HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD Beneficiary Satisfaction Survey Results

HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 Beneficiary Satisfaction Survey Results

HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 Beneficiary Satisfaction Survey Results TABLE OF CONTENTS Executive Summary...1 Survey Overview and Methodology...7 Demographics of Survey Sample and Respondents... 11 Trend Analysis... 19 Comparisons with Benchmark Data... 25 Demographic Analysis... 31 State Regional Analysis... 41 Comparison of ARKids First A with ARKids First B... 45 Tables and Comments... 47 Appendix A Medicaid Adult Letters and Postcard... 73 Appendix B ARKids First A Letters and Postcard... 83 Appendix C Medicaid Adult Survey Tools... 93 Appendix D ARKids First A Survey Tools...119

Executive Summary The Arkansas Division of Medical Services (DMS) contracted with AFMC, a National Committee for Quality Assurance- (NCQA) certified Health Plan Employer Data and Information Set (HEDIS ) 1 survey vendor, to conduct its 2017 Consumer Assessment of Healthcare Providers and Systems (CAHPS ) 2 5.0H Medicaid Adult and Child Beneficiary Satisfaction surveys. After conducting a mail-only survey administration, AFMC received 413 analyzable surveys from the adult beneficiary population between February and May, resulting in an analyzable response rate of 24.7 percent. AFMC also received 404 analyzable surveys from the child beneficiary population between February and May, resulting in an analyzable response rate of 23.3 percent. While this report provides a summary of the 2017 survey results, it also compares the survey data with the 2015 and 2013 Arkansas Medicaid survey results as well as national and regional benchmarks. This comprehensive analysis will assist DMS in determining which services beneficiaries use, how beneficiaries evaluate the Medicaid program and its services, and how the Arkansas Medicaid program compares with other Medicaid programs. TABLE 1. Composite and rating percentages ADULT CHILD COMPOSITES/RATINGS 2017 2015 NCBD 2017 2015 NCBD Getting needed care 53% 57% 54% 56% 67% 61% Getting care quickly 59% 56% 58% 79% 78% 74% How well doctors communicate 71% 72% 74% 74% 78% 78% Customer service 61% 62% 67% 33% 40% 68% Shared decision making 76% 76% 80% 77% 78% 80% Rating of personal doctor 63% 65% 65% 70% 71% 74% Rating of specialist 64% 64% 65% 75% 78% 70% Rating of health care 48% 47% 53% 68% 68% 67% Rating of health plan 44% 48% 57% 69% 74% 68% QUESTION SUMMARY RATES 2017 2015 NCBD 2017 2015 NCBD Health promotion and education 67% 69% 72% 61% 67% 71% Coordination of care 51% 58% 56% 60% 58% 58% EFFECTIVENESS OF CARE 2017 2015 NCBD 2017 2015 NCBD Aspirin use 37% 38% N/A N/A N/A N/A 1: HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). Aspirin discussion 52% 44% N/A N/A N/A N/A Advising tobacco users to quit 38% 36% 40% N/A N/A N/A Discussing tobacco cessation medications 15% 11% 18% N/A N/A N/A Discussing tobacco cessation strategies 11% 9% 15% N/A N/A N/A 2: CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 1

The CAHPS 5.0H Medicaid adult and child surveys include five composite measures, four rating questions, two question summary rates and five effectiveness of care measures. The composite measures represent the percentage of beneficiaries who responded favorably and include: n Getting needed care: Measures the beneficiary s ease of seeing a specialist and getting any care, tests or treatment n Getting care quickly: Measures a beneficiary s access to urgent and nonurgent care in a timely manner n How well doctors communicate: Measures how well doctors listen, explain, spend enough time with and show respect for what beneficiaries have to say n Customer service: Measures how often beneficiaries got the help they needed and were treated with courtesy and respect by Medicaid s customer service n Shared decision making: Measures how often beneficiaries were included in their health care decisions by their providers There are four questions with responses scaled from 0 to 10 in the CAHPS 5.0H survey, where 0 represents the worst possible and 10 represents the best possible. The ratings represent the percentage of beneficiaries who rated the question an 8, 9 or 10. Categories include: n Rating of personal doctor n Rating of specialist n Rating of health care n Rating of health plan The two question summary rates indicate the proportion of beneficiaries that selected Always or Usually for the following questions: n Health promotion and education: Measures how often the beneficiaries and their doctors talk about specific things they could do to prevent illness n Coordination of care: Measures how often beneficiaries personal doctor seemed informed and up to date about the care they got from another doctor or health care provider ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 2

