• CMS Survey Shows that 72 Percent of Providers are Satisfied with their Contractor’s Overall Performance
  • September 15, 2011
  • Law Firm: King Spalding LLP - Atlanta Office
  • According to the Centers for Medicare and Medicaid Services’s (CMS) Medicare Contractor Provider Satisfaction Survey (MCPSS or Survey) dated July 29, 2011, nearly three-fourths (72 percent) of providers are satisfied or very satisfied with their Medicare contractor’s overall performance. The Survey shows that approximately 13 percent of providers are dissatisfied or very dissatisfied with their contractor’s performance. According to the MCPSS, contractor satisfaction scores changed little between 2010 and 2011. The MCPSS elicits information from all provider types, including hospitals, physicians, skilled nursing facilities, and laboratories. The Survey noted that satisfaction with Part B Medicare Administrative Contractors (MACs) was lower than the other contractor types with 15 percent of providers expressing dissatisfaction.

    The MCPSS includes satisfaction results for the following contractor types:

    • Fiscal Intermediaries (FI);
    • Carriers;
    • Part A MACs;
    • Part B MACs;
    • Durable Medical Equipment (DME) MACs; and
    • Regional Home Health Intermediaries.

    Notably absent from the contractor types included in the Survey are Recovery Audit Contractors (RACs) and Zone Program Integrity Contractors (ZPICs). Among the various provider types participating in the Survey, home health agencies and hospices expressed the highest rates of satisfaction and the lowest rates of dissatisfaction. The Survey also shows provider satisfaction by business function for each of the six contractor types. The seven business functions reviewed were: (1) provider inquiries; (2) provider outreach and education; (3) claims processing; (4) appeals; (5) provider enrollment; (6) medical review; and (7) provider audit and reimbursement. Survey results indicate that typically contractor satisfaction exceeds 60 percent for the various business functions. However, provider satisfaction with Part B MACs for four of the six business functions was lower than 60 percent, with provider enrollment satisfaction being only 47 percent.

    The Survey also identifies contractor activities with potential for improving provider satisfaction. According to the Survey, providers identified 13 elements of business-function performance as having the potential to increase provider satisfaction. For example, providers identified the following three items more than once as opportunities for improvement in overall satisfaction:

    • Ability to fully resolve problems without a provider having to make multiple inquiries;
    • Mechanisms offered for exchanging information about first-level appeals; and
    • After leaving a message, the average time before receiving a return call.