CAHPS child health survey for SoonerCare Choice : executive summary and technical specifications

              Oklahoma Health Care Authority
CAHPS® Child Health Survey
for SoonerCare Choice
Executive Summary and
Technical Specifications
Report for Fiscal Year 2009
Report Submitted June 2009
Submitted by:
APS Healthcare
4545 North Lincoln Boulevard
Suite 24
Oklahoma City, Oklahoma 73105
(405) 556-9700
CAHPS® Child Medicaid Survey
Fiscal Year 2009
June 2009 Page 2
CAHPS® Child Survey for SoonerCare Choice
Executive Summary
The Oklahoma Health Care Authority (OHCA) is the state’s single agency
responsible for administering Medicaid. The managed care component of this program is
known as SoonerCare Choice, which operated under a partially capitated case
management system during the first half of the state fiscal year (SFY) 2009. A patient-centered
medical home model was implemented January 1, 2009. In order to evaluate
service satisfaction, the OHCA contracted with APS Healthcare to survey the parents of
child members enrolled in SoonerCare Choice between July 1, 2008, and June 30, 2009.
The OHCA has administered Consumer Assessment of Healthcare Providers and Systems
(CAHPS) surveys to measure consumer satisfaction in the Medicaid population every
other year since 1996.
Comparing the 2007 survey and the 2009 survey, results indicated fairly high
levels of satisfaction holding steady across an array of six quality measures. Two of the
six measures showed statistically significant increases between 2007 and 2009:
• The average rating of “Your Child’s Health Plan” on a 10-point scale
increased from 8.2 to 8.7.
• The composite measure of “Getting Care Quickly” on a 4-point scale had a
significant increase from 3.50 to 3.55.
CAHPS® Child Medicaid Survey
Fiscal Year 2009
June 2009 Page 3
CAHPS® Child Medicaid Survey
Technical Specifications
SoonerCare Choice
INTRODUCTION
Consumer satisfaction surveys are an important source of information to
consumers, purchasers of health care, health plans and program administrators. By
responding to satisfaction surveys, individuals provide valuable information regarding
access to care, use of services, and satisfaction with the care they have received. To
survey the general population of managed care members about their overall experience
with their health plan, OHCA has administered Consumer Assessment of Healthcare
Providers Systems (CAHPS) surveys to SoonerCare members since 1996. CAHPS
questionnaires, administration protocol, and survey analysis were developed by Harvard,
RAND, and the Research Triangle Institute. The health care community has accepted
these methods in producing consumer satisfaction measures that may be compared across
health plans and health service delivery types.
In order to evaluate service satisfaction, the Oklahoma Health Care Authority
(OHCA) contracted with APS Healthcare to survey the members enrolled in SoonerCare
Choice between July 1, 2008, and June 30, 2009. This technical report includes
information on the survey methodology, findings, and summary information on the
respondents’ satisfaction with health plan services they received.
CAHPS® Child Medicaid Survey
Fiscal Year 2009
June 2009 Page 4
METHODOLOGY
The CAHPS Questionnaire
The Child CAHPS Health Plan Survey 4.0 questionnaire (shown in Appendix A)
was administered by The Myers Group (TMG) between August 1 and November 1, 2009.
The questionnaire covered several aspects of health plan performance, including:
• Rating of personal doctors, specialists, health care received, and health plan
• Receiving care without long waits
• Communication with clinicians
• Health plan information and customer service
• Getting needed care
Sampling
Because it is not feasible to survey the entire SoonerCare Choice population,
TMG used recognized sampling techniques to obtain information from a limited number
of members. This information is used to estimate the consumer satisfaction of the
SoonerCare Choice population as a whole.
Sampling for this survey followed CAHPS 4.0 protocols with one exception;
APS limited the sample to members with at least one paid claim from a SoonerCare
Choice provider. APS provided TMG with a list of eligible members for sample
selection. Each member included in the eligibility list met the following criteria:
• 17 years of age or younger as of June 30, 2009;
• Enrolled in the SoonerCare Choice program as of June 30, 2009; and
• Continuously enrolled in SoonerCare Choice between July 1, 2008, and June 30,
2009. (Continuous enrollment was defined as having no more than one 45-day
break in enrollment during the year.)
