LAKE SUCCESS, N.Y., Dec. 18 /PRNewswire-USNewswire/ -- Asian and Latino seniors in New York file few complaints about their health care providers, and downstate seniors file the most complaints, according to a new report released today. The first New York State Medicare Quality of Care Complaints Report Card also shows that few seniors overall file complaints -- .01% of the state's Medicare beneficiaries.* The report is being released today by IPRO, a New York-based not-for-profit organization that contracts with the Centers for Medicare & Medicaid Services (CMS) to improve the quality of health care provided to the state's Medicare beneficiaries, and to resolve beneficiary complaints and appeals.
"This report is a call to action," says Theodore O. Will, Chief Executive Officer, IPRO. "While New York has the second highest number of beneficiary complaints in the nation, we must do much more to educate seniors and their families about how to voice their concerns and use this valuable benefit."
The report comes as IPRO launches "Your Health. Your Voice" -- a new campaign to increase New York seniors' awareness of their right to file complaints. The campaign features outreach programs around the state, public service advertising, a publicity campaign, distribution of multilingual educational materials, a new multilingual Web site, http://www.yourhealthyourvoice.org/, and a helpline, 1-866-391-4682. The New York campaign is one of four funded by CMS to determine the value of intensive public awareness efforts in educating seniors and stimulating complaints.
"We support this campaign, because we see the need to enhance of the quality of life for all of the aged in our state," says Lois Aronstein, State Director, AARP New York. Among the ways AARP is supporting the campaign is through articles and advertising in its publications and outreach to its extensive membership network.
* Calculations may differ from other published counts; the above include all Medicare beneficiaries who were covered at any time during the defined twelve month period, among other variables.
Report Shows Low Levels of Complaints
The report card found that only 343 -- or .01% of the state's almost 3 million Medicare beneficiaries -- filed a complaint last year. In comparison, 7% of New York's Medicaid managed care members and 13%** of the state's commercial health plan members filed complaints against their insurers last year.
Although the overall complaint numbers are low and make comparisons difficult, some numbers stand out. Asian seniors filed just .9% (3) of all complaints, although they represent 2.3% of the state's Medicare population. 1.2% of complaints came from Latinos -- 4 people in total lodged a complaint. Latinos represent 3.3% of New York's Medicare beneficiaries. 13.1% (45) of African Americans, who account for 12.5% of beneficiaries, filed complaints. White New Yorkers, who represent 77.7% of the beneficiary population, filed 82.8% (284) of New York's complaints. Five downstate counties -- Kings, Nassau, New York, Queens and Suffolk, which account for nearly 1.3 million (49%) beneficiaries -- generated more than half (57%) of the overall complaints. A higher percentage of concerns were contained within complaints filed against hospitals (63%) than against nursing homes (18%), physicians (15%) or home health agencies (1%).***
"While all numbers are small, we feel it important to place a special emphasis on minority and underserved communities, where the numbers are lowest," says Janice Hidalgo, Outreach Coordinator, IPRO. Hidalgo and other outreach workers will be conducting multilingual educational presentations around the state for members of the public and health care professionals. They will also be partnering with community-based organizations to extend the program's reach. All "Your Health. Your Voice" materials are available in Spanish, and will soon be available in Chinese and Russian -- the most common languages spoken in New York other than English. Translation services will be available on the helpline and Web site for these languages and others.
What is a Quality of Care Complaint?
A quality of care complaint can be made about a number of issues, including receiving the wrong medication or treatment, sustaining a serious injury while in a nursing home or hospital, or developing bed sores from not being moved regularly.
** Source: New York State Department of Health. Some of these complaints are related to benefits and coverage, not quality of care.
*** Complaints refer to formal written complaints. Concerns refer to the individual issues included in a complaint. A complaint may contain multiple concerns.
"Many of these situations are preventable," says Clare B. Bradley, MD, MPH, Senior Vice President and Chief Medical Officer, IPRO. "By exercising the right to file a complaint, seniors and their families can help insure that the same thing doesn't happen to others."
Initiated by the beneficiary or family member, he or she calls the helpline and will be asked questions that allow the IPRO review case manager to better understand the concern. The patient will also be asked to submit the concern in writing; IPRO provides assistance in preparing the complaint when needed. This information will then be reviewed by medical experts, who will determine if the care given was necessary and appropriate. If the expert reviewer finds that care did not meet appropriate quality standards, IPRO can request a quality improvement plan for the health care provider. IPRO then works with the provider to monitor and provide technical assistance on the plan's implementation. If IPRO determines that the medical provider did meet the professionally recognized standard of care, the beneficiary sometimes has additional options. One of these is called "alternate dispute resolution" or ADR.
For more information, to schedule a presentation or to download educational materials, please call 1-866-391-4682 or visit http://www.yourhealthyourvoice.org/.
Contact: Dennis Tartaglia/Rebecca Janoff
212/481-7000
IPRO
