Medicare Providers Remain Satisfied with Fee-for-Service Contractors

Thursday, September 4, 2008 General News
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WASHINGTON, Sept. 4 The Centers for Medicare & MedicaidServices (CMS) reported today that Medicare health care providers continue tobe satisfied with services provided by Medicare fee-for-service contractorsshowing a relatively smooth transition to the new Medicare AdministrativeContractors (MACs).

The average score based on a satisfaction survey across all contractorswas 4.51 on a scale of 1 to 6. This year's average score was comparable tolast year's average score of 4.56.

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

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

"CMS strives to provide the highest quality of service in all areas anddemands the same from its contractors," CMS Acting Administrator Kerry Weemssaid. "These surveys support our efforts to provide quality service byconveying feedback from providers to our contractors so that they make effortsto improve processes and enhance service to providers. The results fromprevious surveys have enabled CMS to establish performance standards forcontractors and we look forward to incorporating the results into contractorincentive plans."

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

Across all contractor types, claims processing also remained a strongindicator in 2008 of provider satisfaction, as in the past two years. It wasthe top indicator of satisfaction in 2006. The parts of the claims functionparticularly associated with provider satisfaction included claims editing andease of submitting electronic claims.

The 2008 survey queried about 35,000 randomly selected providers -- thephysicians, health care practitioners and facilities, such as hospitals andskilled nursing home facilities, that serve Medicare beneficiaries across thecountry.

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 provideraudit and reimbursement. Respondents were asked to rate their contractorsusing a scale of 1 to 6 on each of the business functions, with "1"representing "not at all satisfied" and "6" representing "completelysatisfied." Contractors received an overall composite score as well as a scoreon each business function. Each contractor will receive an individual summaryof their results.

"The public reporting of the results over the last three years hasincreased awareness about the MCPSS and resulted in contractor accountabilityto the provider community," Weems said. "Contractors have begun to use theinsights gleaned from the MCPSS to make improvements to their systems andprocedures."

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

The summary report of the survey findings is available on the CMS Web sitein the MCPSS section at .Department of Health & Human Services Centers for Medicare & Medicaid Services Room 352-D 200 Independence Avenue, SW Washington, DC 20201

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