The effectiveness of care measures specifically define criteria for the numerator and denominator in that measure. These measures are described in detail below: n Aspirin use: Represents the percentage of beneficiaries who are currently taking aspirin. A single rate is reported where the denominator includes: Women ages 56 79 with at least two risk factors for cardiovascular disease Men ages 46 65 with at least one risk factor for cardiovascular disease Men ages 66 79 regardless of risk factors n Aspirin discussion: Represents the percentage of beneficiaries who discussed the risks and benefits of using aspirin with a doctor or other health care provider. A single rate is reported where the denominator includes: Women ages 56 79 Men ages 46 79 n Advising smokers to quit: Represents the percentage of beneficiaries ages 18 and older who were current smokers or tobacco users and who received advice to quit n Discussing cessation medications: Represents the percentage of beneficiaries ages 18 and older who were current smokers or tobacco users and who discussed or were recommended cessation medications n Discussing cessation strategies: Represents the percentage of beneficiaries ages 18 and older who were current smokers or tobacco users and who discussed or were provided cessation methods or strategies KEY FINDINGS The following summarizes how Medicaid s adult and child survey ratings and composite scores trend over time and how they compare with national and regional benchmarks. For the complete analysis, please refer to Trend Analysis (page 19) and Comparisons with Benchmark Data (page 25). In addition, key findings of demographic comparisons with both 2015 and 2013 and comparisons of the ARKids First A and ARKids First B programs are shown. For complete analysis, please refer to Demographics of Survey Sample and Respondents (page 11) and comparison of ARKids First A to ARKids First B (page 45). AFMC compared the adult and child survey results with the survey results from 2015 and 2013. In demographic comparisons of 2017 respondents with 2015 respondents, Medicaid adult respondents show a statistically higher percentage in the Good mental health status category. ARKids First A respondents show a statistically higher percentage in the 12 or older age category while showing a lower percentage in the 4 7 age category. In demographic comparisons of 2017 respondents with 2013 respondents, Medicaid adult respondents show a statistically higher percentage in the Good mental health status category. ARKids First A respondents show a statistically higher percentage in the 12 or older age category and a statistically lower percentage in the 0 3 and 4 7 age categories and Good overall health status category. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 3

Comparing the 2017 adult survey composites with the 2015 and 2013 results, the Getting needed care, Getting care quickly and How well doctors communicate composites improved slightly from 2015, but the difference was not statistically significant. The Customer service composite dropped from 2015; however, the difference is not statistically significant. None of the rating measures show any statistically significant difference from past years. For the Aspirin discussion measure, more adult respondents report discussing the risks and benefits of aspirin to prevent heart attack and stroke with their health care provider; however, this increase was not statistically significant. Comparing the 2017 child survey composites with the 2015 results, all composite scores for 2017 are slightly lower than in 2015, but the differences were not statistically significant. The Customer service composite dropped almost 11 percent from 2015 to 2017, and although this was not a statistically significant difference, it suggests an area that needs attention and has potential for improvement. The overall ratings for health care has increased from 2013 to 2015 and from 2015 to 2017, and the difference between the 2013 and 2017 ratings is statistically significant. The Health promotion and education summary question has decreased non-significantly from 2015 to 2017. The adult and child survey results were also compared with national benchmarks from the National CAHPS Benchmarking Database (NCBD). The NCBD is a national repository funded by AHRQ containing data from the CAHPS health plan survey to provide comparative data on health plans. In demographic comparisons with the national benchmarks, Medicaid adult survey respondents show statistically higher percentages in the White and Black/African-American race categories, the High school graduate or less education category, the Fair/poor overall health status category, the Fair/poor mental health status category and the Every day smoking status category. Medicaid respondents also show statistically lower percentages in the 55 or older age category, Asian and Other race categories, the Some college and College graduate or more education category, the Excellent/very good overall health status category, the Excellent/very good mental health status category, and the Not at all smoking status category. ARKids First A respondents show statistically significant higher proportion of white respondents than in the NCBD group and a statistically significant lower proportion of Asians and multiracial respondents. ARKids First A respondents also show statistically higher percentages in the Fair/poor overall health status and mental health status categories. When compared with NCBD, Arkansas Medicaid scored significantly lower in the overall Rating of health plan. Arkansas Medicaid also scored significantly lower on the Doctors listening carefully item of the How well doctors communicate composite, the Treated with courtesy and respect component of the Customer service composite and Doctor asked which choice was best within the Shared decision making composite. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 4