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Fiscal Year 2009
June 2009 Page 5
In accordance with CAHPS recommendations, and to reduce the burden on
respondents, TMG only selected one member from a household for the sample. The
CAHPS Survey and Reporting Kit 4.0 standards indicate that a minimum of 300
completed surveys are needed for a valid administration. The total number of members
eligible for the survey was 260,152; TMG selected a random sample of 1,650 members.
Data Collection
The CAHPS survey methodology allowed data to be collected by mail, telephone
interview, or a combination of mail and telephone. The OHCA and APS agreed to
conduct these surveys using mail, and incorporated telephone interviewing only when the
targeted response rate was not received. The survey process had outreach interventions
that included mailings of the survey packet, reminder postcards, and phone follow-up
with interviewers.
After the sample was selected, address lists were processed using the U.S. Postal
Service’s CASS Certified ZIP + 4 Coding Software, which verified the zip code for each
address. Each packet included a questionnaire and a letter that explained the purpose and
the importance of the survey. To encourage participation, the packet also contained a
postage-paid business reply envelope. Reminder postcards served to thank individuals
who had responded to the survey and to remind others to complete their questionnaires.
Members selected for the sample who did not respond to the first survey and/or postcard
mailings were mailed a second survey. All correspondence included a toll-free number
that members could use to contact TMG with questions regarding the survey, or to
complete the survey over the telephone. Each information letter contained a statement
written in Spanish asking the member to call the toll-free number to take the survey by
phone with a Spanish interpreter. If needed, follow-up calls were then initiated with
bilingual interviewers.
TMG developed a database to track the status of members selected for the sample
at each stage of the survey protocol. The database identified members who had not
returned the survey and needed subsequent mailings. The database also indicated the
date that a member responded to the survey, refused to participate in the survey, or was
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Fiscal Year 2009
June 2009 Page 6
determined to be ineligible for the survey. Members were determined to be ineligible for
the survey if they no longer qualified for SoonerCare or had moved to another state.
Data Coding and Data Entry
TMG recorded the responses to the questionnaires in a database specifically
designed for this purpose. The data entry program permitted the entry of only those
responses that were within the accepted range for each specific item; for example, if a
rating was supposed to be on a scale of 0 to 10, a response of 12 could not be entered.
TMG performed a data clean-up process prior to the actual analysis to detect any
additional out-of-range values and response inconsistencies. Typically, inconsistencies
occurred when respondents did not follow the skip pattern of question groups. Whenever
feasible, TMG recoded the items to conform to the questionnaire skip patterns; for
example, if one response indicated the person did not receive health plan forms to fill out,
then any subsequent responses to questions about the ease of completing these forms
were discarded. However, when the intent of the respondent could not be determined, the
analyst recoded the item as missing.
Data Analysis
All analyses and calculations in the study were performed by APS using SAS 9.2,
including the standard CAHPS analysis macro “cc250_cahps36b.sas”. Frequencies were
computed for all the items on the survey. Due to the lengthy results for this type of
analysis, the frequency distributions are reported in Appendix B rather than in the results
section.
The statistical analysis consisted of comparing this year’s survey results with
those from the previous administration of the survey, which was in state fiscal year (SFY)
2007, using the t-test statistic for difference of means as incorporated in the standard
CAHPS analysis macro.
Global ratings, which used a scale of 0 to 10, measured the respondents’
assessment of their health plan and the quality of the care received. APS computed the
means for each global rating and used a t-test to compare means from the SFY 2007 and
CAHPS® Child Medicaid Survey
Fiscal Year 2009
June 2009 Page 7
SFY 2009 SoonerCare Choice surveys. Four global ratings were compared between SFY
2009 and SFY 2007:
• Overall Rating of Child’s Health Care
• Overall Rating of Child’s Personal Doctor
• Overall Rating of Child’s Specialist
• Overall Rating of Child’s Health Plan
Composite measures combine the responses to questions that are closely related to
each other and provide more reliable results than comparing each item separately. APS
computed the mean scores for each composite and used t-tests to compare means from
the SFY 2007 and SFY 2009 SoonerCare Choice surveys. The two composites that can
be compared are:
• Experiences in Getting Treatment Quickly
• Experiences with How Well Clinicians Communicate
Because of changes in the CAHPS questionnaire Version 3 used in 2007 and
Version 4 used in 2009, not all of the quality measures were comparable between years;
specifically, the measures “Getting Needed Care” and “Plan Information and Customer
Service” are omitted from the comparison.
