Utah Qualified Health Plan Enrollee Experience Survey Report

Rating of personal doctor

Rating of health care

Rating of health plan

Rating of specialist seen most often

Access to care

The Access to Care composite is made up of four items. It asks about member experiences with receiving care and getting appointments in a reasonable amount of time (Questions 20 and 21) and member experiences when attempting to get care from doctors and specialists in the last six months (Questions 23 and 39). The Summary Rate represents the percentage of respondents reporting "Always" or "Usually."

Note: The Access to Care composite contains the questions from Getting Needed Care and Getting Care Quickly Composites.

Getting care quickly

The Getting Care Quickly composite measures member experiences with receiving care and getting appointments in a reasonable amount of time (Questions 22 and 23). The Summary Rate represents the percentage of respondents reporting "Always" or "Usually."

Getting needed care

The Getting Needed Care composite measures member experiences when attempting to get care from doctors and specialists in the last six months (Questions 25 and 41). The Summary Rate represents the percentage of respondents reporting "Always" or "Usually."

Access to information

The Access to Information composite is made up of three questions and measures member experiences about whether written materials or the Internet provided the information needed about how the plan works, how often the member found out from the health plan about the cost of a health care service or equipment, and how often the member found out from the health plan the cost for specific prescriptions (Questions 3, 4 and 5). The Summary Rate represents the percentage of respondents reporting "Always" or "Usually."

Care coordination

The Care Coordination composite is made up of six questions and asks members to report whether their doctor had medical records or other information about their care and whether the doctor talked about prescription medicines. This composite also contains questions asking members if they got help managing their care and if the doctor was informed and up-to-date about their care from specialists. Additionally, this composite evaluates whether the member’s personal doctor's office followed up to give them test results and if they got the test results as soon as they needed (Questions 31, 32, 33, 34, 37, and 41). The Summary Rate represents the percentage of respondents reporting "Always" or "Usually."

Cultural competence

The Cultural Competence composite is made up of three questions and asks members about how often they got a needed interpreter, how often forms were available in their preferred language, and how often forms were in their preferred format such as large print or braille (Questions 11, 12 and 24). The Summary Rate represents the percentage of respondents reporting "Always" or "Usually."

Doctor communication

The How Well Doctors Communicate composite includes four questions measuring how well providers explain things, listen carefully to members, show respect for what members have to say, and whether they spend enough time with members (Questions 29, 30, 31 and 32). The Summary Rate represents the percentage of respondents reporting "Always" or "Usually".

Enrollee experience with cost

The Cost composite asks members how often their health plan did not pay for the care their doctor said they needed. Additionally, members are asked how often they had to pay out of pocket for care they thought their health plan would pay for. Finally, the composite asks members how often they delayed visiting a doctor or filling a prescription because of cost (Questions 13, 14, 15, and 16). The Summary Rate represents the percentage of respondents reporting "Never" or "Sometimes."

Plan administration

The QRS Plan Administration measure is made up of five items, all of which are coded on a 1-4 scale in the QHP questionnaire (i.e., 1 = Never, 2 = Sometimes, 3 = Usually, and 4 = Always).

The Plan Administration composite asks members to rate the ease of getting information or help from customer service, how often they were treated with courtesy and respect by customer service staff, how often they waited longer than expected to talk to customer service, how often forms from the health plan were easy to fill out, and how often the health plan explained the purpose of forms (Questions 6, 7, 8, 9 and 10).

Prevention: flu vaccinations for adults

The Flu Vaccinations for Adults Ages 18-64 measure is the percentage of members 18-64 years of age who received a flu shot or flu spray in the nose since July 1, 2020. The Summary Rate for the Flu Vaccinations for Adults Ages 18-64 measure is the proportion of respondents between the ages of 18-64 who responded "Yes" to Question 45, "Have you had either a flu shot or flu spray in the nose since July 1, 2020?"

Total completed surveys

Response rates

Data Note: Data represented in these tables represents data collected Jan-June of the current year, asking respondents about their care in the past calendar year.