	5	14	4	122	4	140	4
	TOTAL	2,061		2,537		414		551		506		376		2,981		3,464
	Not Applicable	604		730		48		51		88		71		740		852
14c	Help when feeling sad and lonely
	Excellent	653	36	879	38	115	33	176	38	133	33	114	37	901	35	1,169	38
	Good	655	36	821	36	139	39	166	36	153	38	106	35	947	37	1,093	36
	Fair	320	18	375	16	66	19	87	19	70	17	60	20	456	18	522	17
	Poor	168	9	219	10	32	9	32	7	45	11	25	8	245	10	276	9
	TOTAL	1,796		2,294		352		461		401		305		2,549		3,060
	Not Applicable	848		952		109		136		189		144v		1,146v		1,232
14d	Allow to stay in home and not in nursing home
	Excellent	1,331	64	1,706	65	272	68	384	72	328	69	218	63	1,931	66	2,308	66
	Good	586	28	730	28	100	25	130	24	118	25	99	29	804	27	959	27
	Fair	109	5	129	5	17	4	11	2	16	3	20	6	142	5	160	5
	Poor	43	2	58	2	9	2	11	2	10	2	7	2	62	2	76	2
	TOTAL	2,069		2,623		398		536		472		344		2,939		3,503
	Not Applicable	560		632		63		69		126		108		749		809
15	How would you rate your plan?
	Excellent	1,095	41	1,430	44	202	45	257	42	286	48	203	45	1,583	42	1,890	44
	Good	1,230	46	1,438	44	189	42	270	45	253	42	196	43	1,672	45	1,904	44
	Fair	301	11	340	10	54	12	71	12	46	8	48	11	401	11	459	11
	Poor	62	2	66	2	8	2	7	1	13	2	5	1	83	2	78	2
	TOTAL	2,688		3,274		453		605		598		452		3,739		4,331

Note: Percentages have been rounded and may not total to 100%.

Table A2: Quality of Care
	All respondents	Partial Cap 2015		Partial CAP 2017		PACE 2015		PACE 2017		MAP 2015		MAP 2017		Statewide 2015		Statewide 2017
Item	Description	N	%	N	%	N	%	N	%	N	%	N	%	N	%	N	%
Section 2A: Quality of Care Providers
16	Regular Doctor
	Excellent	1,424	56	1,790	58	228	51	309	53	319	55	235	54	1,971	55	2,334	56
	Good	907	36	1,062	34	171	38	209	36	208	36	160	37	1,286	36	1,431	35
	Fair	163	6	190	6	35	8	48	8	41	7	30	7	239	7	268	6
	Poor	49	2	68	2	12	3	17	3	15	3	13	3	76	2	98	2
	TOTAL	2,543		3,110		446		583		583		438		3,572		4,131
	Not Applicable	170		226		17		21		23		23		210		270
17	Dentist
	Excellent	536	32	710	33	120	36	159	36	95	25	86	31	751	32	955	33
	Good	678	41	874	41	139	41	184	42	175	47	122	43	992	42	1,180	41
	Fair	293	18	340	16	50	15	56	13	67	18	47	17	410	17	443	15
	Poor	162	10	216	10	28	8	41	9	39	10	26	9	229	10	283	10
	TOTAL	1,669		2,140		337		440		376		281		2,382		2,861
	Not Applicable	918		1,067		119		158		207		155		1,244		1,380
18	Eye Care
	Excellent	906	42	1,127	42	160	41	203	39	231	44	156	40	1,297	42	1,486	41
	Good	855	39	1,095	41	145	37	231	44	215	41	161	41	1,215	39	1,487	41
	Fair	288	13	292	11	57	15	57	11	48	9	50	13	393	13	399	11
	Poor	118	5	162	6	29	7	31	6	27	5	23	6	174	6	216	6
	TOTAL	2,167		2,676		391		522		521		390		3,079		3,588
	Not Applicable	500		623		71		88		79		62		650		773
19	Foot Doctor
	Excellent	840	44	946	44	118	37	171	39	171	42	141	43	1,129	43	1,258	43
	Good	747	39	832	39	143	44	169	39	160	39	129	39	1,050	40	1,130	39
	Fair	217	11	251	12	42	13	69	16	54	13	42	13	313	12	362	12
	Poor	99	5	120	6	19	6	25	6	27	7	19	6	145	5	164	6
	TOTAL	1,903		2,149		322		434		412		331		2,637		2,914
	Not Applicable	679		1,017		125		150		166		102		970		1,269
20a	Home Health Aide
	Excellent	1,361	56	1,788	59	187	50	223	46	314	58	240	57	1,862	56	2,251	57
	Good	762	31	921	31	127	34	172	35	150	28	130	31	1,039	31	1,223	31
	Fair	229	9	212	7	40	11	70	14	50	9	36	9	319	10	318	8
	Poor	85	3	90	3	19	5	20	4	27	5	16	4	131	4	126	3
	TOTAL	2,437		3,011		373		485		541		422		3,351		3,918
	Not Applicable	154		189		70		97		29		25		253		311
20b	Home Health Agency
	Excellent	1,059	42	1,358	44	154	43	159	35	210	37	172	40	1,423	41	1,689	42
	Good	947	38	1,184	38	138	38	180	40	220	39	164	38	1,305	38	1,528	38
	Fair	354	14	386	12	50	14	86	19	111	19	66	15	515	15	538	14
	Poor	151	6	167	5	19	5	27	6	29	5	32	7	199	6	226	6
	TOTAL	2,511		3,095		361		452		570		434		3,442		3,981
	Not Applicable	155		194		84		142		26		20		265		356
21	Care Manager
	Excellent	1,057	43	1,421	46	182	44	255	46	213	39	193	45	1,452	42	1,869	46
	Good	998	40	1,216	39	168	41	194	35	232	42	168	39	1,398	41	1,578	39
	Fair	303	12	322	10	44	11	85	15	69	13	45	10	416	12	452	11
	Poor	121	5	134	4	20	5	17	3	38	7	24	6	179	5	175	4
	TOTAL	2,479		3,093		414		551		552		430		3,445		4,074
	Not Applicable	173		201		37		47		37		21		247		269
22a	Regular Visiting Nurse
	Excellent	1,058	44	1,396	48	207	52	273	51	226	42	151	37	1,491	44	1,840	47
	Good	949	39	1,125	38	144	36	200	37	215	40	166	41	1,308	39	1,491	38
	Fair	292	12	296	10	35	9	49	9	62	11	61	15	389	12	406	10
	Poor	113	5	118	4	15	4	18	3	39	7	25	6	167	5	161	4
	TOTAL	2,412		2,935		401		540		542		403		3,355		3,898
	Not Applicable	286		393		63		70		54		36		403		499
22b	Covering/On Call Nurse
	Excellent	543	35	735	39	121	38	157	39	129	37	94	33	793	36	986	39
	Good	651	42	773	41	148	46	160	40	137	39	126	45	936	42	1,059	41
	Fair	247	16	227	12	43	13	64	16	50	14	40	14	340	15	331	13
	Poor	118	8	136	7	10	3	22	5	36	10	22	8	164	7	180	7
	TOTAL	1,559		1,871		322		403		352		282		2,233		2,556
	Not Applicable	1,017		1,303		135		201		218		159		1,370		1,663
23	Physical Therapist
	Excellent	401	36	550	41	128	43	168	43	64	30	56	32	593	37	774	41
	Good	451	41	501	37	120	41	154	40	88	42	67	38	659	41	722	38
	Fair	156	14	182	14	31	11	54	14	37	17	30	17	224	14	266	14
	Poor	105	9	108	8	16	5	13	3	23	11	22	13	144	9	143	8
	TOTAL	1,113		1,341		295		389		212		175		1,620		1,905
	Not Applicable	1,413		1,804		157		205		355		253		1,925		2,262
24	Occupational Therapist
	Excellent	226	36	305	40	94	43	136	45	40	31	33	34	360	37	474	40
	Good	231	37	278	36	94	43	114	37	57	45	40	41	382	39	432	37
	Fair	95	15	98	13	18	8	42	14	17	13	10	10	130	13	150	13
	Poor	79	13	88	11	15	7	13	4	13	10	15	15	107	11	116	10
	TOTAL	631		769		221		305		127		98		979		1,172
	Not Applicable	1,811		2,279		222		276		423		311		2,456		2,866
25	Speech Therapist
	Excellent	130	40	167	41	33	49	43	46	21	36	23	41	184	41	233	42
	Good	97	30	140	34	20	29	28	30	22	37	17	30	139	31	185	33
	Fair	53	16	57	14	8	12	15	16	7	12	7	13	68	15	79	14
	Poor	44	14	48	12	7	10	7	8	9	15	9	16	60	13	64	11
	TOTAL	324		412		68		93		59		56		451		561
	Not Applicable	2,072		2,595		364		484		485		344		2,921		3,423
26	Social Worker
	Excellent	535	38	644	40	185	48	267	51	99	32	84	36	819	39	995	42
	Good	543	39	644	40	135	35	166	32	127	41	85	37	805	38	895	38
	Fair	203	14	210	13	54	14	64	12	48	16	42	18	305	15	316	13
	Poor	125	9	126	8	11	3	26	5	35	11	20	9	171	8	172	7
	TOTAL	1,406		1,624		385		523		309		231		2,100		2,378
	Not Applicable	1,112		1,478		71		66		245		190		1,428		1,734
27	Medical Supplies and Equipment
	Excellent	873	42	1,092	42	195	49	272	49	209	44	163	44	1,277	43	1,527	43
	Good	810	39	982	37	154	39	200	36	170	36	127	34	1,134	39	1,309	37
	Fair	257	12	363	14	33	8	52	9	67	14	52	14	357	12	467	13
	Poor	126	6	188	7	18	5	27	5	25	5	29	8	169	6	244	7
	TOTAL	2,066		2,625		400		551		471		371		2,937		3,547
	Not Applicable	550		607		57		59		109		81		716		747
28	Audiology / Hearing Aids
	Excellent	185	32	291	38	60	39	72	36	46	33	37	33	291	34	400	37
	Good	197	34	277	36	48	31	77	38	53	38	33	30	298	34	387	36
	Fair	106	18	115	15	24	16	30	15	24	17	18	16	154	18	163	15
	Poor	85	15	91	12	22	14	22	11	16	12	23	21	123	14	136	13
	TOTAL	573		774		154		201		139		111		866		1,086
	Not Applicable	1,886		2,299		287		381		414		300		2,587		2,980
29	Home Delivered Meals / Meals on Wheels
	Excellent	197	47	346	50	35	44	52	47	38	55	38	60	270	48	436	51
	Good	120	29	220	32	27	34	36	33	17	25	18	29	164	29	274	32
	Fair	60	14	76	11	13	16	13	12	3	4	2	3	76	13	91	11
	Poor	38	9	45	7	4	5	9	8	11	16	5	8	53	9	59	7
	TOTAL	415		687		79		110		69		63		563		860
	Not Applicable	2,033		2,380		353		476		481		352		2,867		3,208
30	Meals served at Day Health Center
	Excellent	234	39	295	43	114	33	158	36	40	52	43	52	388	38	496	41
	Good	221	37	249	36	163	47	180	41	19	25	24	29	403	40	453	37
	Fair	87	15	109	16	53	15	77	17	12	16	7	8	152	15	193	16
	Poor	51	9	40	6	14	4	29	7	6	8	9	11	71	7	78	6
	TOTAL	593		693		344		444		77		83		1,014		1,220
	Not Applicable	1,875		2,386		114		156		469		331		2,458		2,873
31	Day Health Center Activities
	Excellent	282	43	345	43	115	33	150	33	45	48	41	44	442	40	536	40
	Good	250	38	305	38	154	44	180	40	28	30	31	33	432	39	516	38
	Fair	96	15	101	13	61	17	96	21	14	15	11	12	171	16	208	16
	Poor	31	5	47	6	20	6	24	5	6	6	10	11	57	5	81	6
	TOTAL	659		798		350		450		93		93		1,102		1,341
	Not Applicable	1,798		2,292		110		152		456		319		2,364		2,763
32	Transportation Services
	Excellent	765	38	971	41	187	44	204	37	158	37	137	40	1,110	39	1,312	40
	Good	764	38	888	37	178	42	234	42	151	35	112	33	1,093	38	1,234	38
	Fair	312	16	333	14	41	10	81	15	72	17	56	16	425	15	470	14
	Poor	159	8	197	8	15	4	32	6	51	12	37	11	225	8	266	8
	TOTAL	2,000		2,389		421		551		432		342		2,853		3,282
	Not Applicable	649		880		41		55		148		105		838		1,040
33	Nursing Home
	Excellent	119	41	127	43	23	44	21	40	22	61	21	54	164	44	169	44
	Good	101	35	100	34	15	29	17	32	9	25	8	21	125	33	125	32
	Fair	45	16	36	12	10	19	6	11	3	8	5	13	58	15	47	12
	Poor	24	8	31	11	4	8	9	17	2	6	5	13	30	8	45	12
	TOTAL	289		294		52		53	36		39		377		386
	Not Applicable	2,095		2,694		373		515	502		362		2,970		3,571
34						Pharmacy Services
Excellent	1,160	51	1,417	50	194	46	282	50	267	49	200	48	1,621	50	1,899	50
Good	924	41	1,074	38	196	46	233	41	204	37	160	39	1,324	41	1,467	39
Fair	153	7	240	9	28	7	42	7	57	10	45	11	238	7	327	9
Poor	44	2	75	3	5	1	11	2	20	4	9	2	69	2	95	3
TOTAL	2,281		2,806		423		568		548		414		3,252		3,788
Not Applicable	388		490		32		41		48		42		468		573
35	Nutritionist
	Excellent	211	33	286	36	108	34	173	40	50	34	48	40	369	33	507	38
	Good	254	40	306	38	157	50	180	42	60	41	41	34	471	43	527	39
	Fair	108	17	144	18	39	12	60	14	17	12	21	18	164	15	225	17
	Poor	69	11	65	8	10	3	17	4	19	13	9	8	98	9	91	7
	TOTAL	642		801		314		430		146		119		1,102		1,350
	Not Applicable	1,820		2,267		137		163		407		306		2,364		2,736