SURVEY RESULTS
Table 1 shows the response rate by method for the current year’s survey and the
previous administration of the survey from SFY 2007.
Table 1. Completed Surveys Rate by Method each Survey by Year
Completed Surveys SFY 2009 Survey SFY 2007 Survey
Mailing 373 401
Phone Follow-Up 273 36
Total Completed Surveys 646 437
The study evaluated each returned questionnaire to determine if it met the CAHPS
definition for a completed survey. To be considered complete, a questionnaire must have
CAHPS® Child Medicaid Survey
Fiscal Year 2009
June 2009 Page 8
had at least one answered question. APS coded returned questionnaires that did not pass
the completion criteria as non-respondents and excluded them from the analysis.
Additionally, returned surveys received by TMG included refusals returned by mail and
those from SoonerCare Choice members who had moved out of state or were not in the
plan.
The adjusted response rate, expressed as a percentage, is the number of completed
surveys divided by the number of eligible surveys.
Adjusted response rate = Number of completed surveys x 100
Number of eligible surveys
(total completes) 646
(Sample) –(Ineligible)
=
1650 – 129
x 100 = 42.5%
The adjusted response rates for the current SoonerCare Choice survey was 42.5%;
the adjusted response rates for the previous SoonerCare Choice survey was 27.6%. The
difference in response rates may be attributable to the decision in 2009 to limit the
sampling frame to participants who had a paid claim with a primary care provider.
Table 2 displays the disposition of surveys deemed ineligible by number and
percentage for SFY 2009.
Table 2. Number of Ineligible Surveys and Total Percentage of Ineligible Surveys
for SFY 2009
Ineligible Disposition N %
Mentally/Physically Incapacitated 2 0.12
Language Barrier 63 3.82
Does Not Meet Criteria 64 3.88
Total Ineligibles 129 7.82
The table above lists the number and dispositions of members from the sample who were
identified as ineligible to participate in the survey.
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Fiscal Year 2009
June 2009 Page 9
Demographics
Respondents were asked the child’s race and ethnicity. Figure 1 shows these
results.
Figure 1. Children’s Reported Racial Identity
Caucasian
32.2%
Asian
5.0%
American
Indian
6.5%
African
American
30.6%
Multiracial /
Other
25.6%
Results showed that Caucasians and African Americans were nearly equally represented
at 32% and 31%, respectively. Native Americans represented 6.5% of the children, 5%
were Asian, and one-fourth of the children were reported to be multiracial. In response to
a separate question about ethnicity, parents/guardians reported 18% of the children to be
Hispanic or Latino.
Global Ratings
In Figures 2 through 5, the overall ratings are shown for the following:
• The child’s health care received.
• The child’s personal doctor.
• The child’s specialist.
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Fiscal Year 2009
June 2009 Page 10
• The child’s health plan.
The means for the global rating items for the two years are shown in bar graphs.
The table below each graph lists the number of respondents analyzed, the means, and the
p-value associated with the t-test of mean difference between the two years. A p-value
less than .05 was considered statistically significant. That is, if the p-value was less than
.05, the two means were statistically different from each other; otherwise, the two means
were not statistically different. *
*A statistical note: The standard CAHPS analysis algorithm does not assume equal variances, but it did not
compute a difference between the OHCA results for SFY 2007 and SFY 2009. APS used SAS PROC
TTEST to compute the significance of difference between years. Reported p-values are from pooled tests
with equal variances assumed. Only two questions failed a test of equal variances, but the decision on the
hypothesis test of equal means would have been the same with a t-test that did not assume equal variances.
CAHPS® Child Medicaid Survey
Fiscal Year 2009
June 2009 Page 11
Overall Rating of Health Care Received
• Using any number from 0 to 10, where 0 is the worst health care possible and 10
is the best health care possible, what number would you use to rate all your
child’s health care in the last 6 months?
