AmeriHealth New Jersey monitors and takes appropriate action to improve the continuity and coordination of care between primary care physicians (PCP), specialists, and organizational providers (hospitals, skilled nursing facilities, and emergency rooms). The PCP satisfaction survey is used to assess satisfaction with the rate of receipt and exchange of information between PCPs and specialists as well as between PCPs and three organizational provider types (as shown below). In the second quarter of 2011, surveys were mailed to the 327 PCP practices in the AmeriHealth New Jersey network with 50 or more members; the survey had a 22.9 percent response rate.

Receipt of discharge summary (Most/Always) Organizational provider type Receipt of discharge summary Hospital 67.1% Skilled nursing facility 48.8% Emergency room 68.6% The PCP satisfaction survey reflects that PCPs were most satisfied with the rate of receipt of discharge summaries from emergency rooms.

PCP satisfaction with exchange of information with organizational providers (Very satisfied/Satisfied) Provider type Frequency Quality Timeliness Confidentiality Hospital 61.2% 76.1% 59.2% 81.4% Skilled nursing facility 74.2% 79.0% 50.0% 74.2% Emergency room 60.6% 70.4% 66.2% 80.0%

With respect to the flow of information from organizational providers, PCP satisfaction with confidentiality of information exchange was the highest area overall. PCPs were most satisfied with the frequency and quality of the information from skilled nursing facilities. For timeliness and confidentiality, PCPs were most satisfied with emergency rooms and hospitals, respectively. PCPs were the least satisfied with the frequency and quality of information from emergency rooms and the least satisfied with the timeliness and confidentiality of information from skilled nursing facilities. PCPs were also asked to assess their satisfaction with the exchange of information with selected high-volume specialists and laboratories to ensure continuity and coordination of care in the management of patients with chronic conditions such as diabetes, asthma, and coronary artery disease.

PCP satisfaction with exchange of information with organizational providers (Very satisfied/Satisfied) Specialist type Frequency Quality Timeliness Confidentiality Cardiology 94.2% 92.9% 85.7% 91.4% Endocrinology 87.2% 91.4% 82.9% 91.4% Allergy/Pulmonary 94.2% 91.4% 84.3% 91.4% Ophthalmologists/Optometrists 67.2% 78.6% 71.4% 90.0% Laboratories 88.6% 87.1% 85.7% 92.8% PCP satisfaction with the confidentiality of information exchange with all specialist types and the flow of information from laboratories was above 90 percent, while satisfaction with the quality of information was also above 90 percent for all specialist types except for ophthalmologists/optometrists and laboratories. PCP survey results reflect higher rates of satisfaction with the frequency and timeliness of the information exchange with the specialties of cardiology, allergy/pulmonary, and laboratories. Opportunities for improvement were noted with respect to PCP satisfaction with the frequency and timeliness of information exchange with endocrinology and ophthalmology/optometry.

PCP satisfaction with the exchange of information with behavioral health practitioners represents an opportunity for improvement for all measures (ranging from 10.6 percent to 39.1 percent).

What AmeriHealth New Jersey is doing

AmeriHealth New Jersey continues its efforts to promote communication between practitioners and organizational providers in order to enhance the continuity, coordination, quality, and safety of patient care. Efforts include, but are not limited to:

• encouraging members through plan publications to take an active role in their care and to advise their PCP or personal physician of any urgent/emergent or inpatient care received to allow for coordination of follow-up care;
• improving coordination of care between behavioral health providers and PCPs through the availability of overview guides on substance-use disorders, depression, and suicide behavioral health issues, through Partners in Health Update, and through our website, www.amerihealth.com/providers. The PCP to Behavioral Health Provider Communication Form, also available on our website, was instituted specifically to promote communication between PCPs and behavioral health practitioners.

In addition, AmeriHealth New Jersey will take steps to reinforce the importance of timely and appropriate dissemination of discharge information by participating organizational providers. We also encourage PCPs and specialists to exchange information and to provide feedback to facilities, as appropriate, regarding the frequency, quality, timeliness, and confidentiality of information received from organizational providers to facilitate coordination of care management and ensure the healthiest outcomes for our members.

Thank you to those providers who participated in this year's survey.