Table A3: Timeliness of Care
	All respondents	Partial Cap 2015		Partial CAP 2017		PACE 2015		PACE 2017		MAP 2015		MAP 2017		Statewide 2015		Statewide 2017
Item	Description	N	%	N	%	N	%	N	%	N	%	N	%	N	%	N	%
Section 2B: Timeliness
36	Home Health Aide
	Always	1,781	72	2,187	72	229	61	271	55	403	75	288	69	2,413	71	2,746	70
	Usually	501	20	618	20	108	29	147	30	109	20	91	22	718	21	856	22
	Sometimes	147	6	156	5	31	8	74	15	20	4	31	7	198	6	261	7
	Never	42	2	57	2	6	2	3	1	8	1	8	2	56	2	68	2
	TOTAL	2,471		3,018		374		495		540		418		3,385	3,931
	Not Applicable	185		216		73		105		41		31		299	352
37	Care Manager / Case Manager
	Always	1,149	51	1,552	55	200	53	272	51	241	49	191	50	1,590	51	2,015	54
	Usually	728	32	876	31	127	33	166	31	160	32	132	35	1,015	32	1,174	31
	Sometimes	289	13	296	10	38	10	73	14	66	13	41	11	393	13	410	11
	Never	104	5	116	4	15	4	18	3	27	5	15	4	146	5	149	4
	TOTAL	2,270		2,840		380		529		494		379		3,144	3,748
	Not Applicable	324		360		63		58		72		64		459	482
38a	Regular Visiting Nurse
	Always	1,168	51	1,463	53	227	62	295	57	236	46	189	47	1,631	51	1,947	53
	Usually	699	30	820	30	89	24	145	28	163	32	125	31	951	30	1,090	30
	Sometimes	336	15	368	13	41	11	64	12	93	18	72	18	470	15	504	14
	Never	94	4	106	4	11	3	15	3	20	4	16	4	125	4	137	4
	TOTAL	2,297		2,757		368		519		512		402		3,177	3,678
	Not Applicable	360		474		80		80		69		50		509	604
38b	Covering/On Call Nurse
	Always	643	44	756	44	145	48	182	48	136	41	97	37	924	44	1,035	44
	Usually	431	30	546	32	99	33	120	32	106	32	82	31	636	30	748	32
	Sometimes	250	17	265	15	42	14	57	15	52	16	54	21	344	16	376	16
	Never	135	9	161	9	15	5	21	6	38	11	30	11	188	9	212	9
	TOTAL	1,459		1,728		301		380		332		263		2,092	2,371
	Not Applicable	1,080		1,371		148		208		227		166		1,455	1,745
39	Physical Therapist
	Always	368	43	533	48	120	49	171	51	64	38	47	34	552	43	751	48
	Usually	268	31	307	28	77	31	95	29	43	25	38	27	388	31	440	28
	Sometimes	114	13	146	13	31	13	47	14	27	16	30	21	172	14	223	14
	Never	106	12	119	11	17	7	20	6	35	21	25	18	158	12	164	10
	TOTAL	856		1,105		245		333		169		140		1,270	1,578
	Not Applicable	1,629		1,947		198		243		376		280		2,203	2,470
40	Occupational Therapist
	Always	205	41	301	47	92	52	128	51	40	39	26	30	337	43	455	47
	Usually	128	26	144	23	55	31	71	28	21	21	20	23	204	26	235	24
	Sometimes	72	14	79	12	19	11	33	13	9	9	13	15	100	13	125	13
	Never	92	19	111	17	12	7	19	8	32	31	29	33	136	18	159	16
	TOTAL	497		635		178		251		102		88		777		974
	Not Applicable	1,934		2,356		262		319		423		319		2,619		2,994
41	Speech Therapist
	Always	113	40	161	45	30	50	38	51	18	30	17	31	161	40	216	45
	Usually	61	21	65	18	13	22	16	22	8	13	9	17	82	20	90	19
	Sometimes	37	13	27	8	5	8	6	8	5	8	3	6	47	12	36	7
	Never	74	26	104	29	12	20	14	19	30	49	25	46	116	29	143	29
	TOTAL	285		357		60		74		61		54		406		485
	Not Applicable	2,134		2,626		373		489		459		352		2,966		3,467
42	Social Worker
	Always	507	43	632	45	192	56	271	56	109	41	74	37	808	45	977	47
	Usually	352	30	416	30	86	25	122	25	75	28	66	33	513	28	604	29
	Sometimes	211	18	206	15	45	13	70	14	47	18	36	18	303	17	312	15
	Never	121	10	138	10	22	6	22	5	35	13	26	13	178	10	186	9
	TOTAL	1,191		1,392		345		485		266		202		1,802		2,079
	Not Applicable	1,256		1,652		97		94			219		1,353		1,965
43	Home Delivered Meals / Meals on Wheels
	Always	206	48	388	59	53	62	67	63	31	38	32	46	290	49	487	58
	Usually	99	23	132	20	18	21	25	24	17	21	14	20	134	22	171	21
	Sometimes	45	10	38	6	3	3	6	6	5	6	5	7	53	9	49	6
	Never	80	19	100	15	12	14	8	8	28	35	19	27	120	20	127	15
	TOTAL	430		658		86		106		81		70		597		834
	Not Applicable	1,985		2,339		345		468		442		344		2,772		3,151
44a	Transportation TO Day Center
	Always	387	57	452	56	200	61	227	52	57	56	54	51	644	58	733	54
	Usually	176	26	224	28	96	29	141	32	21	21	22	21	293	26	387	29
	Sometimes	59	9	60	7	24	7	60	14	10	10	11	10	93	8	131	10
	Never	59	9	76	9	8	2	6	1	13	13	19	18	80	7	101	7
	TOTAL	681		812		328		434		101		106		1,110		1,352
	Not Applicable	1,450		1,860		120		142		354		249		1,924		2,251
44b	Transportation FROM Day Center
	Always	341	55	402	56	183	59	222	52	44	52	49	54	568	56	673	54
	Usually	161	26	192	27	95	31	134	32	16	19	17	19	272	27	343	28
	Sometimes	62	10	58	8	19	6	58	14	9	11	8	9	90	9	124	10
	Never	52	8	69	10	13	4	10	2	15	18	17	19	80	8	96	8
	TOTAL	616		721		310		424		84		91		1,010		1,236
	Not Applicable	1,446		1,855		122		143		357		244		1,925		2,242
44c	Transportation TO the doctor
	Always	953	54	1,106	53	225	61	264	53	198	52	166	54	1,376	55	1,536	53
	Usually	467	26	620	30	109	29	167	34	88	23	75	24	664	26	862	30
	Sometimes	237	13	220	11	32	9	51	10	64	17	46	15	333	13	317	11
	Never	106	6	122	6	4	1	13	3	32	8	22	7	142	6	157	5
	TOTAL	1,763		2,068		370		495		382		309		2,515		2,872
	Not Applicable	721		957		66		82		155		104		942		1,143
44d	Transportation FROM the doctor
	Always	908	52	1,040	51	208	56	246	51	191	50	160	52	1,307	52	1,446	51
	Usually	454	26	589	29	103	28	153	31	87	23	69	22	644	26	811	29
	Sometimes	261	15	266	13	48	13	67	14	72	19	56	18	381	15	389	14
	Never	130	7	142	7	11	3	21	4	32	8	24	8	173	7	187	7
	TOTAL	1,753		2,037		370		487		382		309		2,505		2,833
	Not Applicable	725		956		66		83		153		108		944		1,147
45	Medical Supplies and Equipment
	Always	982	53	1,203	51	219	57	291	58	247	58	187	55	1,448	54	1,681	53
	Usually	551	30	719	31	117	30	150	30	114	27	96	28	782	29	965	30
	Sometimes	220	12	295	13	37	10	47	9	51	12	46	13	308	12	388	12
	Never	108	6	135	6	14	4	10	2	14	3	14	4	136	5	159	5
	TOTAL	1,861		2,352		387		498		426		343		2,674		3,193
	Not Applicable	613		714		60		82		122		88		795		884
46	Pharmacy Services
	Always	1,429	65	1,707	63	255	61	356	64	332	65	255	64	2,016	64	2,318	63
	Usually	617	28	765	28	136	32	163	29	128	25	112	28	881	28	1,040	28
	Sometimes	110	5	158	6	19	5	28	5	35	7	23	6	164	5	209	6
	Never	46	2	70	3	9	2	9	2	14	3	11	3	69	2	90	2
	TOTAL	2,202		2,700		419		556		509		401		3,130		3,657
	Not Applicable	416		509		35		38		58		49		509		596
47	Audiology/Hearing Aids
	Always	191	39	292	44	66	50	66	40	43	39	40	39	300	41	398	43
	Usually	150	30	173	26	37	28	56	34	29	26	28	27	216	29	257	27
	Sometimes	66	13	97	15	10	8	25	15	14	13	15	15	90	12	137	15
	Never	88	18	105	16	18	14	18	11	25	23	20	19	131	18	143	15
	TOTAL	495		667		131		165		111		103		737		935
	Not Applicable	1,951		2,339		307		414		413		315		2,671		3,068

