Annual update on Medicare accessibility results

In August 2009, a survey was mailed to a statistically valid sample of family practice, general practice and internal medicine Asuris TruAdvantage physician offices. The survey measured a variety of different accessibility standards. Listed below is a brief summary of the results.

	Standard and goal	Percent of compliance	Results
Appointment wait times
Emergent care	100% of offices surveyed will assess, treat or refer emergent patient within five minutes	90%	Not met
Urgent, acute care	95% of offices will schedule appointments for urgent, acute care within 24 hours	99%	Met
Non-urgent, symptomatic care	95% of offices will schedule non-urgent care for symptomatic conditions within seven days	89%	Not met
Non-urgent, asymptomatic care	95% of offices will schedule non-urgent appointments for asymptomatic conditions within 30 calendar days	100%	Met
Preventive care	95% of offices will schedule appointments for extended visits (e.g., comprehensive exam, preventive care) within 42 days	94%	Not met
After hours availability
Phone coverage	100% of offices will direct patients to an answering service or an on call provider when their office is closed	92%	Not met
Advance directives Learn more.
Availability of advance directives	Offices will provide copies of advance directives or advise patients on how to obtain one	94%	Not met
Documentation of advance directive	Offices have a procedure to document when there is an advance directive in the patient chart and that it is prominently displayed	82%	Not met

Emergent Care: The standard of assessing, treating or referring an emergent patient within five minutes was met by only 90% of offices surveyed, rather than the goal of 100%. Most non-compliant respondents indicated six minutes to half an hour as their wait time for emergent care.

Non-urgent, Symptomatic Care: This standard was not met. Of the offices surveyed, 11% were not able to schedule a patient for an appointment within seven days for non-urgent, symptomatic care. Some indicated that wait times could be two weeks or more.

Preventive Care: This standard, an appointment scheduled within 42 calendar days for preventive care, was not met. The majority of non-compliant offices responded with a timeframe of 43-90 days.

After hours phone coverage: The standard requires that 100% of family practice, general practice and internal medicine offices have a provision for coverage 24 hours a day, seven days a week. It is important for offices to give complete and clear instructions to patients about how to reach their physician or an on-call provider after hours:

• A recorded message indicating that the patient should call 9-1-1 or go to the emergency room does not meet this standard and is considered only partial compliance.
• 8% were in partial compliance, but no offices were non-compliant.

Planned interventions for standards that were not met include individual letters and ongoing articles in our newsletter clarifying key standards and our expectations.

Although our survey measures only primary care offices, we urge all participating physicians and health care professionals to be aware of our standards and implement steps to meet them. View the standards.

 

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