Date

Press release

MEDICARE PROVIDERS REMAIN SATISFIED WITH FEE-FOR-SERVICE CONTRACTORS

MEDICARE PROVIDERS REMAIN SATISFIED WITH FEE-FOR-SERVICE CONTRACTORS

 

The Centers for Medicare & Medicaid Services (CMS) reported today that Medicare health care providers continue to be satisfied with services provided by Medicare fee-for-service contractors showing a relatively smooth transition to the new Medicare Administrative Contractors (MACs).  

 

      The average score based on a satisfaction survey across all contractors was 4.51 on a scale of 1 to 6. This year’s average score was comparable to last year’s average score of 4.56.

 

      The Medicare Contractor Provider Satisfaction Survey (MCPSS), conducted by CMS for the third year, is designed to gather and report objective, quantifiable data on provider satisfaction with the fee-for-service contractors who process and pay Medicare claims.

In 2007, more than one billion claims were processed and paid to approximately one million health care providers who provided medically necessary items and services to 44 million beneficiaries.

     

      “CMS strives to provide the highest quality of service in all areas and demands the same from its contractors,” CMS Acting Administrator Kerry Weems said. “These surveys support our efforts to provide quality service by conveying feedback from providers to our contractors so that they make efforts to improve processes and enhance service to providers. The results from previous surveys have enabled CMS to establish performance standards for contractors and we look forward to incorporating the results into contractor incentive plans.”

 

      As in 2007, the top indicator of satisfaction among providers in 2008 was how Medicare contractors handled provider inquiries. This is the third consecutive year this function was cited as one of the key indicators of provider satisfaction.

 

      Across all contractor types, claims processing also remained a strong indicator in 2008 of provider satisfaction, as in the past two years. It was the top indicator of satisfaction in 2006. The parts of the claims function particularly associated with provider satisfaction included claims editing and ease of submitting electronic claims.

 

       The 2008 survey queried about 35,000 randomly selected providers – the physicians, health care practitioners and facilities, such as hospitals and skilled nursing home facilities, that serve Medicare beneficiaries across the country.

 

Survey questions focused on seven business functions of the provider-contractor relationship:  provider outreach and education, provider inquiries, claims processing, appeals, provider enrollment, medical review, and provider audit and reimbursement. Respondents were asked to rate their contractors using a scale of 1 to 6 on each of the business functions, with “1” representing “not at all satisfied” and “6” representing “completely satisfied.” Contractors received an overall composite score as well as a score on each business function. Each contractor will receive an individual summary of their results.

 

“The public reporting of the results over the last three years has increased awareness about the MCPSS and resulted in contractor accountability to the provider community,” Weems said. “Contractors have begun to use the insights gleaned from the MCPSS to make improvements to their systems and procedures.”

 

The survey is mandated by the Medicare Prescription Drug, Improvement, and  Modernization Act (MMA) of 2003. Specifically, the law calls for CMS to develop contract performance requirements, including measuring provider satisfaction with Medicare contractors. The MCPSS enables CMS to make valid comparisons of provider satisfaction between contractors and, over time, improvements to Medicare.   

 

The summary report of the survey findings is available on the CMS Web site in the MCPSS section at www.cms.hhs.gov/MCPSS.  

 

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