Table A4: Access to Care (Urgent Appointments)
	All respondents	Partial Cap 2015		Partial CAP 2017		PACE 2015		PACE 2017		MAP 2015		MAP 2017		Statewide 2015		Statewide 2017
Item	Description	N	%	N	%	N	%	N	%	N	%	N	%	N	%	N	%
Section 2C: Access to Care - Urgent Appointment
48						Regular Doctor
Same day	1,033	50	1,246	49	185	50	224	47	224	49	171	49	1,442	50	1,641	49
1 to 3 days	695	34	894	35	140	38	203	42	140	30	109	31	975	34	1,206	36
4 days or longer	329	16	385	15	43	12	51	11	96	21	69	20	468	16	505	15
TOTAL	2,057		2,525		368		478		460		349		2,885		3,352
Not Applicable	575		706		84		112		114		96		773		914
49						Dentist
Same day	324	31	428	30	45	20	280	56	78	32	65	34	447	29	551	29
1 to 3 days	439	41	531	37	81	37	104	21	83	34	63	33	603	40	698	37
4 days or longer	299	28	477	33	95	43	118	24	82	34	61	32	476	31	656	34
TOTAL	1,062		1,436		221		502		243		189		1,526		1,905
Not Applicable	1,449		1,666		228		302		310		233		1,987		2,201
50						Eye Care
Same day	502	34	586	31	76	27	79	22	129	33	104	35	707	33	769	31
1 to 3 days	546	36	643	34	92	33	139	39	143	37	92	31	781	36	874	35
4 days or longer	449	30	635	34	110	40	142	39	118	30	97	33	677	31	874	35
TOTAL	1,497		1,864		278		360		390		293		2,165		2,517
Not Applicable	1,057		1,289		173		223		183		147		1,413		1,659
51	Foot Doctor
Same day	476	35	481	32	71	30	85	28	99	32	95	38	646	34	661	32
1 to 3 days	525	38	570	38	82	35	96	31	110	36	79	31	717	38	745	36
4 days or longer	367	27	468	31	82	35	126	41	100	32	79	31	549	29	673	32
TOTAL	1,368		1,519		235		307		309		253		1,912		2,079
Not Applicable	1,192		1,597		217		272		247		180		1,656		2,049
52						Audiology/Hearing Aids
Same day	128	34	179	34	32	30	32	23	31	28	22	31	191	32	233	32
1 to 3 days	118	31	169	32	31	30	41	29	41	37	27	38	190	32	237	32
4 days or longer	132	35	175	33	42	40	69	49	38	35	23	32	212	36	267	36
TOTAL	378		523		105		142		110		72		593		737
Not Applicable	2,048		2,508		337		430		428		339		2,813		3,277

