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Health Connector patients mostly satisfied with service

Survey does find some problems

By Kay Lazar
Globe Staff / March 11, 2011

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The first survey of consumers who receive subsidized health insurance through the state’s Health Connector shows most give it high marks, according to results released yesterday by the Connector Authority.

Eighty-six percent of those surveyed said they were pleased with the range of services covered and the quality of care available, and 82 percent had similar feelings about their choice of doctors.

A majority of patients, 81 percent, reported they had seen a doctor for regular care at least once since receiving coverage through the Commonwealth Care program, which is the state-subsidized health insurance program created for low- and moderate-income residents under Massachusetts’ 2006 health care law.

The survey found, however, that some members did encounter problems.

For instance, 31 percent said that over the past year they were told by a provider that their type of insurance was not accepted, and 23 percent said they were told that a doctor’s office was not accepting new patients.

One of the goals of the 2006 law was to reduce patients’ use of expensive emergency rooms for the flu, sprains, and other non-urgent care, by providing health coverage for most of the uninsured. But about a third of patients surveyed said they had gone to a hospital emergency room in the past year. That mirrors the findings of an Urban Institute study last year of patients statewide, including those who have private health insurance.

Among the Commonwealth Care patients who used the ER, the new survey found that roughly half said they needed care after doctors’ traditional daytime hours.

“Probably these folks work long hours and don’t have the same ability to be flexible with their hours [for a doctor’s appointment] as someone with a better paying job might have,’’ said Connector board member Celia Wcislo, who also is a vice president at 1199SEIU United Healthcare Workers East, a union that represents many lower-paid health care workers.

A state study last summer showed a growing reliance on ERs, even among consumers with private insurance, and officials said that trend has significant cost implications because private insurers and government programs pay substantially more for a visit to the emergency room than for a doctor appointment.

The Connector survey also found that program officials have work to do to help patients understand how to keep their coverage. Twenty percent of those surveyed said they had lost coverage at least once in the previous year. About a quarter of those patients said they did not receive a renewal form and did not know about the process. Another 16 percent said they just did not complete the paperwork.

Sarah Iselin, president of the Blue Cross Blue Shield of Massachusetts Foundation, which works to expand access to health care, is curious to see whether the Connector receives high marks next year, given the significant changes anticipated in its insurance plans.

Faced with soaring costs, vanishing resources, and an expected jump in enrollment, the Connector Authority last month pushed insurers to cut rates. Health care advocates warned that cuts would probably mean that insurance plans will offer patients a much narrower choice of hospitals and physicians, and more restrictions on use of specialists.

“That’s the way we are seeing things moving in the private system and the public market, too,’’ Iselin said. “It’s the way the world is moving.’’

The telephone and mail survey of 695 patients was commissioned by the Connector Authority and conducted by an Oregon-based market research firm from Oct. 19 to Nov. 30. The survey had a margin of error of 3.7 percentage points.

Kay Lazar can be reached at klazar@globe.com.