Core for Health Plan 3.2

CORE 39 - Consumer Satisfaction

Submited by: Tom Goddard

The Basics

This short standard requires that your organization have a mechanism to collect information about your consumers' satisfaction.
This often is done in the form of customer satisfaction surveys, consumer complaints, and sometimes even focus groups. Find out what your organization does -- it's likely more than one mechanism.

Management Tips

It is not merely important that you collect information about consumer satisfaction. URAC typically looks for evidence that this process is built right into your operations. This means that you have P&Ps that address this issue. It also might mean that you use multiple mechanisms to collect this information.  
Perhaps as important as the fact that you collect this information is that you do something with it. Make sure reports regarding consumer satisfaction regularly go to your quality management committee, and that the committee minutes reflect that. Data alone are pretty useless -- make sure you document that your organization does something with those data.

Accreditation Tips

Desktop Review
For your AccreditNet submission, present both your P&Ps or program description that describe your consumer satisfaction data collection mechanisms and evidence that you've implemented those policies. That evidence will come in the form of sample survey reports or tracking and trending reports of consumer complaints. If you have a template consumer satisfaction questionnaire, submit that, too.
Validation Review
Management personnel will have an opportunity to discuss consumer satisfaction with the reviewer.
Document Review
During the onsite review, the URAC reviewer will examine QM committee minutes for evidence that the committee receives the appropriate reports on consumer satisfaction.