When compared with other Medicaid plans within the south region, Arkansas Medicaid scored significantly lower in the Rating of health care, overall Rating of health plan and Health promotion and health education summary measure. Arkansas Medicaid also scored significantly lower on the Doctors listening carefully and Treated with courtesy and respect components of the How well doctors communicate and Customer service composites, respectively. When compared with NCBD, ARKids First A scored significantly higher on the Obtaining care right away component of the Getting care quickly composite but scored significantly lower on two components of the How well doctors communicate composite. ARKids First A scores are also significantly lower in the Customer service composite, including every component of this measure. ARKids First A also shows a significantly lower rate for Health promotion and education. When compared with other Medicaid plans within the south region, ARKids First A scored significantly lower on the Customer service composite, as well as every component of this measure and on the Getting needed care composite. ARKids First A also scored significantly lower for Health promotion and education, Rating of personal doctor, and Doctor explaining things in an understandable way and Doctor explaining things in an understandable way to your child components of the How well doctors communicate composite. The Obtaining care right away component of the Getting care quickly composite scored significantly higher. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 5

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Survey Overview and Methodology BACKGROUND As part of its contract with DMS, AFMC regularly surveys Medicaid beneficiaries about their health care experiences as Medicaid enrollees. AFMC used the 2017 CAHPS 5.0H Medicaid Adult and Child Beneficiary Satisfaction Surveys. The CAHPS surveys are a set of survey tools developed to assess patient satisfaction with their health plan. CAHPS is funded by AHRQ and was developed jointly by AHRQ and NCQA. AFMC first conducted this survey in 1998. It is repeated biennially. This report summarizes results derived from the CAHPS 5.0H Medicaid adult and child surveys as applied to a systemic random sample of Medicaid Adult and ARKids First A beneficiaries. The five composite measures and four rating questions covered by the CAHPS survey are Getting needed care, Getting care quickly, How well doctors communicate, Customer service and Shared decision making composites; and Personal doctor, Specialist, Health care, and Health plan ratings. In addition, the CAHPS survey covers two summary questions and five effectiveness of care measures where applicable: Health promotion and education, Coordination of care, Aspirin use, Aspirin discussion, Advising tobacco users to quit, Discussing tobacco cessation medications, and Discussing tobacco cessation strategies. Satisfaction is presented as the percentage of respondents who chose the most positive question responses as specified by NCQA. Where applicable, scores are shown alongside the NCBD national benchmark and regional rates in order to assess how well they perform in comparison to other Medicaid plans. RESPONSE RATE Per NCQA guidelines, 2,024 adult and 2,145 child beneficiaries were systematically selected from the Arkansas Medicaid Enterprise (AME) Decision Support System (DSS) claims data. A total of 449 adult surveys and 446 child surveys were received, resulting in cooperation rates of 22.2 percent and 20.8 percent, respectively. After further adjusting for incorrect addresses, the analyzable sample sizes were 1,669 for adults and 1,735 for child beneficiaries. Surveys without any valid responses and not meeting enrollment criteria were excluded, and 413 adult surveys (24.7%) and 404 child surveys (23.3%) were available for analysis. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 7