Figure 2. Rating of Child’s Health Care Received
8.34
8.37
0 1 2 3 4 5 6 7 8 9 10
2007
2009
Mean
Year N Mean p-value
2009 487 8.37
2007 341 8.34
.8125
Figure 2 demonstrates that SoonerCare Choice parents remained fairly satisfied with the
health care their child received in 2009 compared with the ratings in 2007. The slight
increase was not statistically significant.
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Fiscal Year 2009
June 2009 Page 12
Overall Rating for Personal Doctor
• Using any number from 0 to 10, where 0 is the worst personal doctor possible and
10 is the best personal doctor possible, what number would you use to rate your
child’s personal doctor in the last 6 months?
Figure 3. Overall Rating for Child’s Personal Doctor
8.42
8.64
0 1 2 3 4 5 6 7 8 9 10
2007
2009
Mean
Year N Mean p-value
2009 527 8.64
2007 342 8.42
.0984
Figure 3 shows that SoonerCare Choice parents were highly satisfied with their child’s
personal doctor in 2009 compared with 2007. The slight increase in satisfaction was not
significant.
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Fiscal Year 2009
June 2009 Page 13
Overall Rating for Child’s Specialist
• We want to know your rating of the specialist your child saw most often in the last
6 months. Using any number from 0 to 10, where 0 is the worst specialist
possible and 10 is the best specialist possible, what number would you use to rate
that specialist?
Figure 4. Overall Rating for Child’s Specialist
8.50
8.46
0 1 2 3 4 5 6 7 8 9 10
2007
2009
Mean
Year N Mean p-value
2009 124 8.46
2007 88 8.50
.8812
Figure 4 shows that SoonerCare Choice parents were highly satisfied with their child’s
specialist doctor seen most often in 2009 compared with 2007. The slight decrease was
not statistically significant.
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Fiscal Year 2009
June 2009 Page 14
Overall Rating for Child’s Health Plan
• Using any number from 0 to 10, where 0 is the worst health plan possible and 10
is the best health plan possible, what number would you use to rate your child’s
health plan?
Figure 5. Overall Rating for Child’s Health Plan
8.24
8.73
0 1 2 3 4 5 6 7 8 9 10
2007
2009
Mean
Year N Mean p-value
2009 628 8.73
2007 430 8.24
<.0001
Figure 5 shows that SoonerCare Choice parents were more satisfied with their child’s
health plan in 2009 compared with 2007. The increase from 2007 to 2009 was
statistically significant.
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Fiscal Year 2009
June 2009 Page 15
Composite Measures
In Figures 6 and 7, composite measures for the following services are provided:
• Experiences in getting treatment quickly
• Experiences with how well clinicians communicate
These questions are answered on a four-point ordinal scale, where 1= “never,” 2 =
“sometimes,” 3 = “usually,” and 4 = “always.” Responses of “never” and “sometimes”
were combined into one category for the purpose of graphing since there were small
percentages in those categories. The mean of the four-point scale was computed and
compared between years using a t-test, following standard CAHPS analysis protocol.
The percentage in each category for the composite measures is shown in the bar graph.
The table below each graph lists the number of respondents analyzed, the means and the
p-value associated with the t-test comparison of means.
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Fiscal Year 2009
June 2009 Page 16
Getting Treatment Quickly
• In the last 6 months, when your child needed care right away, how often did your
child get care as soon as you thought he or she needed?
• In the last 6 months, not counting the times your child needed care right away,
how often did you get an appointment for health care at a doctor’s office or clinic
as soon as you thought your child needed?
Figure 6. Getting Treatment Quickly
18.61%
12.36%
29.50%
17.36%
51.89%
70.28%
0% 20% 40% 60% 80% 100%
2007
2009
Never/Sometimes Usually Always
Year N Mean p-value
2009 514 3.57
2007 328 3.29
.0003
Figure 6 shows that 70.28% of the respondents in 2009 reported they always
received treatment quickly. This is substantially more than in 2007 when 51.89%
reported that they always received treatment quickly.
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Fiscal Year 2009
June 2009 Page 17
How Well Clinicians Communicate
• In the last 6 months, how often did your child’s personal doctor explain things in
a way that was easy to understand?
