Annual Access Study
| To: | Primary Care Providers (PCP) and Specialists |
| From: | Quality Management Department |
| Subject: | Annual Access Study |
| Products: | Medi-Cal |
The California Department of Managed Health Care requires health plans to establish metrics for measuring and monitoring the adequacy of a health plan’s contracted provider network to provide enrollees with timely access to needed health care services during normal and after business hours.
Health Plan of San Joaquin will visit provider offices to survey patients regarding appointment availability and waiting room times. The surveys are conducted unannounced in PCP and Specialist provider offices during the months of November and December. A Health Plan of San Joaquin representative will also be contacting provider offices after hours to determine a system for after-hours urgent care as well as provider response time to call back.
A five question physician survey will be provided to assess your experience with Health Plan of San Joaquin either through fax or during our on-site member survey.
HPSJ will submit the results to the provider office surveyed. The scoring matrix and total scores utilized in calculating results for the availability and waiting room times is as follows:
| Wait Time in Waiting Room | Wait Time in Exam Room | Time Spent with Practitioner | Discharge Time |
|---|---|---|---|
| < 45 Min. (+4) | < 15 Min (+4) | 15-60 Min (+4) | < 15 Min (+4) |
| 45-60 Min (+3) | 16-30 Min (+3) | 61-90 Min (+3) | 16-30 Min (+3) |
| 61 Min-2 Hours (+2) | 31-60 Min (+2) | 91 Min – 2 Hours (+2) | 31-60 Min (+2) |
| 3+ Hours (+1) | > 1 Hour (+1) | < 15 Min OR > 2 Hours (+1) | > 1 Hour (+1) |
If you have any questions please contact our Quality Improvement Department at (209) 461-2287.