QMetrics has been a trusted administrator of healthcare surveys in California since 2017, conducting Provider Surveys and, more recently, Enrollee Surveys since 2023. These surveys are designed to fulfill key regulatory and accreditation requirements for health plans, including mandates from the California Department of Managed Health Care (DMHC) and the National Committee for Quality Assurance (NCQA).
Required by the DMHC, this survey assesses timely access to urgent, non-urgent, and behavioral health follow-up appointments. Outreach is performed by contacting provider offices via fax, email/online, and telephone to assess urgent and non-urgent provider availability. This survey targets PCPs, 10 types of Specialists (SCP), Psychiatrists (PSY), Non-Physician Mental Health Providers (NPMH), and Ancillary (ANC) service providers (Mammography and Physical Therapy). In addition to administering the survey, QMetrics also serves as a required validator, ensuring that the survey process and results meet all applicable regulatory standards and validation requirements.
QMetrics understands the critical importance of accurate contact data and has developed the prevalidation process to ensure quality and minimize errors before survey fielding begins. This proactive approach involves reviewing and reconciling the Health Plan Network File with associated documents, in close collaboration with the Health Plan. By identifying potential issues early, the prevalidation process reduces errors during survey administration and lightens the post-survey quality assurance workload. Additionally, it identifies high-volume providers in advance, allowing us to strategically plan for maximum survey completion, adding exceptional value and efficiency to the process.
QMetrics expertly administers the Provider Appointment Availability Survey (PAAS) in full compliance with the PAAS Manual, DMHC guidelines, FAQs, and All Plan Letters (APLs) for the current measurement year. Our survey administration spans fax, email, and telephonic modalities, with a strong focus on minimizing provider abrasion and maximizing response rates. To ensure smooth survey completion, we’ve developed the White Glove process, specifically designed for high-volume provider offices. In partnership with the Health Plan, we proactively manage these offices to optimize response rates, minimize errors, and meet the required sample size outlined in the DMHC Survey Methodology.
Additionally, our Operations and Programming Analytics team provides real-time interim reporting through a convenient dashboard, offering valuable insights into survey progress. This dashboard tracks survey response rates, compliance thresholds, and provides a breakdown by provider type, including Primary Care Providers, Specialists, Ancillary providers, and more, ensuring the Health Plan stays informed and on track throughout the survey process.
The Department of Managed Health Care (DMHC) mandates that health plans partner with an external vendor to validate their Timely Access Compliance Reports and submit a Quality Assurance Report. QMetrics provides expert validation based on the rigorous Quality Assurance process outlined in the current Provider Appointment Availability Survey (PAAS) Manual, along with supplemental DMHC documents and FAQs. Our team ensures that the Health Plan’s PAAS Report Forms are thoroughly validated for accuracy, validity, and completeness. We reconcile Contact Lists with the Plan’s Network Filing and cross-check Raw Data to ensure that survey results reflect the true provider network. Any discrepancies are promptly identified and submitted to the Plan for correction, validation, or feedback, ensuring full compliance and accurate reporting.
Starting in RY 2024/MY 2023, the Department of Managed Healthcare (DMHC) requires Primary Plans to report all required data for PAAS providers made available through Plan-to-Plan contracts in their Timely Access Compliance Report. QMetrics offers a contracted service to perform a comprehensive Quality Assurance Review and deliver consolidated results for the Primary Plan’s Plan-to-Plan arrangement, ensuring full compliance with DMHC requirements. Our review includes algorithmic verification of calculations, accuracy checks of network/counties represented, and final tabulations to guarantee that the health plan meets all necessary standards.
The Enrollee Experience Survey fulfills DMHC requirements by employing a statistically valid and reliable methodology to capture member perspectives on key access and service domains. It gathers feedback on the ability to obtain timely appointments, awareness of enrollee rights related to timely care, and the experiences of limited English proficient individuals in accessing interpreter services. Administered via mail with an online completion option, the survey supports health plans in identifying barriers to care and enhancing the overall enrollee experience.
The Patient Assessment Survey (PAS) gathers critical patient feedback on communication, access, coordination, and overall satisfaction, helping healthcare providers focus on key areas of improvement. With the growing emphasis on patient-centered care, PAS allows for direct insights from patients to highlight strengths and identify opportunities for better care. By using PAS, your Health Plan can improve quality, ensure accountability, benchmark performance, and enhance patient engagement, ultimately boosting the overall healthcare experience. QMetrics offers customization of the PAS to meet the specific needs of your organization.
With extensive experience in survey administration, QMetrics delivers customized solutions to fit your specific needs. We offer a range of survey options, including Telehealth surveys for both providers and health plans, client and member surveys, and employee satisfaction surveys, all designed to provide actionable insights and drive improvements across your organization. Let us help you gather the feedback that matters most and enhance your decision-making process.