1601 N. Tucson Blvd. Suite 9
Tucson, AZ 85716-3450
Phone: (800) 635-1196
Hotline: (800) 419-4777
Association fo American Physicians and Surgeons, Inc.
A Voice for Private Physicians Since 1943
Omnia pro aegroto

Results of 1997 Arizona Managed Care Survey

303 respondants to survey as of 2/23/97

1. What is your specialty?

Specialty Number Percent
Family Practice 54 17.8%
Internal Medicine 32 10.6%
OB/GYN 18 5.9%
Orthopedics 17 5.6%
Psychiatry 16 5.3%
Pediatrics 16 5.3%
General Surgery 14 4.6%
Anesthesiology 12 4.0%
Opthamology 11 3.6%
Dermatoloty 11 3.6%
General Practice 10 3.3%
Allergy 7 2.3%
Oncology 6 2.0%
Radiology 4 1.3%
Neurology 4 1.3%

2. What are the principal managed-care plans to which these answers refer?

Plan Number Percent
CIGNA 108 35.6%
Intergroup 98 32.3%
FHP 76 25.1%
Partners 60 19.8%
Blue Cross 45 14.9%
ACCCHS 29 9.6%
Humana 28 9.2%
Aetna 25 8.3%
no contracts 8 2.6%
Maricopa Foundation 7 2.3%
PHCS 7 2.3%
Samaritan 6 2.0%
United Health 6 2.0%
Mercy 4 1.3%
UPI 3 1.0%

3. Are you and your family insured under any of the managed-care plans with which you have a contractual relationship?

Answer Number Percent
yes 94 31.0%
no 177 58.4%
not applicable 10 3.3%

4. I am encouraged by my managed-care plan to acquire new skills and keep old skills sharp.

Answer Number Percent
strongly agree 13 4.3%
agree 35 11.6%
neutral 72 23.8%
disagree 103 34.0%
strongly disagree 69 22.8%

5. Participation in managed care has increased my interest in keeping up with new developments in my field?

Answer Number Percent
strongly agree 8 2.6%
agree 21 6.9%
neutral 71 23.4%
disagree 122 40.3%
strongly disagree 82 27.1%

6. The quality of sickness care has received by my managed-care patients, compared with fee-for-service patients is, on the average:

Answer Number Percent
much better 1 0.3%
somewhat better 5 1.7%
about the same 126 41.6%
somewhat worse 111 36.6%
much worse 45 14.9%

7. Managed care has increased the efficiency of my office.

Answer Number Percent
strongly agree 5 1.7%
agree 18 5.9%
neutral 17 5.6%
disagree 86 28.4%
strongly disagree 165 54.5%

8. My patients have a good understanding of their managed-care contract.

Answer Number Percent
strongly agree 2 0.7%
agree 11 3.6%
neutral 14 4.6%
disagree 103 34.0%
strongly disagree 164 54.1%

9. My medical judgement is respected by managed-care officials.

Answer Number Percent
strongly agree 7 2.3%
agree 36 11.9%
neutral 51 16.8%
disagree 104 34.3%
strongly disagree 93 30.7%

10. The managed-care staff members with whom I deal are knowledgeable and well -qualified to perform their functions.

Answer Number Percent
strongly agree 5 1.7%
agree 22 7.3%
neutral 77 25.4%
disagree 107 35.3%
strongly disagree 77 25.4%

11. Managed care decreases the unit cost of providing service and not just expenditures for medical care. (Expenditures can be decreased by rationing, even if the unit cost is higher.)

Answer Number Percent
strongly agree 8 2.6%
agree 33 10.9%
neutral 53 17.5%
disagree 108 35.6%
strongly disagree 82 27.1%

12. Under my managed-care contract, I have no fear of deselection.

Answer Number Percent
strongly agree 6 2.0%
agree 30 9.9%
neutral 40 13.2%
disagree 119 39.3%
strongly disagree 93 30.7%

13. The overall quality of medical care in Arizona is:

Answer Number Percent
continuously improving 15 5.0%
staying about the same 74 24.4%
deteriorating 190 62.7%

Questions 14. - 19. were to be answered by "primary care providers"
130 surveys contained answers for these questions. Percentages out of 130.

14. I feel pressured by my managed care plan, for financial reasons, to perform procedures with which I do not feel comfortable and which I would prefer to refer.

Answer Number Percent
never 42 32.3%
rarely 32 24.6%
sometimes 32 24.6%
often 9 6.9%
always 7 5.4%

15. I am able to provide better preventive care to my managed-care patients than to fee-for-service patients.

Answer Number Percent
always 2 1.5%
usually 18 13.8%
sometimes 29 22.3%
rarely 43 33.1%
never 28 21.5

16. If I make a referral or order diagnostic tests, the added cost:

Answer Number Percent
comes out of the cap 19 14.6%
affects the withhold 23 17.7%
has no effect on my compensation 68 52.3%

17. The financial incentives of my managed-care plan have no effect on my decisions about referrals or recommendations for diagnostic tests.

Answer Number Percent
strongly agree 18 13.8%
agree 33 25.4%
neutral 19 14.6%
disagree 33 25.4%
strongly disagree 20 15.4%

18. Under my managed-care contracts, the time I have to spend with patients is:

Answer Number Percent
more than adequate 6 4.6%
adequate 44 33.8%
marginal 51 39.2%
severely limited 19 14.6%

19. The availability of medications needed by your managed-care patient is:

Answer Number Percent
more than adequate 10 7.7%
adequate 30 23.1%
marginal 67 51.5%
severely limited 19 14.6%

Questions 20. - 26. were to be answered by "specialists"
206 surveys contained answers for these questions. Percentages out of 206.

20. Following the progress of your managed-care patients, as compared with your standard fee-for-service patients, is:

Answer Number Percent
much easier 2 1.0%
somewhat easier 6 2.9%
about the same 41 19.9%
somewhat harder 82 39.8%
much harder 66 32.0%

21. Under terms of my managed-care contract, services are paid for by:

Answer Number Percent
capitation 61 29.6%
usual and customary 7 3.4%
discounted fee-for-service 161 78.2%

22. The financial incentives in my managed-care plan have no effect on my treatment decisions.

Answer Number Percent
strongly agree 43 20.9%
agree 57 27.7%
neutral 31 15.0%
disagree 50 24.3%
strongly disagree 18 8.7%

23. How often are needed procedures denied for your managed-care patients?

Answer Number Percent
never 13 6.3%
seldom 41 19.9%
sometimes 110 53.4%
often 35 17.0%

24. The availability of diagnostic tests and medications for you managed-care patients is:

Answer Number Percent
more than adequate 9 4.4%
adequate 64 31.1%
marginal 104 50.5%
severely limited 20 9.7%

25. How often do you see managed-care patients whose referral has been unreasonably delayed?

Answer Number Percent
never 3 1.5%
seldom 19 9.2%
sometimes 101 49.0%
often 74 35.9%

26a. I must modify some aspect of my practice due to "carve outs"

Answer Number Percent
yes 56 27.2%
no 52 25.2%

26b. The effect of "carve outs" on patient care is:

Answer Number Percent
an improvement 3 1.5%
neutral 44 21.4%
detrimental 64 31.1%