December 2015 For CCA 1 grievances were filed, totaling 0.01% of membership For 7 grievances were filed, totaling 0.34% of membership Slide 43 MassHealth Grievance Oversight Process Currently plans report grievances directly to MassHealth on a monthly basis. These Grievance Reports are circulated to a variety of One Care staff including: MassHealth Leadership MassHealth Contract Management MassHealth Quality CMS Counterparts Staff review reports and identify any areas of concern, or questions they may have to further discuss with the plans. of concern/questions are then sent to the plans and discussed during the bi-weekly contract management meetings. During bi-weekly contract management meetings, plans provide responses on the previously identified grievances concerns/ questions. Additionally grievance data is aggregated by quality staff and shared with the plans, allowing plans to Proactively identify areas of concerns, and Implement strategies to improve plan operations and member satisfaction Plan responses illustrating past, previous, and current strategies are shown on the following 44 CCA’S Response to Transportation Grievance Data Background/Context 81% of CCA’s grievances are transportation related Transportation utilization consistently increasing April 2016 average is over 20,000 rides per month. – Grievances decreasing each month despite steady increases in utilization. Complaints consistently remain less than 1% of trip volume. The decrease in complaints is attributed to numerous efforts and interventions (see right). Top 3 issues are: Vendor/driver lateness Vendor/driver no-shows Customer service, including clerical errors INTERVENTIONS Lateness Implemented a one hour pick-up window for Boston and Greater Boston Observed immediate improvement in member satisfaction Reinforced communications policy for vendors to notify CCA when they are late so CCA can call the member and provider offices as appropriate No-shows and Lateness Reduce volume of to no-show and late vendors Work with vendor to address issues impacting lateness, no-shows, customer service Annual vendor meetings and regular communication to vendors via fax and blasts Other
December 2015 For CCA 1 grievances were filed, totaling 0.01% of membership For 7 grievances were filed, totaling 0.34% of membership Slide 43 MassHealth Grievance Oversight Process Currently plans report grievances directly to MassHealth on a monthly basis. These Grievance Reports are circulated to a variety of One Care staff including: MassHealth Leadership MassHealth Contract Management MassHealth Quality CMS Counterparts Staff review reports and identify any areas of concern, or questions they may have to further discuss with the plans. of concern/questions are then sent to the plans and discussed during the bi-weekly contract management meetings. During bi-weekly contract management meetings, plans provide responses on the previously identified grievances concerns/ questions. Additionally grievance data is aggregated by quality staff and shared with the plans, allowing plans to Proactively identify areas of concerns, and Implement strategies to improve plan operations and member satisfaction Plan responses illustrating past, previous, and current strategies are shown on the following 44 CCA’S Response to Transportation Grievance Data Background/Context 81% of CCA’s grievances are transportation related Transportation utilization consistently increasing – April 2016 average is over 20,000 rides per month. Grievances decreasing each month despite steady increases in utilization. Complaints consistently remain less than 1% of trip volume. The decrease in complaints is attributed to numerous efforts and interventions (see right). Top 3 issues are: Vendor/driver lateness Vendor/driver no-shows Customer service, including clerical errors INTERVENTIONS Lateness Implemented a one hour pick-up window for Boston and Greater Boston Observed immediate improvement in member satisfaction Reinforced communications policy for vendors to notify CCA when they are late so CCA can call the member and provider offices as appropriate No-shows and Lateness Reduce volume of to no-show and late vendors Work with vendor to address issues impacting lateness, no-shows, customer service Annual vendor meetings and regular communication to vendors via fax and blasts Other