TABLE 2. Sample size and response rates 2017 SURVEY ADULT CHILD Survey sample size 2,024 2,145 Total surveys returned 449 446 Cooperation rate 22.2% 20.8% Analyzable sample size* 1,669 1,735 Analyzable surveys 413 404 Analyzable response rate 24.7% 23.3% *Excludes bad addresses and ineligibles SAMPLING FRAME Beneficiary information was obtained from AME DSS claims data. NCQA guidelines require each beneficiary to be enrolled for a minimum of six months with no more than one gap in enrollment of up to 45 days prior to participating in the survey. Although NCQA defines the allowable gap as 45 days, AFMC sets this criterion at 30 days because the enrollment data are reported monthly. The adult sampling frame consisted of all Arkansas Medicaid primary care case management (PCCM) enrollees who were at least 18 years old as of Dec. 31, 2016. The sampling frame for children/adolescents consisted of all ARKids First A PCCM enrollees who were 17 years old or younger as of Dec. 31, 2016. The adult and child beneficiaries six-month continuous enrollment began on July 1, 2016. Beneficiaries selected within the last 24 months were excluded from the population this year, and only one beneficiary per household was selected. SURVEY PROCEDURE An advance letter (Appendix A), written on DMS letterhead and signed by the director of DMS, was mailed to each selected adult beneficiary. For the selected children, the parent/ guardian received the advance letter (Appendix B). The letter explained the purpose of the survey, informed the beneficiary of its confidential and voluntary nature, and gave information on requesting a Spanish-language version of the survey (Appendix C/D). Approximately two weeks later a packet containing a questionnaire (Appendix C/D), a postage-paid return envelope and a cover letter was sent to each beneficiary. The cover letter (Appendix A/B), on DMS letterhead and signed by the director, reiterated the information in the advance letter and gave specific instructions on completing and returning the survey. A reminder postcard (Appendix A/B) was mailed 10 days later to those beneficiaries who did not respond. Approximately one month after the initial survey was sent, a second survey was mailed to any beneficiary who had not returned a survey. Ten days after the second survey, a second reminder postcard was mailed. All mail was sent bulk rate with return receipt and address correction requested. Letters and surveys that were returned as undeliverable with an address correction were re-mailed. Since beneficiary telephone numbers were not available, telephone follow-up of nonrespondents was not performed. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 8

TABLE 3. Survey time table SURVEY MAILINGS AND DATE ADULT CHILD Advance letter Feb. 15 Feb. 16 First survey March 6 March 7 First reminder postcard March 16 March 17 Second survey April 3 April 4 Second reminder postcard April 13 April 14 Data cutoff May 2 May 2 SURVEY TRACKING A unique number was assigned to each survey for tracking purposes only. This tracking number was used so that a second survey could be mailed to nonresponders, but not to those who had already completed and returned the survey. Beneficiary confidentiality was never compromised. DISQUALIFIED SURVEYS Adult and child surveys received after the cutoff date of May 2 were not included in survey analysis. Surveys without any valid responses and those no longer meeting enrollment criteria were excluded from the analysis. These exclusions were made following standard HEDIS/CAHPS protocol and recommendations. Total excluded or disqualified surveys represented 8.0 percent of the total adult surveys and 9.4 percent of the child surveys received. NONANALYZABLE SURVEYS A total of 1,611 adult and 1,741 child surveys was either not returned or not available for analysis. AFMC tracked the reasons why these surveys were not returned or were ineligible for analysis following NCQA guidelines. TABLE 4. Nonanalyzable surveys FINAL DISPOSITIONS ADULT CHILD Incomplete surveys returned 6 2 Incorrect address 324 372 No response after maximum attempts 1,249 1,327 Beneficiary refusal 1 2 Beneficiary deceased 0 0 Beneficiary physically/mentally incapacitated* 5 NA Does not meet eligibility criteria 26 38 *This code is not valid for CAHPS 5.0H Child Surveys. SPANISH-LANGUAGE SURVEYS AFMC translates all surveys into Spanish and provides the Spanish-language version to beneficiaries by request. Of the 449 adult surveys that were returned, none was completed in Spanish. Of the 446 child surveys that were returned, two were completed in Spanish. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 9