Table A5: Access to Care (Regular Appointments)
	All respondents	Partial Cap 2015		Partial CAP 2017		PACE 2015		PACE 2017		MAP 2015		MAP 2017		Statewide 2015		Statewide 2017
Item	Description	N	%	N	%	N	%	N	%	N	%	N	%	N	%	N	%
Section 2D: Access to Care - Regular Appointment
53						Regular Doctor
Always	1,518	63	1,867	63	203	53	287	58	339	64	256	62	2,060	62	2,410	62
Usually	618	26	780	26	126	33	144	29	119	22	92	22	863	26	1,016	26
Sometimes	209	9	237	8	41	11	54	11	56	11	47	11	306	9	338	9
Never	67	3	81	3	13	3	7	1	19	4	18	4	99	3	106	3
TOTAL	2,412		2,965		383		492		533		413		3,328		3,870
Not Applicable	245		302		75		100		48		41		368		443
54						Dentist
Always	558	42	699	41	93	37	124	38	113	38	98	44	764	41	921	41
Usually	438	33	610	35	85	34	109	34	85	29	61	27	608	32	780	34
Sometimes	221	17	287	17	51	20	61	19	65	22	42	19	337	18	390	17
Never	106	8	127	7	24	9	29	9	34	11	24	11	164	9	180	8
TOTAL	1,323		1,723		253		323		297		225		1,873		2,271
Not Applicable	1,195		1,391		194		255		272		203		1,661		1,849
55						Eye Care
Always	826	47	987	45	116	39	160	41	203	48	155	49	1,145	46	1,302	45
Usually	580	33	738	34	107	36	141	36	129	31	92	29	816	33	971	34
Sometimes	266	15	349	16	62	21	68	17	69	16	51	16	397	16	468	16
Never	95	5	105	5	15	5	22	6	18	4	19	6	128	5	146	5
TOTAL	1,767		2,179		300		391		419		317		2,486		2,887
Not Applicable	806		987		151		192		155		118		1,112		1,297
56						Foot Doctor
Always	814	51	804	45	102	40	139	42	171	48	143	52	1,087	49	1,086	46
Usually	505	31	597	34	85	33	100	30	100	28	74	27	690	31	771	32
Sometimes	198	12	265	15	48	19	66	20	59	17	45	16	305	14	376	16
Never	91	6	105	6	20	8	24	7	27	8	14	5	138	6	143	6
TOTAL	1,608		1,771		255		329		357		276		2,220		2,376
Not Applicable	979		1,354		194		256		209		159		1,382		1,769
57						Audiology/Hearing Aids
Always	201	41	273	42	42	35	60	39	44	38	40	40	287	40	373	41
Usually	135	28	194	30	38	31	42	27	33	28	25	25	206	28	261	29
Sometimes	74	15	108	17	22	18	35	23	14	12	21	21	110	15	164	18
Never	76	16	73	11	19	16	17	11	25	22	14	14	120	17	104	12
TOTAL	486		648		121		154		116		100		723		902
Not Applicable	1,979		2,377		317		422		425		316		2,721		3,115

Table A6: About You All respondents Partial Cap 2015 Partial CAP 2017 PACE 2015 PACE 2017 MAP 2015 MAP 2017 Statewide 2015 Statewide 2017 Item Description N % N % N % N % N % N % N % N % Section 3: About You 58 Content with Quality of Life Very much 992 32 1,235 31 207 37 243 32 276 41 195 35 1,475 34 1,673 31 Quite a bit 934 30 1,158 29 166 30 228 30 135 20 134 24 1,235 28 1,520 29 Somewhat 755 24 1,030 26 134 24 193 25 163 24 112 20 1,052 24 1,335 25 A little bit 325 10 388 10 28 5 59 8 68 10 64 12 421 10 511 10 Not at all 141 4 212 5 21 4 37 5 33 5 45 8 195 4 294 6 TOTAL 3,147 4,023 556 760 675 550 4,378 5,333 59 Rate your current state of health Excellent 122 4 149 4 24 4 47 6 39 6 30 5 185 4 226 4 Very good 287 9 432 11 116 21 133 18 92 13 70 13 495 11 635 12 Good 776 24 998 25 178 32 246 33 149 22 104 19 1,103 25 1,348 25 Fair 1,515 48 1,870 46 176 32 259 34 317 46 265 48 2,008 46 2,394 45 Poor 474 15 611 15 61 11 71 9 87 13 86 15 622 14 768 14 TOTAL 3,174 4,060 555 756 684 555 4,413 5,371 60 Rating of overall mental/emotional health Excellent 283 9 338 8 59 11 89 12 73 11 58 11 415 9 535 10 Very Good 421 13 574 14 109 20 152 20 108 16 81 15 638 14 807 15 Good 930 29 1,177 29 187 34 241 32 207 30 174 32 1,324 30 1,592 30 Fair 1,217 38 1,512 38 159 29 223 29 230 34 179 32 1,606 36 1,914 36 Poor 323 10 403 10 40 7 55 7 68 10 60 11 431 10 518 10 TOTAL 3,174 4,004 554 760 686 552 4,414 5,366 61 What is your gender? Male 848 27 1,135 28 144 26 191 25 130 19 129 23 1,122 26 1,455 27 Female 2,310 73 2,925 72 410 74 567 75 558 81 423 77 3,278 75 3,915 73 TOTAL 3,158 4,060 554 758 688 552 4,400 5,370 62 What is your age? 18-44 50 2 64 2 1 0 1 0 8 1 4 1 59 1 69 1 45-64 432 14 594 15 45 8 66 9 85 12 69 12 562 13 729 14 65-74 692 22 976 24 131 24 165 22 144 21 133 24 967 22 1,274 24 75-84 1,045 33 1,247 31 171 31 232 30 233 34 178 32 1,449 33 1,657 31 over 85 969 30 1,191 29 207 37 300 39 218 32 173 31 1,394 31 1,664 31 TOTAL 3,188 4,072 555 764 688 557 4,431 5,393 63a Are you Hispanic/Latino origin? Yes 772 25 848 21 91 17 135 18 293 44 269 50 1,156 27 1,252 24 No 2,321 75 3,115 79 456 83 613 82 379 56 264 50 3,156 73 3,992 76 TOTAL 3,093 3,963 547 748 672 533 4,312 5,244 63b+ What is your race? American Indian or Alaskan Native 56 2 76 2 11 2 20 3 16 3 6 2 83 2 102 2 Asian 525 20 692 20 53 10 57 8 43 9 39 10 621 17 788 17 Black or African American 639 24 723 21 95 19 117 17 250 50 173 45 984 27 1,013 22 Native Hawaiian or Pacific Islander 10 0 13 0 1 0 1 0 2 0 1 0 13 0 15 0 White 1,482 55 1,989 56 353 69 485 71 192 39 162 42 2,027 55 2,636 57 class="left">Other 4 0 30 1 0 0 4 1 1 0 4 1 5 0 38 1 TOTAL 2,675 3,523 509 684 496 385 3,680 4,592 64 How well do you speak English? Very well 1,200 38 1,714 43 359 65 477 64 312 46 197 36 1,871 43 2,388 45 Well 392 12 515 13 76 14 96 13 108 16 98 18 576 13 709 13 Not well 692 22 785 20 56 10 79 11 138 20 141 25 886 20 1,005 19 Not at all 876 28 995 25 62 11 96 13 122 18 118 21 1,060 24 1,209 23 TOTAL 3,160 4,009 553 748 680 554 4,393 5,311 English 1,729 52 2,008 50 450 78 553 74 417 59 253 46 2,596 57 2,814 53 Spanish 520 16 645 16 54 9 110 15 232 33 229 42 806 18 984 19 Russian 472 14 473 12 9 2 13 2 6 1 4 1 487 11 490 9 Chinese 371 11 534 13 34 6 37 5 15 2 12 2 420 9 583 11 Other 214 6 324 8 27 5 38 5 42 6 50 9 283 6 412 8 TOTAL 3,306 3,984 574 751 712 548 4,592 5,283 66 Education level completed 8th grade or less 982 32 1,197 30 135 25 181 25 273 41 240 45 1,390 32 1,618 31 Some high school, did not graduate 471 15 588 15 68 13 111 15 141 21 91 17 680 16 790 15 High school graduate or GED 703 23 1,004 25 148 28 205 28 134 20 107 20 985 23 1,316 25 Some college or 2 year degree 391 13 531 13 76 14 106 14 82 12 56 10 549 13 693 13 4 year college graduate 288 9 337 9 55 10 64 9 19 3 26 5 362 8 427 8 More than 4 year college degree 261 8 296 7 53 10 68 9 19 3 14 3 333 8 378 7 TOTAL 3,096 3,953 535 735 668 534 4,299 5,222 67 Do you live Alone 1,471 46 1,854 46 255 47 370 50 370 53 292 52 2,096 48 2,516 47 With a family member or friend 1,514 48 1,865 47 212 39 295 40 295 43 251 45 2,021 46 2,411 45 With other than a family member or friend 185 6 290 7 74 14 79 11 27 4 15 3 286 6 384 7 TOTAL 3,170 4,009 541 744 692 558 4,403 5,311 68 Did someone help you complete this survey Yes 1,985 64 2,550 64 389 71 517 68 468 70 358 66 2,842 65 3,425 65 No 1,132 36 1,433 36 161 29 238 32 205 30 186 34 1,498 35 1,857 35 TOTAL 3,117 3,983 550 755 673 544 4,340 5,282 69 ♦ + Who helped you Family member 1,295 65 1,648 64 234 60 325 64 321 69 228 62 1,850 65 2,201 64 Friend 185 9 215 8 46 12 31 6 24 5 18 5 255 9 264 8 Home Care Aide 344 17 440 17 33 8 32 6 107 23 89 24 484 17 561 16 Care Manager or Visiting Nurse 69 3 96 4 29 7 25 5 12 3 11 3 110 4 132 4 Other 97 5 180 7 48 12 97 19 11 2 19 5 156 5 296 9 TOTAL 1,985 2,579 389 510 468 365 2,842 3,454 70 ♦ + How did this person help you Read the questions to me 1,090 55 1,460 38 219 56 281 36 288 62 230 43 1,597 56 1,971 38 Wrote down the answers that I gave 897 45 1,194 31 194 50 256 33 189 40 161 30 1,280 45 1,611 31 Answered the questions for me 515 26 687 18 134 34 178 23 105 22 75 14 754 27 940 18 Translated into my language 328 17 399 10 24 6 43 5 64 14 53 10 416 15 495 9 Helped in some other way 119 6 149 4 12 3 27 3 31 7 20 4 162 6 196 4 TOTAL 1,985 3,889 389 785 468 539 2,842 5,213 71 Has health plan talked to you about appointing someone to make decisions about your health if you are unable to do so? Yes 1,689 63 2,532 73 385 77 566 82 447 75 407 80 2,521 67 3,505 75 No 971 37 946 27 112 23 122 18 153 26 99 20 1,236 33 1,167 25 TOTAL 2,660 3,478 497 688 600 506 3,757 4,672 Not sure 471 541 54 69 80 43 605 653 72^∧ Do you have a legal document or advance directive appointing someone to make decisions about your health care if you are unable to do so? Yes 1,402 53 2,198 65 415 84 571 85 357 61 320 69 2,174 58 3,089 68 No 1,243 47 1,186 35 79 16 102 15 226 39 147 31 1,548 42 1,435 32 TOTAL 2,645 3,384 494 673 583 467 3,722 4,524 Not sure 459 543 65 71 101 61 625 675 73^∧ ♦ Does the health plan have a copy of this advance directive document? Yes 684 75 1,209 80 327 94 480 97 175 71 204 83 1,186 79 1,893 84 No 229 25 308 20 21 6 17 3 70 29 41 17 320 21 366 16 TOTAL 913 1,517 348 497 245 245 1,506 2,259 Not sure 459 647 65 70 101 69 625 786