• In the last 6 months, how often did your child’s personal doctor listen carefully to
you?
• In the last 6 months, how often did your child’s personal doctor show respect for
what you had to say?
• In the last 6 months, how often did your child’s personal doctor explain things in
a way that was easy for your child to understand?
• In the last 6 months, how often did your child’s personal doctor spend enough
time with your child?
Figure 7. How Well Clinicians Communicate
12.06%
12.62%
22.36%
16.95%
65.58%
70.42%
0% 20% 40% 60% 80% 100%
2007
2009
Never/Sometimes Usually Always
Year N Mean p-value
2009 429 3.55
2007 350 3.50
.3022
CAHPS® Child Medicaid Survey
Fiscal Year 2009
June 2009 Page 18
Figure 7 indicates that 70.42% of members felt that their clinicians always
communicated well during SFY 2009. This is an increase from 65.58% in SFY 2007;
however, the increase in average score was not statistically significant.
Discussion
Overall, the 2009 survey results indicated reasonably high levels of satisfaction
holding steady across an array of six quality measures when compared to 2007. Two
quality measures, the rating of “Your Child’s Health Plan” and “Getting Care Quickly,”
had statistically significant differences between SFY 2007 and SFY 2009. The average
rating of “Your Child’s Health Plan” on a 10-point scale increased from 8.2 to 8.7. How
members rate their health plan is an important indicator of plan quality. Satisfaction is
influenced by the quality of services provided by the plan and the quality of care
provided by the plan. The composite measure of “Getting Care Quickly” on a four-point
scale had a significant increase from 3.50 to 3.55. This measure is a key indicator of
access to care. The ability to make appointments and see a provider is important to
ensuring that illness is prevented or that an existing illness does not progress further.
In SFY 2009 APS introduced a new sampling methodology that involved limiting
the sampling frame to members with paid claims. Using this method, the number of
completed survey responses increased by 47.8% when compared to the SFY 2007. The
increase in completed surveys also contributed to an adjusted response rate which was
54% higher than the previous years. It appears to be a successful method in that
members utilizing SoonerCare services are more likely to have an opinion on their health
care plan. APS recommends the OHCA continue to follow the new sampling
methodology for future surveys.
Appendix A
CAHPS® Child Medicaid Survey
Fiscal Year 2009
June 2009 Page 21
Appendix B
Below are the responses by survey question. There were 646 total respondents.
Frequencies depicted in the tables reflect the number of people responding to each item;
percentages depicted in the tables reflect the total number of respondents to the particular
question.
1. Our records show that your child is now in SoonerCare
Choice. Is that right?
Q1 Frequency Percent
Yes 639 100.00
3. In the last 6 months, did your child have an illness,
injury, or condition that needed care right away in a clinic,
emergency room, or doctor’s office?
Q3 Frequency Percent
Yes 286 44.55
No 356 55.45
Item Totals 642 100.00
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Fiscal Year 2009
June 2009 Page 22
4. In the last 6 months, when your child needed care right
away, how often did your child get care as soon as you
thought he or she needed?
Q4 Frequency Percent
Never 2 0.71
Sometimes 24 8.57
Usually 41 14.64
Always 213 76.07
Item Totals 280 100.00
5. In the last 6 months, not counting the times your child
needed care right away, did you make any appointments
for your child’s health care at a doctor’s office or clinic?
Q5 Frequency Percent
Yes 480 75.24
No 158 24.76
Item Totals 638 100.00
6. In the last 6 months, not counting the times your child
needed care right away, how often did you get an
appointment for health care at a doctor’s office or clinic
as soon as you thought your child needed?
Q6 Frequency Percent
Never 10 2.11
Sometimes 63 13.32
Usually 95 20.08
Always 305 64.48
Item Totals 473 100.00
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Fiscal Year 2009
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7. In the last 6 months, not counting the times your child
went to an emergency room, how many times did he or
she go to a doctor’s office or clinic to get health care?
Q7 Frequency Percent
0 135 21.13
1 154 24.10
2 145 22.69
3 84 13.15
4 55 8.61
5 48 7.51
6 18 2.82
Item Totals 639 100.00
8. In the last 6 months, how often did you and your
child’s doctor or other health provider talk about specific
things you could do to prevent illness in your child?