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Demographics of Survey Sample and Respondents AFMC follows NCQA protocol and uses the systematic random sampling method, therefore, the adult and child survey samples should be similar to the Medicaid adult and ARKids First A population. Table 7 and Table 8 show how the sample demographic compares with the respective populations and to the demographics of the survey respondents. Table 5 and Table 6 show the percentage of respondents by each demographic category of age, gender, education, health status and race. Table 5 and Table 6 also compare the demographics of survey respondents with the 2016 NCBD and 2015 and 2013 Arkansas Medicaid respondents. The comparison with the previous years data shows how the Medicaid adult and child respondents have changed over time. The comparison to the national benchmark shows how similar or different the Arkansas Medicaid respondents are when compared with other Medicaid program beneficiaries from across the nation. AFMC also highlights where the Medicaid respondents change significantly and whether the Medicaid respondents differ significantly when compared with the national benchmark. A z-test was used to determine significant differences in proportions. In demographic comparisons with the national benchmarks, Medicaid adult survey respondents show statistically higher percentages in the White and Black/African- American race categories, the High school graduate or less education category, the Fair/ poor overall health status category, the Fair/poor mental health status category and the Every day smoking status category. Medicaid respondents also show statistically lower percentages in the 55 or older age category, Asian and Other race categories, the Some college and College graduate or more education categories, the Excellent/ very good overall health status category, the Excellent/very good mental health status category, and the Not at all smoking status category. ARKids First A respondents show significantly higher proportion of white respondents than in the NCBD group and a significantly lower proportion of Asians and multiracial respondents. ARKids First A respondents also show statistically higher percentages in the Fair/poor overall health status and mental health status categories. In demographic comparisons of 2017 respondents with 2015 respondents, Medicaid adult respondents show a statistically higher percentage in the Good mental health status category. ARKids First A respondents show a statistically higher percentage in the 12 or older age category while showing a lower percentage in the 4 7 age category. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 11

In demographic comparisons of 2017 respondents with 2013 respondents, Medicaid adult respondents show a statistically higher percentage in the Good mental health status category. ARKids First A respondents show a statistically higher percentage in the 12 or older age category and a statistically lower percentage in the 0 3 and 4 7 age categories and Good overall health status category. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 12

TABLE 5. Profile of adult survey respondents: comparison with 2015, 2013 and NCBD DEMOGRAPHIC CATEGORY 2017 2015 2013 2016 NCBD 2017 VS. 2015 SIGNIFICANT DIFFERENCE 2017 VS. 2013 2017 VS. NCBD Gender Male 39.5% 37.7% 33.3% 38.8% Not significant Not significant Not significant Female 60.5% 62.3% 66.7% 61.2% Not significant Not significant Not significant Age 18 34 29.0% 28.5% 34.8% 29.6% Not significant Not significant Not significant Race* Education Overall health status Mental health status Smoking status 35 44 18.3% 15.2% 14.6% 15.9% Not significant Not significant Not significant 45 54 24.5% 23.8% 26.5% 21.1% Not significant Not significant Not significant 55 or older 28.2% 32.5% 24.1% 33.4% Not significant Not significant Significantly lower White 64.5% 60.1% 62.0% 57.3% Not significant N/A Black/ African- American 27.0% 31.8% 29.6% 20.1% Not significant N/A Significantly higher Significantly higher Asian 0.2% 0.5% 0.2% 5.9% Not significant N/A Significantly lower Multiracial 4.2% N/A N/A 8.2% N/A N/A Significantly lower Other 4.0% 7.5% 8.2% 8.5% N/A N/A Significantly lower High school graduate or less Some college College graduate or more Excellent/ very good 79.0% 81.5% 78.9% 60.0% Not significant Not significant Significantly higher 16.7% 15.5% 18.5% 29.2% Not significant Not significant Significantly lower 4.3% 3.0% 2.6% 10.8% Not significant Not significant Significantly lower 17.0% 18.3% 16.2% 34.4% Not significant Not significant Significantly lower Good 30.8% 26.4% 29.4% 34.0% Not significant Not significant Not significant Fair/poor 52.2% 55.3% 54.4% 31.7% Not significant Not significant Excellent/ very good Significantly higher 20.0% 25.5% 23.0% 44.6% Not significant Not significant Significantly lower Good 32.0% 25.5% 25.2% 29.0% Significantly higher Significantly higher Fair/Poor 47.9% 48.9% 51.8% 26.4% Not significant Not significant Every day 27.6% 31.3% 30.1% 20.3% Not significant Not significant Some days Not significant Significantly higher Significantly higher 13.4% 12.8% 16.6% 11.3% Not significant Not significant Not significant Not at all 59.0% 55.9% 53.3% 67.7% Not significant Not significant Significantly lower *Calculation changes in 2015 do not allow for comparisons with 2013. 2013 results are as previously reported. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 13