Note: Percentages have been rounded and may not total to 100%.
♦ Items based on skip pattern.
+ Member can check all that apply.
^ Question and/or responses have been re-worded since 2015.

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Appendix B. Aggregate Tables

Table B1: Plan Evaluation – Comparison by Survey Year
	2017	2015	2017 v. 2015 (▼,▲ or - )
Item	Description	Denom*	2017 v. 2015 (▼,▲ or - )	Percent	Denom*	Percent
Section 1: MLTC Plan Evaluation		Denom*		Percent	Denom*	Percent
1a	Member of a [health plan]	5,079	96	4,276	97	_
2a	Live at home/community	4,989	95	4,207	97	▼
12	Plan asked to see prescription/over the counter medicines	4,326	94	3,702	94	_
14d	Plan has been excellent/good at helping to allow me to stay in my home	3,503	93	2,939	93	_
10♦	Always treated with politeness and respect	2,199	93	1,809	92	_
14a	Plan has been excellent/good at helping me to take my medications the way my doctor wants me to	3,627	89	3,138	89	_
3	Plan always/usually explained services clearly	4,352	88	3,738	86	_
15	Rated plan as good or excellent	4,331	88	3,739	87	_
14b	Plan has been excellent/good at helping me to manage my illnesses	3,464	86	2,981	85	_
73^∧	Health plan has a copy of this advance directive document	2,259	84	1,506	79	▲
9♦	Always able to understand the answers	2,188	84	1,791	82	_
13	Health plan explain Consumer Directed Personal Assistance	3,037	79	2,495	75	▲
4	Always/Usually involved in decisions about plan of care	4,329	79	3,710	77	_
71	Health plan has talked about appointing someone to make health care decisions	4,672	75	3,757	67	▲
8♦	Questions always answered quickly	2,202	75	1,801	75	_
14c	Plan has been excellent/good at helping me when I´m feeling sad and lonely	3,060	74	2,549	73	_
7♦	Always spoke with a person quickly	2,197	73	1,800	74	_
72^∧	Has a legal document or advance directive appointing someone to make health care decisions	4,524	68	3,722	58	▲
11♦	Complaint/grievance always/usually handled to satisfaction	1,758	67	1,397	68	_
5	Family member or caregiver always/usually involved in making decisions about plan of care	4,401	66	3,758	65	_
6	Called plan with question or for help or complaint/grievance	4,446	51	3,825	48	_

Table B2: Quality of Care – Comparison by Survey Year
	2017	2015
Item	Description	Denom*	Percent	Denom*	Percent	2017 v. 2015 (▼,▲ or - )
Section 2A: Quality of Care Providers (Excellent/Good)		Denom*	Percent	Denom*	Percent	2017 v. 2015 (▼,▲ or - )
16	Regular doctor	4,131	91	3,572	91	-
34	Pharmacy Services	3,788	89	3,252	91	-
20a	Home Health Aide, Personal Care Aide	3,918	89	3,351	87	-
22a	Regular Visiting Nurse/Registered Nurse	3,898	86	3,355	83	-
21	Care Manager/Case Manager	4,074	85	3,445	83	-
18	Eye Care	3,588	83	3,079	82	-
29	Home Delivered Meals/Meals on Wheels	860	83	563	77	-
19	Foot Doctor	2,914	82	2,637	83	-
20b	Home Health Agency, Personal Care Agency	3,981	81	3,442	76	▲
27	Medical Supplies and Equipment	3,547	80	2,937	82	-
22b	Covering/On-call nurse	2,556	80	2,233	77	-
26	Social Worker	2,378	80	2,100	77	-
23	Physical Therapist	1,905	79	1,620	77	-
31	Day Health Center Activities	1,341	78	1,102	79	-
30	Meals served at the Day Health Center	1,220	78	1,014	78	-
32	Transportation Services	3,282	78	2,853	77	-
24	Occupational Therapist	1,172	77	979	76	-
35	Nutritionist	1,350	77	1,102	76	-
33	Nursing Home	386	76	377	77	-
17	Dentist	2,861	75	2,382	73	-
25	Speech Therapist	561	75	451	72	-
28	Audiology/Hearing Aids	1,086	73	866	68	-

