Contractor Report Card Shows Good Marks

BALTIMORE–Results of a CMS satisfaction survey conducted
earlier this year show that a majority of health care providers
gave their Medicare contractors relatively good grades, although
DME contractors received the lowest marks.

With data collected from January through April this year, CMS’
second Medicare Contractor Provider Satisfaction Survey showed that
on a six-point scale–with 1 representing “not at all satisfied”
and 6 representing “completely satisfied”–the national average
across contractors was 4.56.

Of four contractor types in the survey, fiscal intermediaries
received an average score of 4.66; regional home health
intermediaries received 4.77; carriers received 4.42; and durable
medical equipment contractors received 4.34. Scores fell slightly
for all of the contractor types from those in the 2006 survey; last
year DME contractors also received the lowest average score at
4.43.

In the survey, CMS asked a random sample of 36,359 Medicare
providers about seven business functions of the provider-contractor
relationship: provider communications, provider inquiries, claims
processing, appeals, provider enrollment, medical review and
provider audit and reimbursement. The agency said the survey is one
way it can gauge provider satisfaction with key services performed
by the contractors, which process and pay more than $280 billion in
Medicare claims annually.

For all contractor types, the survey showed the key predictor of
a provider’s satisfaction was the contractor’s handling of provider
inquiries, with claims processing coming in at No. 2.

All four DME contractors received scores below the national
survey average: Jurisdiction B’s National Government Services
scored the highest of the group at 4.50; Jurisdiction C, Palmetto
GBA, came in at 4.44; Jurisdictions D and A, which both were served
by multiple contractors during the survey period, received scores
of 4.21 and 4.20 respectively.

Of the service functions surveyed among DME contractors,
providers gave them the highest scores on claims processing at an
average of 4.47, and the lowest on appeals at 4.07.

Of 18 Part B carriers in the survey, the highest scores went to
Blue Cross Blue Shield of Kansas and HealthNow New York, which both
received 4.66. The lowest scores in the group went to Noridian
Administrative Services at 4.12 and Jurisdiction 3, which was
served by multiple contractors during the survey, at 3.91.

As required by the Medicare Modernization Act of 2003, the
survey will enable CMS “to begin establishing provider satisfaction
performance standards for its contractors,” the agency said, noting
that the results provide a “tangible benchmark” that contractors
can use to support process improvement efforts.

For a PDF of the survey, click here.