FIGURE 1. (ADULT) Demographics GENDER Arkansas National EDUCATION SOME COLLEGE 16.7% 79.0% HIGH SCHOOL GRADUATE OR LESS COLLEGE GRADUATE OR MORE 4.3% SOME COLLEGE 29.2% 60.0% COLLEGE GRADUATE OR MORE 10.8% HIGH SCHOOL GRADUATE OR LESS AGE FEMALE 60.5% RACE 18 34 35 44 45 54 55 OR OLDER WHITE BLACK/AFRICAN AMERICAN ASIAN MULTIRACIAL OTHER MALE 39.5% 0.2% 5.9% 4.2% 8.2% 4.0% 8.5% 18.3% 15.9% 29.0% 29.6% 24.5% 21.1% 28.2% 33.4% 27.0% 20.1% FEMALE 61.2% 64.5% 57.3% MALE 38.8% 0.0% 50.0% 100.0% 0.0% 50.0% 100.0% OVERALL HEALTH STATUS FAIR/POOR 52.2% MENTAL HEALTH STATUS FAIR/POOR 47.9% EXCELLENT/VERY GOOD 17.0% GOOD 30.8% EXCELLENT/VERY GOOD 20.0% GOOD 32.0% SMOKING STATUS EVERY DAY 27.6% NOT AT ALL 59.0% SOME DAYS 13.4% FAIR/POOR 31.7% FAIR/POOR 26.4% GOOD 34.0% GOOD 29.0% EVERY DAY 20.3% EXCELLENT/ VERY GOOD 34.4% NOT AT ALL 67.7% EXCELLENT/ VERY GOOD 44.6% SOME DAYS 11.3% ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 14

TABLE 6. Profile of child survey respondents: comparison with 2015, 2013 and NCBD DEMOGRAPHIC CATEGORY 2017 2015 2013 2016 NCBD 2017 VS. 2015 SIGNIFICANT DIFFERENCE 2017 VS. 2013 2017 VS. NCBD Gender Male 55.0% 51.6% 52.6% 52.8% Not significant Not significant Not significant Age Race Parent s education Overall health status Mental health status Female 45.0% 48.4% 47.4% 47.2% Not significant Not significant Not significant 0 3 17.3% 21.1% 29.5% 19.0% Not significant 4 7 18.9% 26.0% 29.0% 22.8% Significantly lower Significantly lower Significantly lower Not significant Not significant 8 11 25.0% 24.9% 20.3% 23.6% Not significant Not significant Not significant 12 or older 38.8% 27.9% 21.2% 34.5% Significantly higher Significantly higher White 63.9% 62.0% 63.6% 52.3% Not significant Not significant Black/ African- American Not significant Significantly higher 20.5% 21.6% 20.6% 19.2% Not significant Not significant Not significant Asian 1.0% 1.6% 1.2% 3.9% Not significant Not significant Multiracial 5.1% 6.0% 5.4% 13.0% Not significant Not significant Significantly lower Significantly lower Other 9.5% 8.7% 9.2% 11.5% Not significant Not significant Not significant High school graduate or less Some college College graduate or more Excellent/ very good 54.9% 60.1% 55.2% 53.6% Not significant Not significant Not significant 32.6% 31.6% 35.5% 33.4% Not significant Not significant Not significant 12.4% 8.3% 9.2% 13.1% Not significant Not significant Not significant 73.5% 74.2% 68.3% 74.5% Not significant Not significant Not significant Good 18.3% 20.8% 24.4% 20.2% Not significant Significantly lower Fair/poor 8.2% 5.0% 7.3% 5.3% Not significant Not significant Excellent/ very good Not significant Significantly higher 68.6% 69.5% 68.5% 71.4% Not significant Not significant Not significant Good 18.8% 20.0% 20.3% 18.9% Not significant Not significant Not significant Fair/Poor 12.6% 10.5% 11.2% 9.7% Not significant Not significant Significantly higher ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 15