Table B3: Timeliness of Care – Comparison by Survey Year
	2017	2015
Item	Description	Denom*	Percent	Denom*	Percent	2017 v. 2015 (▼,▲ or - )
Section 2B: Timeliness (Always/Usually)		Denom*	Percent	Denom*	Percent	2017 v. 2015 (▼,▲ or - )
46	Pharmacy Services	3,657	92	3,130	93	-
36	Home Health Aide, Personal Care Aide	3,931	92	3,385	93	-
37	Care Manager/Case Manager	3,748	85	3,144	83	-
44c	Transportation: TO the doctor	2,872	84	2,515	81	-
45	Medical Supplies and Equipment	3,193	83	2,674	83	-
44a	Transportation: TO Day Center	1,352	83	1,110	84	-
38a	Regular Visiting Nurse/Registered Nurse	3,678	83	3,177	81	-
44b	Transportation: FROM Day Center	1,236	82	1,010	83	-
44d	Transportation: FROM the doctor	2,833	80	2,505	78	-
43	Home Delivered Meals/Meals on Wheels	834	79	597	71	▲
42	Social Worker	2,079	76	1,802	73	-
39	Physical Therapist	1,578	76	1,270	74	-
38b	Covering/On-call nurse	2,371	75	2,092	75	-
40	Occupational Therapist	974	71	777	70	-
47	Audiology/Hearing Aids	935	70	737	70	-
41	Speech Therapist	485	63	406	60	-

Table B4: Timely Access to Urgent Appointments (Same Day) – Comparison by Survey Year
	2017	2015
Item	Description	Denom*	Percent	Denom*	Percent	2017 v. 2015 (▼,▲ or - )
Section 2D: Access to Care - Urgent Appointments (Same day)		Denom*	Percent	Denom*	Percent	2017 v. 2015 (▼,▲ or - )
48	Regular doctor	3,352	49	2,885	50	–
51	Foot Doctor	2,079	32	1,912	34	–
52	Audiology/Hearing Aids	737	32	593	32	–
50	Eye Care	2,517	31	2,165	33	–
49	Dentist	1,905	29	1,526	29	–

Table B5: Timely Access to Regular Appointments (As Soon As Member Thought Appointment Needed) – Comparison by Survey Year
	2017	2015
Item	Description	Denom*	Percent	Denom*	Percent	2017 v. 2015 (▼,▲ or - )
Section 2C: Access to Care - Regular Appointments (Always/Usually)		Denom*	Percent	Denom*	Percent	2017 v. 2015 (▼,▲ or - )
53	Regular doctor	3,870	89	3,328	88	–
55	Eye Care	2,887	79	2,486	79	–
56	Foot Doctor	2,376	78	2,220	80	–
54	Dentist	2,271	75	1,873	73	–
57	Audiology/Hearing Aids	902	70	723	68	–

Table B6: Plan Evaluation – Analysis of Composite Measures by Survey Year
	2017	2015
Item	Description	N*	%	N*	%	2017 v. 2015
Domain 1: MLTC Plan Evaluation		N*	%	N*	%	2017 v. 2015
Q3	The plan explains all of their services clearly (Always/Usually)	4,352	88%	3,738	86%	_
Q4-Q5^∧	My family member (or caregiver) and I are involved in making decisions about my plan of care (Always/Usually)	4,529	72%	3,896	70%	_
Q7-Q11^∧	The plan provided helpful, timely, and courteous customer service when I or my caregiver or family members have called with a question, needed help, or had a complaint or grievance (Always/Usually)	2,241	79%	1,832	79%	_
Q12	Since joining the health plan, someone from the plan has asked to see all of the prescriptions and over the counter medicines I´ve been taking	4,326	94%	3,702	94%	_
Q13	Since joining the health plan, someone from the plan has explained the Consumer Directed Personal Assistance option	3,037	79%	2,495	75%	▲
Q14a-d^∧	The plan´s helpfulness in assisting my family and I with medication management, managing my illness, helping me when I am sad and lonely, and allowing me to stay in my home instead of a nursing home (Excellent/Good)	4,149	85%	3,593	84%	_
Q15	Overall MLTC plan rating (Excellent/Good)	4,331	88%	3,739	87%	_
Domain 2: Quality of Providers and Long-Term Care Services
Q16 – Q35^∧	The quality of care provided by long-term care provider/services (Excellent/Good)	4,502	82%	3,884	81%	_
Domain 3: Timeliness of Providers and Long-Term Care Services
Q36 - Q47^∧	The timeliness of care provided by long-term care provider/services (Always/Usually)	4,370	82%	3,774	82%	_
Domain 4: Access to Care for Urgent Appointments
Q48 – Q52^∧	Getting timely urgent appointments with long-term care provider/services (Same day)	3,676	37%	3,166	39%	_
Domain 5: Access to Care for Regular Appointments
Q53 – Q57^∧	Getting timely regular appointments with long-term care provider/services since joining the health plan (Always/Usually)	4,030	82%	3,476	81%	_
Domain 6: Advance Directives
Q71	The health plan has talked to me about appointing someone to make decisions about my health if I am unable to do so	4,672	75%	3,757	67%	▲
Q72+	I have a legal document or advance directive appointing someone to make decisions about my health care if I am unable to do so	4,524	68%	3,722	58%	▲
Q73+	The health plan has a copy of this advance directive document	2,259	84%	1,506	79%	▲

Table B7: Analysis of Composite Measures – Comparison by Plan Type
		Plan Type
		Partial Cap	PACE	MAP	Partial Cap vs. PACE vs. MAP
Item	Description	N*	%	N*	Partial Cap vs. PACE vs. MAP	%	N*	%
Domain 1: MLTC Plan Evaluation
Q3	The plan explains all of their services clearly (Always/Usually)	3,301	88%	602	86%	449	89%	_
Q4-Q5^∧	My family member (or caregiver) and I are involved in making decisions about my plan of care (Always/Usually)	3,423	73%	632	71%	474	68%	_
Q7-Q11^∧	The plan provided helpful, timely, and courteous customer service when I or my caregiver or family members have called with a question, needed help, or had a complaint or grievance (Always/Usually)	1,668	79%	342	77%	231	78%	_
Q12	Since joining the health plan, someone from the plan has asked to see all of the prescriptions and over the counter medicines I´ve been taking	3,277	95%	590	93%	459	95%	_
Q13	Since joining the health plan, someone from the plan has explained the Consumer Directed Personal Assistance option	2,359	81%	362	61%	316	84%	MAP, Partial Cap>PACE
Q14a-d^∧	The plan´s helpfulness in assisting my family and I with medication management, managing my illness, helping me when I am sad and lonely, and allowing me to stay in my home instead of a nursing home (Excellent/Good)	3,109	85%	605	88%	435	84%	_
Q15	Overall MLTC plan rating (Excellent/Good)	3,274	88%	605	87%	452	88%	_
Domain 2: Quality of Providers and Long-Term Care Services
Q16 – Q35^∧	The quality of care provided by long-term care providers/services (Excellent/Good)	3,412	82%	620	81%	470	80%	_
Domain 3: Timeliness of Providers and Long-Term Care Services
Q36 - Q47^∧	The timeliness of care provided by long-term care providers/services (Always/Usually)	3,305	83%	607	84%	458	80%	_
Domain 4: Access to Care for Urgent Appointments
Q48 – Q52^∧	Getting timely urgent appointments with long-term care providers/services (Same day)	2,757	38%	523	34%	396	39%	_
Domain 5: Access to Care for Regular Appointments
Q53 – Q57^∧	Getting timely regular appointments with long-term care providers/services since joining the health plan (Always/Usually)	3,080	83%	521	79%	429	80%	_
Domain 6: Advance Directives
Q71	The health plan has talked to me about appointing someone to make decisions about my health if I am unable to do so	3,478	73%	668	82%	506	80%	PACE, MAP>Partial Cap
Q72+	I have a legal document or advance directive appointing someone to make decisions about my health care if I am unable to do so	3,384	65%	673	85%	467	69%	PACE>MAP, Partial Cap
Q73+	The health plan has a copy of this advance directive document	1,517	80%	497	97%	245	83%	PACE>MAP, Partial Cap

