How California providers improved the care experience for low-income patients

Improving patient satisfaction takes hard work and a lot of time, but a new report from the Blue Shield of California Foundation shows providers that the goal is anything but impossible.

The report, "Delivering on a Promise: Advances and Opportunities in Heath Care for Low-Income Californians," compared the 2011 and 2014 results of random, telephone surveys of Californians with household incomes less than 200 percent of the poverty level. The report found that efforts from the state's comprehensive community health centers and clinics to improve patient satisfaction paid off in a big way: In 2011, 48 percent of patients ranked the quality of their care as "very good" or "excellent," and in 2014 the percentage jumped to 53 percent.

This overall improvement was driven by gains in more specific measures of care quality such as: satisfaction with the ability to see the same provider (45 percent in 2014 and 36 percent in 2011); ability to schedule timely appointments (46 percent in 2014 and 37 percent in 2011); high-rated staff courtesy (62 percent, up from 49 percent); satisfaction with waiting times (34 percent compared to 23 percent); and high-rated facility cleanliness (52 percent compared to 60 percent).

More patients also reported the affordability of their care as very good or excellent--47 percent in 2014 compared with 40 percent in 2011.  

"Clinics listened to what patients were saying about their care experience and made improvements to care delivery, and now we see increased satisfaction among patients," Peter V. Long, M.D., president of the foundation, said in an announcement. "Given the uncertainty spurred by passage of the Affordable Care Act, and the influx of newly insured patients, this progress is particularly remarkable."

Much of the patient satisfaction improvement can be traced to strengthening the provider-patient relationship among clinics and the low-income Californians they serve. The report notes "vast differences in patient satisfaction on the basis of how much time the provider spends with them, how well the provider communicates with them, and how positively they rate the treatment options offered."

Patients also were more likely to report satisfaction when they felt that staff members understood their cultural background, and facilities' ability to respond to cultural differences has narrowed or eliminated many of the patient satisfaction gaps between whites and Latinos—who make up 68 percent of clinic patients--since 2011, the report states. Nationwide, providers have worked to reduce racial disparities in access to care and care quality, as well better understand the patient population in order to improve the patient experience, FierceHealthcare has reported.

In spite of the progress, however, "low-income Californians continue to trail their higher-income counterparts in terms of basic quality-of-care ratings and loyalty to their healthcare facility," the report notes.

Indeed, Long indicated that more work needs to be done.

"Change takes time, and now that we have a better understanding of where we are going and how to get there, we must continue to take deliberate steps forward," he said in the statement. "We are confident that lessons learned in California can be applied to a range of care settings across the country."

To learn more:
- here's the announcement
- check out the report