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Providing High-Quality Services to Children with Special Health Care Needs (CSHCN) Under Managed Care

Measuring Consumer Satisfaction

Care Provided to CSHCN

Presenters:

Polly Arango, Director, Family Voices, Algodones, NM.

Ann Boyd Taylor, Ed.D., Assistant Director, New England SERVE, Boston, MA.


Measurement of consumer satisfaction is an important element of any quality monitoring strategy. In the case of children with special health care needs, this monitoring focuses on families' satisfaction with a range of aspects of their children's care. The presenters, Polly Arango, Director of Family Voices, and Ann Taylor, Associate Director of New England SERVE, discussed the importance of including a family perspective in a quality assurance plan.

Polly Arango started the session with a brief description of Family Voices, a national grassroots organization of families of CSHCN. Ms. Arango explained that many parents of CSHCN are concerned about moving their children into a managed care environment due to poor managed care treatment in the past, as well as worries about access and capacity to serve these children's needs. She said that the key to creating appropriate managed care plans for this population is to remember that the care must be coordinated, family-centered, and able to forge family-professional partnerships to keep families informed and satisfied.

Family Voices has come to some of these conclusions as the result of a recent survey which compared the experiences of families with CSHCN in managed care with those in traditional insurance plans. In the future, Arango feels that managed care plans can help families by collecting more data, setting high standards, and building better family partnerships, in order to increase both the quality of care and consumer satisfaction.

Ann Taylor described how New England SERVE has been monitoring quality and consumer satisfaction with managed care in several ways, including:

  • Establishing a New England-wide task force to study the quality of managed care for CSHCN.
  • Conducting a survey-based needs assessment of families, providers and Managed Care Organizations (MCOs).
  • Developing a model for quality improvement in managed care.

Ms. Taylor described the results of her organization's surveys of families, providers, and health maintenance organization (HMO) staff within managed care plans on their satisfaction with the plans' services. Based on the results of this needs assessment, New England SERVE is developing a set of specialized measures with which to assess the quality of care provided to CSHCN by managed care plans. As a result of these studies, Dr. Taylor feels that there is evidence that illustrates the importance of involving families and providers in designing and reviewing quality improvement initiatives, as well as in developing measures for specialized services and indicators of family-centered care.

References

Family Voices. "Children with Special Health Care Needs In Managed Care: Questions To Ask and Answer." Managed Care Questions 95, January 12, 1996.

Family Voices and Brandeis University. "Family Partners." Federation for Children with Special Needs.

Family Voices. "Family Voices Discusses: Managed Care." January 1996.

Family Voices. "Summary Report on the Family Voices Managed Care Survey." Federation for Children with Special Needs, June 1997.

The ABC's of Managed Care-Standards and Criteria for Children with Special Health Care Needs was initiated and developed by members of the National Coalition for Family Leadership at the Egg Harbor Family Summit, September 1995.

New England SERVE. Assessing the Quality of Managed Care for Children with Special Health Care Needs. Summary of a Regional Survey of Families, Primary Care Providers, and Managed Care Organizations in New England. Boston, Massachusetts.

New England SERVE. Ensuring Quality: Monitoring the Impact of Managed Care and Health Care Reform on Children with Special Health Care Needs and Their Families. Boston, Massachusetts.

New England SERVE. Promoting Health Systems Development for Children, Youth & Families. Boston, Massachusetts.


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