Article by Molly Burke, RMS Research Analyst –
Introduction:
A national behavioral health network recently partnered with Research & Marketing Strategies, Inc. (RMS) to conduct market research with the contracted healthcare providers within their network. The client wanted to explore why these providers within their network were not accepting or providing services to patients with a specific health insurance plan. This was achieved by collaboratively developing a survey instrument that was administered directly to the healthcare providers. The survey was a mixed mode survey, utilizing both online and direct mail approaches to reach the intended audience. By utilizing a mixed-mode methodology, RMS was able to reach various providers from different demographic backgrounds.
Objective:
The main objective of this market research study was to understand why the network’s providers were not accepting or providing services to patients with a specific health insurance plan. Based on the survey results, the client developed strategies to ultimately increase the number of accepted patients with this specific health insurance plan by improving their processes across the organization.
Methodology:
RMS administered a brief 3-to-5-minute survey to the contracted providers in the network, through both online and direct mail modalities. The survey was developed collaboratively with RMS staff and a designated client project team. It consisted of only 9 questions of different types, including open-ended, single, and multiple-choice questions. The research gathered information from the providers about:
- Whether they accept or see patients with the specific health insurance plan or not;
- Why they do not accept or see these patients specifically;
- What insurance plans they accept;
- How long they have been a contracted provider within the network;
- What type(s) of services they provide;
- How many patients they see on a weekly basis;
- Their overall experience being a contracted provider with this network.
The survey was sent to the client’s providers via an email database provided by the client. Those providers who did not have a valid email address received a survey through the mail.
Results:
Overall, the survey yielded some very beneficial insights into the factors contributing to the low acceptance rate of patients with the specific health insurance plan. After analyzing the data, the following reasons for non-acceptance or refusal of services included:
- The providers did not receive many referrals for patients with this type of insurance.
- The providers experienced difficulty with billing and payment procedures for the patients they saw.
- The providers expressed difficulties receiving payment/reimbursement for services provided to these patients.
The data analysis further revealed that providers who do accept patients with the specific health insurance plan experienced poor customer service from the network. Many providers stated that the credentialing process with the client was very lengthy and difficult, and that the client’s customer service was not available nor helpful in the process.
Impact:
After analyzing the results of this provider engagement survey, RMS provided the client with a detailed report which included the analysis of each question and delivered seven key recommendations to help them achieve their stated goals. RMS provided these recommendations to encourage the client to act on items as appropriate and leverage the data from this study to work toward an improved provider-network relationship. In addition, the survey responses revealed the importance of providing high-quality, accurate contact lists for surveys like this. Several of the providers were already accepting patients with the specific health insurance plan and were confused as to why they received the survey. Ultimately, this survey provided several important takeaways for the client as well as the potential for future projects to delve deeper into the client’s processes and workflow.
Relational RMS Blogs:
How to Overcome Common Barriers to Employee Satisfaction Surveys
Satisfaction Surveys for the Win
8 Benefits of Using an Employee Survey
About the Author – Molly Burke
Molly supports the design, administration, and analysis of RMS Research Analytics Division projects works to ensure that all reporting follows RMS guidelines for quality and leverages her industry knowledge to enhance recommendations, particularly for RMS healthcare clients.
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About RMS
Research & Marketing Strategies, Inc. (RMS) is a full-service market research firm in Central New York. Formed in 2002, RMS helps organizations that are looking to know more about their customers and/or potential customers. They conduct surveys, focus groups, mystery shopping, studies and analysis. Each project is customized and gets personal attention by the best in the business. RMS has a reputation for getting results and offers an independent means to conduct telephone, on-line and mail surveying, In-depth interviews, intercept interviews, and participant recruitment as well as focus group hosting through QualiSight, its onsite call center and focus group facility. Taking advantage of the region’s reputation for being a great market study barometer, RMS recruits and moderates for focus groups, community forums and town meetings.
