Fillable 140912 Feedback Survey Instrument (Commonwealth of Massachusetts)

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140912 Feedback Survey Instrument (Commonwealth of Massachusetts)

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Page 1
One Care Implementation Council Provider Feedback SurveyOne Care Implementation Council Provider Feedback SurveyOne Care Implementation Council Provider Feedback SurveyOne Care Implementation Council Provider Feedback Survey
TheOneCareImplementationCouncilisgatheringfeedbackandinputfromprovidersregardingtheirexperienceswith
OneCare.ThisisanimportantopportunityfortheprovidercommunitytogivedirectfeedbacktotheImplementation
Council(Council)ontheirexperiencesandsatisfactionwithOneCareandtohelpshapetheCouncil’spriorities.
Asyoumayknow,OneCareisanewintegratedhealthcareoptionforadultsages21to64whoareeligibleforboth
MassHealthandMedicare.OneCareisservingover18,800Massachusettsresidentsacrossninecountieswiththegoal
ofintegratingthedeliveryofmedicalcare,behavioralhealthcareandlong
termservicesandsupports.
TheImplementationCouncildevelopedaconfidential10
minuteonlinesurveytolearnhowOneCareisworkingforyou
andthepeopleyouserve.
TheCouncilwasconvenedbytheMassachusettsExecutiveOfficeofHealthHumanServices
(EOHHS)toplayakeyroleinprovidingsupportandinputtotheEOHHSregardingtheimplementationofOneCare.
The
CouncilwillusetheinformationitcollectsfromthissurveytoinformandmakerecommendationstoEOHHS.
Thankyoufortakingtimetimetocompletethisimportantsurvey.
ThesurveywillremainopenuntilAugust28th2014.
Survey Intro
Page 2
One Care Implementation Council Provider Feedback SurveyOne Care Implementation Council Provider Feedback SurveyOne Care Implementation Council Provider Feedback SurveyOne Care Implementation Council Provider Feedback Survey
ThepurposeofthissurveyistocollectdataonOneCareproviderexperienceswithOneCare.Datacollectedfromthis
surveywillassisttheImplementationCounciltomonitortheimplementationofOneCareandprovidevaluablefeedbackto
MassHealth.
Thissurveyisbeingcollectedanonymously,thatis,withoutanynamesidentified(unlesstherespondentvolunteers
his/hername).Respondentsmayvoluntarilyprovidetheirnameandcontactinformation;however,surveydatawillnotbe
associatedwithanindividualrespondent.
Multiplechoicesurveyresponseswillbepublishedasoverallresponsesonly(ex:
“
14respondentssaidYes
”
).Some
open
endedresponsesmaybepublishedtocommunicateaconceptraisedbyrespondents.
Tomaintainconfidentiality,eachrespondentisresponsibleforensuringthatentriesdonotcontaininformationthatwould
identifyanorganizationormember.
OnlystafffromUMassMedicalSchoolconductingtheresearchwillhaveaccesstotherawsurveyresults.
Ifyouhaveanyquestionsaboutthesurvey,pleasecontact,KateRussellatKate.Russell@umassmed.edu
Privacy Statement
Page 3
One Care Implementation Council Provider Feedback SurveyOne Care Implementation Council Provider Feedback SurveyOne Care Implementation Council Provider Feedback SurveyOne Care Implementation Council Provider Feedback Survey
1. Identify your provider category or categories. (Please check all that apply)
AgingServicesAccessPoint
gfedc
CommunityBehavioralHealthCenter
gfedc
CommunityHealthCenter
gfedc
HomeHealthAgency
gfedc
IndependentLivingCenter
gfedc
IndividualswithDevelopmentalDisabilitiesProvider
gfedc
Hospital:General
gfedc
Hospital:Psychiatric
gfedc
Hospital:Special(e.g.Rehabilitation)
gfedc
PhysicianOrganization:PrimaryCarePractice
gfedc
PhysicianOrganization:SpecialtyGroup
gfedc
RecoveryLearningCommunity
gfedc
Other(pleasespecify)
gfedc
Page 4
One Care Implementation Council Provider Feedback SurveyOne Care Implementation Council Provider Feedback SurveyOne Care Implementation Council Provider Feedback SurveyOne Care Implementation Council Provider Feedback Survey
2. Annual number of people served by your organization:
3. Total One Care enrollees served as of today:
4. How many One Care plans does your organization have contracts with? (Please check
all that apply)
Demographics
CommonwealthCareAlliance
gfedc
FallonTotalCare
gfedc
NetworkHealthUnify
gfedc
Page 5
One Care Implementation Council Provider Feedback SurveyOne Care Implementation Council Provider Feedback SurveyOne Care Implementation Council Provider Feedback SurveyOne Care Implementation Council Provider Feedback Survey
Pleaserateyoursatisfactionwiththeplansandincludeanycommentsasnecessary.
5. Contracting and Billing: Please rate your overall satisfaction with......
6. Communication: Please rate your overall satisfaction with.....
7. Services and Performance: Rate your overall satisfaction with....
Overall Satisfaction
VeryDissatisfied
Dissatisfied
NeitherSatisfied
norDissatisfied
Satisfied
VerySatisfied
NotApplicable
(N/A)
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VeryDissatisfied
Dissatisfied
NeitherSatisfied
norDissatisfied
Satisfied
VerySatisfied
NotApplicable
(N/A)
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VeryDissatisfied
Dissatisfied
NeitherSatisfied
norDissatisfied
Satisfied
VerySatisfied
NotApplicable
(N/A)
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Comments:
Comments:
Comments:
Page 6
One Care Implementation Council Provider Feedback SurveyOne Care Implementation Council Provider Feedback SurveyOne Care Implementation Council Provider Feedback SurveyOne Care Implementation Council Provider Feedback Survey
8. What has been the most positive aspect of One Care?
9. What has been the most challenging aspect of One Care?
Open
Ended Questions
Page 7
One Care Implementation Council Provider Feedback SurveyOne Care Implementation Council Provider Feedback SurveyOne Care Implementation Council Provider Feedback SurveyOne Care Implementation Council Provider Feedback Survey
ThankyouforthecompletingtheOneCareImplementationCouncilProviderFeedbackSurvey.Onthispageyouhave
theoptiontoprovideyournameandcontactinformationforinformationonsurveyresults.
10. Organization (Optional):
11. Name (Optional):
12. Email Address (Optional):
Thank You
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140912 Feedback Survey Instrument (Commonwealth of Massachusetts)

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Completed 26 July 2020

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