Table B8: Analysis of Composite Measures – Comparison by Gender
		Gender
Male		Female		Male vs. Female
Item	Description	N*	%	Male vs. Female	N*	%
Domain 1: MLTC Plan Evaluation
Q3	The plan explains all of their services clearly (Always/Usually)	1157	89%	3,064	87%	_
Q4-Q5^∧	My family member (or caregiver) and I are involved in making decisions about my plan of care (Always/Usually)	1200	72%	3,189	72%	_
Q7-Q11^∧	The plan provided helpful, timely, and courteous customer service when I or my caregiver or family members have called with a question, needed help, or had a complaint or grievance (Always/Usually)	560	80%	1,622	79%	_
Q12	Since joining the health plan, someone from the plan has asked to see all of the prescriptions and over the counter medicines I´ve been taking	1151	94%	3,043	95%	_
Q13	Since joining the health plan, someone from the plan has explained the Consumer Directed Personal Assistance option	840	80%	2,099	79%	_
Q14a-d^∧	The plan´s helpfulness in assisting my family and I with medication management, managing my illness, helping me when I am sad and lonely, and allowing me to stay in my home instead of a nursing home (Excellent/Good)	1090	84%	2,947	85%	_
Q15	Overall MLTC plan rating (Excellent/Good)	1154	88%	3,059	88%	_
Domain 2: Quality of Providers and Long-Term Care Services
Q16 – Q35^∧	The quality of care provided by long-term care providers/services (Excellent/Good)	1187	81%	3,188	82%	_
Domain 3: Timeliness of Providers and Long-Term Care Services
Q36 - Q47^∧	The timeliness of care provided by long-term care providers/services (Always/Usually)	1147	82%	3,109	83%	_
Domain 4: Access to Care for Urgent Appointments
Q48 – Q52^∧	Getting timely urgent appointments with long-term care providers/services (Same day)	972	38%	2,612	37%	_
Domain 5: Access to Care for Regular Appointments
Q53 – Q57^∧	Getting timely regular appointments with long-term care providers/services since joining the health plan (Always/Usually)	1061	82%	2,867	82%	_
Domain 6: Advance Directives
Q71	The health plan has talked to me about appointing someone to make decisions about my health if I am unable to do so	1219	71%	3,372	77%	▼
Q72+	I have a legal document or advance directive appointing someone to make decisions about my health care if I am unable to do so	1152	64%	3,302	70%	▼
Q73+	The health plan has a copy of this advance directive document	537	84%	1,678	84%	_

Table B9: Analysis of Composite Measures – Comparison by Race
Race		Race
White		Black		Asian		Other		White vs. Black vs. Asian vs. Other
Item	Description	N*	%	N*	%	N*	%	White vs. Black vs. Asian vs. Other	N*	%
Domain 1: MLTC Plan Evaluation
Q3	The plan explains all of their services clearly (Always/Usually)	2,016	88%	757	86%	667	88%	57	84%	_
Q4-Q5^∧	My family member (or caregiver) and I are involved in making decisions about my plan of care (Always/Usually)	2,090	73%	800	70%	673	70%	57	64%	_
Q7-Q11^∧	The plan provided helpful, timely, and courteous customer service when I or my caregiver or family members have called with a question, needed help, or had a complaint or grievance (Always/Usually)	1,152	80%	406	75%	290	80%	38	75%	_
Q12	Since joining the health plan, someone from the plan has asked to see all of the prescriptions and over the counter medicines I´ve been taking	2,000	95%	781	95%	632	93%	55	96%	_
Q13	Since joining the health plan, someone from the plan has explained the Consumer Directed Personal Assistance option	1,397	76%	530	80%	447	85%	37	70%	Asian>Black, White, Other
Q14a-d^∧	The plan´s helpfulness in assisting my family and I with medication management, managing my illness, helping me when I am sad and lonely, and allowing me to stay in my home instead of a nursing home (Excellent/Good)	1,920	87%	736	85%	634	82%	54	85%	_
Q15	Overall MLTC plan rating (Excellent/Good)	2,019	88%	773	88%	638	86%	59	81%	_
Domain 2: Quality of Providers and Long-Term Care Services
Q16 – Q35^∧	The quality of care provided by long-term care providers/services (Excellent/Good)	2,093	85%	800	78%	671	80%	60	79%	White>Black, Asian
Domain 3: Timeliness of Providers and Long-Term Care Services
Q36 - Q47^∧	The timeliness of care provided by long-term care providers/services (Always/Usually)	2,033	86%	775	79%	656	82%	59	81%	White>Black, Asian
Domain 4: Access to Care for Urgent Appointments
Q48 – Q52^∧	Getting timely urgent appointments with long-term care providers/services (Same day)	1,712	37%	669	35%	515	41%	51	37%	_
Domain 5: Access to Care for Regular Appointments
Q53 – Q57^∧	Getting timely regular appointments with long-term care providers/services since joining the health plan (Always/Usually)	1,887	86%	722	79%	574	77%	55	80%	White>Black, Asian
Domain 6: Advance Directives
Q71	The health plan has talked to me about appointing someone to make decisions about my health if I am unable to do so	2,236	73%	860	76%	591	72%	67	72%	_
Q72+	I have a legal document or advance directive appointing someone to make decisions about my health care if I am unable to do so	2,261	73%	819	71%	549	51%	68	79%	White, Black, Other>Asian
Q73+	The health plan has a copy of this advance directive document	1,228	86%	428	83%	193	79%	31	81%	_

Table B10: Analysis of Composite Measures – Comparison by Level of Education
		Level of Education
Less than High School		At least High School		Less than High School vs. At least High School
Item	Description	N*	%	N*	%
Domain 1: MLTC Plan Evaluation
Q3	The plan explains all of their services clearly (Always/Usually)	1,878	88%	2,243	88%	_
Q4-Q5^∧	My family member (or caregiver) and I are involved in making decisions about my plan of care (Always/Usually)	1,963	73%	2,313	71%	_
Q7-Q11^∧	The plan provided helpful, timely, and courteous customer service when I or my caregiver or family members have called with a question, needed help, or had a complaint or grievance (Always/Usually)	921	79%	1,203	79%	_
Q12	Since joining the health plan, someone from the plan has asked to see all of the prescriptions and over the counter medicines I´ve been taking	1,872	94%	2,215	95%	_
Q13	Since joining the health plan, someone from the plan has explained the Consumer Directed Personal Assistance option	1,310	83%	1,547	76%	▲
Q14a-d^∧	The plan´s helpfulness in assisting my family and I with medication management, managing my illness, helping me when I am sad and lonely, and allowing me to stay in my home instead of a nursing home (Excellent/Good)	1,804	84%	2,132	86%	_
Q15	Overall MLTC plan rating (Excellent/Good)	1,859	87%	2,242	88%	_
Domain 2: Quality of Providers and Long-Term Care Services
Q16 – Q35^∧	The quality of care provided by long-term care providers/services (Excellent/Good)	1,945	81%	2,319	83%	_
Domain 3: Timeliness of Providers and Long-Term Care Services
Q36 - Q47^∧	The timeliness of care provided by long-term care providers/services (Always/Usually)	1,902	82%	2,254	84%	_
Domain 4: Access to Care for Urgent Appointments
Q48 – Q52^∧	Getting timely urgent appointments with long-term care providers/services (Same day)	1,605	39%	1,901	35%	_
Domain 5: Access to Care for Regular Appointments
Q53 – Q57^∧	Getting timely regular appointments with long-term care providers/services since joining the health plan (Always/Usually)	1,747	80%	2,096	84%	▼
Domain 6: Advance Directives
Q71	The health plan has talked to me about appointing someone to make decisions about my health if I am unable to do so	2,003	78%	2,467	73%	▲
Q72+	I have a legal document or advance directive appointing someone to make decisions about my health care if I am unable to do so	1,911	66%	2,447	70%	_
Q73+	The health plan has a copy of this advance directive document	930	84%	1,235	84%	_

