Some plans have developed programs to improve physician performance. Member satisfaction surveys are sometimes used in the formula to determine compensation for a primary care physician. You should ask if your plan uses these or other programs. The Department of Health approves complaints or grievance procedures for HMOs as a condition for receiving a Certificate of Authority to operate in Pennsylvania. Ask to see those procedures and ask how quickly grievances are handled by the health plan.
Grievances are one way to assess member satisfaction with service and service providers.
Not only is the number of grievances useful information, but the average length of time in answering a grievance may be an indicator of the sensitivity of the plan to consumer complaints. Some health plans survey their members about how satisfied they have been with services. Many of the questions are targeted at specific service areas. There is usually at least one question about overall satisfaction. The plan should be able to report the results of the surveys and indicate how the plan uses the patient satisfaction survey results as part of its quality improvement efforts.