Q8 Frequency Percent
Never 77 15.46
Sometimes 116 23.29
Usually 98 19.68
Always 207 41.57
Item Totals 498 100.00
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Fiscal Year 2009
June 2009 Page 24
9. In the last 6 months, did your child’s doctor or other
health provider tell you there was more than one choice
for your child’s treatment or healthcare?
Q9 Frequency Percent
Yes 217 44.11
No 275 55.89
Item Totals 492 100.00
10. In the last 6 months, did your child’s doctor or other
health provider talk with you about the pros and cons of
each choice for your child’s treatment or health care?
Q10 Frequency Percent
Definitely Yes 148 68.20
Somewhat Yes 52 23.96
Somewhat No 11 5.07
Definitely No 6 2.76
Item Totals 217 100.00
11. In the last 6 months, when there was more than one
choice for your child’s treatment or healthcare, did your
child’s doctor or other health provider ask you which
choice you thought was best for your child?
Q11 Frequency Percent
Definitely Yes 139 64.65
Somewhat Yes 51 23.72
Somewhat No 11 5.12
Definitely No 14 6.51
Item Totals 215 100.00
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Fiscal Year 2009
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12. Using any number from 0 to 10, where 0 is the worst
health care possible and 10 is the best health care possible,
what number would you use to rate all your child’s health
care in the last 6 months?
Q12 Frequency Percent
0 Worst 2 0.41
2 2 0.41
3 6 1.23
4 5 1.03
5 40 8.21
6 22 4.52
7 47 9.65
8 92 18.89
9 72 14.78
10 Best 199 40.86
Item Totals 487 100.00
13. A personal doctor is the one your child would see if he or
she needs a check-up or gets sick or hurt. Does your child
have a personal doctor?
Q13 Frequency Percent
Yes 535 84.65
No 97 15.35
Item Totals 632 100.00
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Fiscal Year 2009
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14. In the last 6 months, how many times did your child visit
his or her personal doctor for care?
Q14 Frequency Percent
0 102 19.21
1 142 26.74
2 130 24.48
3 62 11.68
4 47 8.85
5 35 6.59
6 13 2.45
Item Totals 531 100.00
15. In the last 6 months, how often did your child’s personal
doctor explain things in a way that was easy to understand?
Q15 Frequency Percent
Never 5 1.17
Sometimes 29 6.79
Usually 76 17.80
Always 317 74.24
Item Totals 427 100.00
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Fiscal Year 2009
June 2009 Page 27
16. In the last 6 months, how often did your child’s personal
doctor listen carefully to you?
Q16 Frequency Percent
Never 6 1.42
Sometimes 43 10.14
Usually 64 15.09
Always 311 73.35
Item Totals 424 100.00
17. In the last 6 months, how often did your child’s personal
doctor show respect for what you had to say?
Q17 Frequency Percent
Never 9 2.14
Sometimes 34 8.08
Usually 49 11.64
Always 329 78.15
Item Totals 421 100.00
18. Is your child able to talk with doctors about his or her
health care?
Q18 Frequency Percent
Yes 263 62.47
No 158 37.53
Item Totals 421 100.00
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Fiscal Year 2009
June 2009 Page 28
19. In the last 6 months, how often did your child’s personal
doctor explain things in a way that was easy for your child to
understand?
Q19 Frequency Percent
Never 17 6.56
Sometimes 30 11.58
Usually 46 17.76
Always 166 64.09
Item Totals 259 100.00
20. In the last 6 months, how often did your child’s personal
doctor spend enough time with your child?
Q20 Frequency Percent
Never 13 3.04
Sometimes 52 12.18
Usually 96 22.48
Always 266 62.30
Item Totals 427 100.00
21. In the last 6 months, did your child’s personal doctor talk with
you about how your child is feeling, growing, or behaving?
Q21 Frequency Percent
Yes 357 84.60
No 65 15.40
Item Totals 422 100.00
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Fiscal Year 2009
June 2009 Page 29
22. In the last 6 months, did your child get care from a doctor or
other health provider besides his or her personal doctor?