Table B11: Analysis of Composite Measures – Comparison by Age Group
		Age
18-64 Years	65+ Years	18-64 Years vs. 65+ Years
Item	Description	18-64 Years vs. 65+ Years	N*	%	N*	%
Domain 1: MLTC Plan Evaluation
Q3	The plan explains all of their services clearly (Always/Usually)	639	85%	3,594	88%	_
Q4-Q5^∧	My family member (or caregiver) and I are involved in making decisions about my plan of care (Always/Usually)	664	67%	3,735	73%	▼
Q7-Q11^∧	The plan provided helpful, timely, and courteous customer service when I or my caregiver or family members have called with a question, needed help, or had a complaint or grievance (Always/Usually)	333	74%	1,856	80%	_
Q12	Since joining the health plan, someone from the plan has asked to see all of the prescriptions and over the counter medicines I´ve been taking	643	95%	3,560	94%	_
Q13	Since joining the health plan, someone from the plan has explained the Consumer Directed Personal Assistance option	468	77%	2,480	80%	_
Q14a-d^∧	The plan´s helpfulness in assisting my family and I with medication management, managing my illness, helping me when I am sad and lonely, and allowing me to stay in my home instead of a nursing home (Excellent/Good)	615	84%	3,432	85%	_
Q15	Overall MLTC plan rating (Excellent/Good)	644	85%	3,575	88%	_
Domain 2: Quality of Providers and Long-Term Care Services
Q16 – Q35^∧	The quality of care provided by long-term care providers/services (Excellent/Good)	669	81%	3,719	82%	_
Domain 3: Timeliness of Providers and Long-Term Care Services
Q36 - Q47^∧	The timeliness of care provided by long-term care providers/services (Always/Usually)	647	82%	3,622	83%	_
Domain 4: Access to Care for Urgent Appointments
Q48 – Q52^∧	Getting timely urgent appointments with long-term care providers/services (Same day)	572	37%	3,026	37%	_
Domain 5: Access to Care for Regular Appointments
Q53 – Q57^∧	Getting timely regular appointments with long-term care providers/services since joining the health plan (Always/Usually)	626	79%	3,320	82%	_
Domain 6: Advance Directives
Q71	The health plan has talked to me about appointing someone to make decisions about my health if I am unable to do so	705	73%	3,906	76%	_
Q72+	I have a legal document or advance directive appointing someone to make decisions about my health care if I am unable to do so	674	62%	3,801	69%	▼
Q73+	The health plan has a copy of this advance directive document	313	81%	1,923	84%	_

Table B12: Analysis of Composite Measures – Comparison by Primary Language Spoken
		Primary Language
English	Non-English	English vs. Non-English
Item	Description	English vs. Non-English	N*	%	N*	%
Domain 1: MLTC Plan Evaluation
Q3	The plan explains all of their services clearly (Always/Usually)	2,159	86%	1,982	89%	_
Q4-Q5^∧	My family member (or caregiver) and I are involved in making decisions about my plan of care (Always/Usually)	2,261	71%	2,045	73%	_
Q7-Q11^∧	The plan provided helpful, timely, and courteous customer service when I or my caregiver or family members have called with a question, needed help, or had a complaint or grievance (Always/Usually)	1,284	78%	842	80%	_
Q12	Since joining the health plan, someone from the plan has asked to see all of the prescriptions and over the counter medicines I´ve been taking	2,155	95%	1,958	94%	_
Q13	Since joining the health plan, someone from the plan has explained the Consumer Directed Personal Assistance option	1,418	73%	1,476	85%	▼
Q14a-d^∧	The plan´s helpfulness in assisting my family and I with medication management, managing my illness, helping me when I am sad and lonely, and allowing me to stay in my home instead of a nursing home (Excellent/Good)	2,077	86%	1,882	84%	_
Q15	Overall MLTC plan rating (Excellent/Good)	2,196	88%	1,923	87%	_
Domain 2: Quality of Providers and Long-Term Care Services
Q16 – Q35^∧	The quality of care provided by long-term care providers/services (Excellent/Good)	2,247	82%	2,038	82%	_
Domain 3: Timeliness of Providers and Long-Term Care Services
Q36 - Q47^∧	The timeliness of care provided by long-tem care providers/services (Always/Usually)	2,179	83%	1,981	83%	_
Domain 4: Access to Care for Urgent Appointments
Q48 – Q52^∧	Getting timely urgent appointments with long-term care providers/services (Same day)	1,842	33%	1,657	43%	▼
Domain 5: Access to Care for Regular Appointments
Q53 – Q57^∧	Getting timely regular appointments with long-term care providers/services since joining the health plan (Always/Usually)	2,010	82%	1,827	82%	_
Domain 6: Advance Directives
Q71	The health plan has talked to me about appointing someone to make decisions about my health if I am unable to do so	2,446	74%	2,004	76%	_
Q72+	I have a legal document or advance directive appointing someone to make decisions about my health care if I am unable to do so	2,450	78%	1,845	56%	▲
Q73+	The health plan has a copy of this advance directive document	1,402	86%	749	81%	_

Table B13: Analysis of Composite Measures – Comparison by Self-Reported Health Status
		Self-Reported Health Status
Good/Fair/Poor	Excellent/Very Good	Good/Fair/Poor vs. Excellent/Very Good
Item	Description	Good/Fair/Poor vs. Excellent/Very Good	N*	%	N*	%
Domain 1: MLTC Plan Evaluation
Q3	The plan explains all of their services clearly (Always/Usually)	2,466	84%	1,794	92%	▼
Q4-Q5^∧	My family member (or caregiver) and I are involved in making decisions about my plan of care (Always/Usually)	2,565	70%	1,831	75%	▼
Q7-Q11^∧	The plan provided helpful, timely, and courteous customer service when I or my caregiver or family members have called with a question, needed help, or had a complaint or grievance (Always/Usually)	1,292	75%	891	84%	▼
Q12	Since joining the health plan, someone from the plan has asked to see all of the prescriptions and over the counter medicines I´ve been taking	2,449	94%	1,756	95%	_
Q13	Since joining the health plan, someone from the plan has explained the Consumer Directed Personal Assistance option	1,727	78%	1,215	81%	_
Q14a-d^∧	The plan´s helpfulness in assisting my family and I with medication management, managing my illness, helping me when I am sad and lonely, and allowing me to stay in my home instead of a nursing home (Excellent/Good)	2,372	81%	1,671	91%	▼
Q15	Overall MLTC plan rating (Excellent/Good)	2,457	84%	1,761	93%	▼
Domain 2: Quality of Providers and Long-Term Care Services
Q16 – Q35^∧	The quality of care provided by long-term care providers/services (Excellent/Good)	2,565	79%	1,815	87%	▼
Domain 3: Timeliness of Providers and Long-Term Care Services
Q36 - Q47^∧	The timeliness of care provided by long-term care providers/services (Always/Usually)	2,503	80%	1,761	87%	▼
Domain 4: Access to Care for Urgent Appointments
Q48 – Q52^∧	Getting timely urgent appointments with long-term care providers/services (Same day)	2,097	36%	1,497	39%	_
Domain 5: Access to Care for Regular Appointments
Q53 – Q57^∧	Getting timely regular appointments with long-term care providers/services since joining the health plan (Always/Usually)	2,318	80%	1,620	84%	▼
Domain 6: Advance Directives
Q71	The health plan has talked to me about appointing someone to make decisions about my health if I am unable to do so	2,669	74%	1,923	76%	_
Q72+	I have a legal document or advance directive appointing someone to make decisions about my health care if I am unable to do so	2,598	64%	1,857	74%	▼
Q73+	The health plan has a copy of this advance directive document	1,204	82%	1,015	86%	_

* Denominator excludes Not Applicable responses. Total responses to each survey item varied; percentages were calculated on the number of responses for each item, and exclude Not Applicable responses.
♦ Items based on skip pattern.
▲/▼ Indicates a significantly higher/lower rate than 2015 (p < .001).
- Not statistically significant.
^ Questions and/or responses have been reworded since 2015.

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Appendix C. Survey Tool

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^{1. The CAHPS® proportional scoring method for creating and scoring composite measures was used. 1}

Department of Health

Managed Long-Term Care

2017 Member Satisfaction Survey Summary Report

April 2018

Table of Contents

Executive Summary

Introduction

Methodology

Key Findings

Recommendations

Section 1: Introduction

Background

Objectives

Section 2: Methodology

Survey Instrument

Survey Sample

Composite Measures

Section 3: Results

Response Rates

Respondent Demographics

Plan Evaluation/Rating of Health Plan

Quality of Care

Timeliness of Care

Access to Care

Analysis of Composite Measures and Individual Survey items within Domains

Domain 1: Measures Related to MLTC Plan Evaluation (Table B6)

Figure 1: MLTC Plan Evaluation (Domain 1)

Domains 2-5: Measures Related to Quality, Timeliness, and Access to Care (Table B6)

Figure 2: Quality, Timeliness, and Access to Care (Domains 2-5)

Domain 6: Advance Directives (Table B6)

Figure 3: Advance Directives (Domain 6)

Analysis of Composite Measures and Individual Survey Items by Subgroup

Comparison by Plan Type (Table B7)

Comparison by Gender (Table B8)

Comparison by Race/Ethnicity (Table B9)

Comparison by Education (Table B10)

Comparison by Age (Table B11)

Comparison by Primary Language (Table B12)

Comparison by Self-Reported Health Status (Table B13)

Section 4: Limitations

Section 5: Supplemental Phone Survey

Section 6: Conclusions and Recommendations

Appendix A. Frequency Tables

Appendix B. Aggregate Tables

Appendix C. Survey Tool

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