The Practitioner Conection
Volume XXV, 1st Quarter

TELEPHONE AND APPOINTMENT ACCESS

Ease of access to care is a strong predictor of overall participant satisfaction and is a critical component of healthcare service and quality. CIGNA measures access to care regularly, and standards are defined for both telephonic responsiveness and appointment access:

* Derived from the percent of ECHO Participant Satisfaction responses of Always and Usually.

2007 Telephonic Access Performance:
Telephonic response, consistent with clinical presentation, is encouraged through use of separate Intake and Crisis Lines. Automated system reports are used to continuously monitor responsiveness to callers on both the Intake and Crisis lines and to determine if participants receive timely behavioral health and related services. Annual measurement for the Intake Line reveals that the California and Chesapeake Operating Units failed to meet goal for average telephonic speed of answer and abandonment rates for CIGNA’s Risk and Administrative Services Only business. Only Chesapeake failed to meet goal for CIGNA Preferred Provider Organization business.

Performance for all sites met goals from July through December 2007, when a Six Sigma project successfully increased efficiencies in call handling, modified workflows, and increased staff coverage to drive improvement. For four years, through the Care Advocacy Program (CAP), participants have been able to access Routine care with contracted network practitioners without calling CIGNA. However, a December 2007 study showed that a high percentage of participants still choose to call CIGNA, where they are additionally informed about treatment options and are provided educational resources. This higher level of service increases call duration, contributing to increased latency of response to incoming calls on the Intake line. Annual measurement for the Crisis Line reveals that all locations met threshold for average telephonic speed of answer and abandonment rate. Opportunities exist in 2008 for sustained improvement in average telephonic speed of answer and abandonment rates on the Intake line.

2007 Appointment Access Performance:
CIGNA achieved statistically significant improvement for urgent and non-life threatening emergent appointment access over the three year period from 2005 – 2007. For Urgent care, compliance has risen from 88.3% to 98.2%. For Non-Life Threatening Emergent care, compliance has risen from 96.3% to 99.8%. Interventions that drove improvement included increasing the number of network practitioners with prescribing authority, recruitment that increased network capability for response to cultural diversity, the creation and growth of the Intermediate Care network and Crisis Stabilization network, and enhancement to our internal and Web site databases to better identify practitioners with availability to respond to higher levels of need.

Nationally, participants report that goal was met for office wait times in 2007, while Routine access scores decreased in 2007 and did not meet goal. CIGNA continues to encourage participants to independently access care through the Online Practitioner Directory at CIGNA’s Web site, and also encourages practitioners to develop informative Personal Self Introductions that facilitate care access. Notation of access standards, and a reminder to call CIGNA for assistance in scheduling appointments to standard, placed near the Online Provider Directory search function, now complements CIGNA's staff ability to assist participant access using practitioner specialty searches and educational materials. Routine care access has been identified as an opportunity for improvement in 2008.

Other Featured Articles:

INTERVENTION & DOCUMENTATION OF THE SUICIDAL PARTICIPANT

TREATMENT RECORD REVIEWS

COORDINATION OF BEHAVIORAL CARE WITH PRIMARY CARE

SERVING AIRLINE CREW MEMBERS

PLACE OF SERVICE COLUMN

WHO'S WHO IN CIGNA

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