Q22 Frequency Percent
Yes 181 42.79
No 242 57.21
Item Totals 423 100.00
23. In the last 6 months, how often did your child’s personal
doctor seem informed and up-to-date about the care your child
got from these doctors or other health care providers?
Q23 Frequency Percent
Never 20 11.63
Sometimes 16 9.30
Usually 48 27.91
Always 88 51.16
Item Totals 172 100.00
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Fiscal Year 2009
June 2009 Page 30
24. Using any number from 0 to 10, where 0 is the worst personal
doctor possible and 10 is the best personal doctor possible, what
number would you use to rate your child’s personal doctor?
Q24 Frequency Percent
0 Worst 2 0.38
1 5 0.95
2 3 0.57
3 7 1.33
4 10 1.90
5 19 3.61
6 23 4.36
7 35 6.64
8 73 13.85
9 81 15.37
10 Best 269 51.04
Item Totals 527 100.00
25. Specialists are doctors like surgeons, heart doctors, allergy
doctors, skin doctors, and other doctors who specialize in one area
of health care. In the last 6 months, did you try to make any
appointments for your child to see a specialist?
Q25 Frequency Percent
Yes 150 23.51
No 488 76.49
Item Totals 638 100.00
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Fiscal Year 2009
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26. In the last 6 months, how often was it easy to get
appointments for your child with specialists?
Q26 Frequency Percent
Never 11 7.43
Sometimes 32 21.62
Usually 42 28.38
Always 63 42.57
Item Totals 148 100.00
27. How many specialists has your child seen in the last 6
months?
Q27 Frequency Percent
0 19 12.75
1 91 61.07
2 29 19.46
3 5 3.36
4 2 1.34
5 3 2.01
Item Totals 149 100.00
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Fiscal Year 2009
June 2009 Page 32
28. Using any number from 0 to 10, where 0 is the worst specialist
possible and 10 is the best specialist possible, what number would
you use to rate that specialist?
Q28 Frequency Percent
0 Worst 1 0.81
3 3 2.42
4 2 1.61
5 5 4.03
6 10 8.06
7 10 8.06
8 16 12.90
9 21 16.94
10 Best 56 45.16
Item Totals 124 100.00
29. In the last 6 months, did you try to get any kind of care,
tests, or treatment for your child through his or her health
plan?
Q29 Frequency Percent
Yes 239 38.00
No 390 62.00
Item Totals 629 100.00
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Fiscal Year 2009
June 2009 Page 33
30. In the last 6 months, how often was it easy to get the care,
tests, or treatment you thought your child needed through his
or her health plan?
Q30 Frequency Percent
Never 12 5.06
Sometimes 29 12.24
Usually 59 24.89
Always 137 57.81
Item Totals 237 100.00
31. In the last 6 months, did you try to get information or help
from customer service at your child’s health plan?
Q31 Frequency Percent
Yes 78 12.40
No 551 87.60
Item Totals 629 100.00
32. In the last 6 months, how often did customer service at
your child’s health plan give you the information or help you
needed?
Q32 Frequency Percent
Never 4 5.41
Sometimes 18 24.32
Usually 23 31.08
Always 29 39.19
Item Totals 74 100.00
CAHPS® Child Medicaid Survey
Fiscal Year 2009
June 2009 Page 34
33. In the last 6 months, how often did customer service staff
at your child’s health plan treat you with courtesy and
respect?
Q33 Frequency Percent
Never 3 4.23
Sometimes 11 15.49
Usually 15 21.13
Always 42 59.15
Item Totals 71 100.00
34. In the last 6 months, did your child’s health plan give you
any forms to fill out?
Q34 Frequency Percent
Yes 154 24.96
No 463 75.04
Item Totals 617 100.00
35. In the last 6 months, how often were the forms from your
child’s health plan easy to fill out?
Q35 Frequency Percent
Never 3 2.01
Sometimes 16 10.74
Usually 50 33.56
Always 80 53.69
Item Totals 149 100.00
CAHPS® Child Medicaid Survey
Fiscal Year 2009
June 2009 Page 35
36. Using any number from 0 to 10, where 0 is the worst health
plan possible and 10 is the best health plan possible, what
number would you use to rate your child’s health plan?
