Neighborhood currently surveys primary care practices each quarter to ensure our members’ access to care.
Neighborhood’s access standards are as follows:
- Urgent care appointments to members within 24 hours
- Non-urgent symptomatic care to members within 30 days
- Routine care (excluding complete physical exams) within 30 days
- Appointments for new members to the Plan who do not have an existing relationship with a primary care practitioner within 60 days
- Routine physical exam within 180 days
Additionally, the survey determines whether primary care practices are adhering to the Plan standard of ensuring that a covering provider contacts a member calling after hours within thirty (30) minutes. The survey also provides an opportunity for Neighborhood to learn if primary care practices are experiencing difficulties when scheduling appointments with a specialist for Plan members. Later this year, a survey specific to access to specialty care will be administered …more to come on specialty care access soon.
In June 2016, Neighborhood Provider Network Management staff surveyed sixty-two (62) primary care practices with five hundred (500) or more assigned members. Staff requested independent access information for new and established members within the survey. Findings show that 100% of the practices met the “Non-Urgent/Symptomatic Care” and “Routine Physical Exam” standards. The “Urgent Care” standard and the “New Plan Member” standard were met by all but one practice each, and two practices failed to meet the “Routine Care” standard. Overall, given the growth in the insured population, our network’s performance is exceptional!
Furthermore, the percentage of practices that provide a call back to an after-hours caller within thirty (30) minutes increased from eighty-seven (87%) percent to ninety-five (95%) percent. More great news!
Neighborhood wishes to extend its appreciation to the provider network.