Q36 Frequency Percent
1 1 0.16
3 3 0.48
4 6 0.96
5 33 5.25
6 29 4.62
7 39 6.21
8 117 18.63
9 97 15.45
10 Best 303 48.25
Item Totals 628 100.00
37. In general, how would you rate your child’s overall health?
Q37 Frequency Percent
Excellent 243 38.15
Very Good 230 36.11
Good 126 19.78
Fair 34 5.34
Poor 4 0.63
Item Totals 637 100.00
CAHPS® Child Medicaid Survey
Fiscal Year 2009
June 2009 Page 36
38. What is your child’s age?
Q38 Frequency Percent
0 13 2.13
1 38 6.23
2 52 8.52
3 48 7.87
4 42 6.89
5 39 6.39
6 40 6.56
7 36 5.90
8 32 5.25
9 35 5.74
10 32 5.25
11 29 4.75
12 24 3.93
13 30 4.92
14 24 3.93
15 27 4.43
16 34 5.57
17 30 4.92
18 5 0.82
Item Totals 610 100.00
39. Is your child male or female?
Q39 Frequency Percent
Male 320 50.08
Female 319 49.92
Item Totals 639 100.00
CAHPS® Child Medicaid Survey
Fiscal Year 2009
June 2009 Page 37
40. Is your child of Hispanic or Latino origin or descent?
Q40 Frequency Percent
Yes 115 18.25
No 515 81.75
Item Totals 630 100.00
41. Child's race
Race Frequency Percent
Caucasian 187 32.19
African American 178 30.64
American Indian 38 6.54
Asian 29 4.99
Multiracial / Other 149 25.65
Item Totals 581 100.00
* Respondents who selected more than one race were grouped into the
multiracial/other category.
CAHPS® Child Medicaid Survey
Fiscal Year 2009
June 2009 Page 38
42. What is your age?
Q42 Frequency Percent
Under 18 280 43.55
18-24 80 12.44
25-34 127 19.75
35-44 94 14.62
45-54 36 5.60
55-64 16 2.49
65-74 7 1.09
75 or older 3 0.47
Item Totals 643 100.00
43. Are you male or female?
Q43 Frequency Percent
Male 32 8.42
Female 348 91.58
Item Totals 380 100.00
CAHPS® Child Medicaid Survey
Fiscal Year 2009
June 2009 Page 39
44. What is the highest grade or level of school that you have
completed?
Q44 Frequency Percent
8th grade or less 66 10.39
Some high school 162 25.51
HS grad or GED 215 33.86
Some college 142 22.36
College grad 40 6.30
More than 4yr
college
10 1.57
Item Totals 635 100.00
45. How are you related to the child?
Q45 Frequency Percent
Mother or father 365 57.12
Grandparent 260 40.69
Aunt or uncle 2 0.31
Other relative 1 0.16
Legal guardian 11 1.72
Item Totals 639 100.00
46. Did someone help you complete this survey?
Q46 Frequency Percent
Yes 20 5.42
No 349 94.58
Item Totals 369 100.00
CAHPS® Child Medicaid Survey
Fiscal Year 2009
June 2009 Page 40
47. Kind of Help:
Q47A-Q47E Frequency
Read the questions to me 6
Wrote down the answers I gave 4
Answered the questions for me 3
Translated the questions into my language 9
Helped in some other way 1
* Respondents could select more than one kind of help. Percentages
were not computed because of low response rate (the 20 people who
responded “yes” on Question 46).
48. In the last 6 months, how often did you have a hard time
speaking with or understanding your child's doctors or other
health providers because you spoke different languages?
Q48 Frequency Percent
Never 547 87.66
Sometimes 56 8.97
Usually 13 2.08
Always 8 1.28
Item Totals 624 100.00
49. What language do you mainly speak at home?
Q49 Frequency Percent
English 578 91.31
Spanish 50 7.90
Other 5 0.79
Item Totals 633 100.00
CAHPS® Child Medicaid Survey
Fiscal Year 2009
June 2009 Page 41
50. What language does your child mainly speak at home?
Q50 Frequency Percent
English 579 93.09
Spanish 38 6.11
Other 5 0.80
Item Totals 622 100.00