FIGURE 2. (CHILD) Demographics GENDER Arkansas National PARENTS EDUCATION SOME COLLEGE 32.6% 54.9% COLLEGE GRADUATE OR MORE 12.4% HIGH SCHOOL GRADUATE OR LESS SOME COLLEGE 33.4% 53.6% COLLEGE GRADUATE OR MORE 13.1% HIGH SCHOOL GRADUATE OR LESS FEMALE 45.0% MALE 55.0% FEMALE 47.2% MALE 52.8% OVERALL HEALTH STATUS GOOD 18.3% FAIR/POOR 8.2% GOOD 20.2% FAIR/POOR 5.3% AGE RACE 0 3 4 7 8 11 12 OR OLDER WHITE BLACK/AFRICAN AMERICAN ASIAN MULTIRACIAL OTHER 0.0% 50.0% 100.0% 1.0% 3.9% 20.5% 19.2% 5.1% 13.0% 9.5% 11.5% 17.3% 19.0% 18.9% 22.8% 25.0% 23.6% 38.8% 34.5% 0.0% 50.0% 100.0% 63.9% 52.3% EXCELLENT/ VERY GOOD 73.5% MENTAL HEALTH STATUS GOOD 18.8% EXCELLENT/ VERY GOOD 68.6% FAIR/POOR 12.6% EXCELLENT/ VERY GOOD 74.5% GOOD 18.9% EXCELLENT/ VERY GOOD 71.4% FAIR/POOR 9.7% ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 16

TABLE 7: Medicaid adult sample and population demographics DEMOGRAPHIC CATEGORY BENEFICIARIES SURVEYED PCT. OF TOTAL MEDICAID ADULT POPULATION ANALYZABLE RESPONSES PCT. OF TOTAL ANALYZABLE RESPONSE RATE Gender Female 1,048 62.8% 65.5% 250 60.5% 23.9% Male 621 37.2% 34.5% 163 39.5% 26.2% TOTAL 1,669 100.0% 100.0% 413 100.0% 24.7% Age 18 24 418 25.0% 25.2% 66 16.0% 15.8% 25 34 392 23.5% 25.5% 58 14.0% 14.8% 35 44 317 19.0% 18.7% 76 18.4% 24.0% 45 54 264 15.8% 14.2% 95 23.0% 36.0% 55 64 247 14.8% 14.5% 107 25.9% 43.3% 65 74 20 1.2% 1.3% 6 1.5% 30.0% 75 or older 11 0.7% 0.6% 5 1.2% 45.5% TOTAL 1,669 100.1% 100.0% 413 100.0% 24.7% Race White 863 51.7% 52.4% 224 54.2% 26.0% Geographic region Black/African- American American Indian or Alaska Native Hispanic or Latino 456 27.3% 25.9% 101 24.5% 22.1% 10 0.6% 0.6% 2 0.5% 20.0% 38 2.3% 2.4% 9 2.2% 23.7% Asian-American 12 0.7% 0.6% 2 0.5% 16.7% Native Hawaiian or other Pacific Islander 0 0.0% 0.1% 0 0.0% 0.0% Multiracial 10 0.6% 0.8% 2 0.5% 20.0% Unknown 280 16.8% 17.2% 73 17.7% 26.1% TOTAL 1,669 100.0% 100.0% 413 100.0% 24.7% Northwest 452 27.1% 25.8% 122 29.5% 27.0% Northeast 380 22.8% 22.9% 99 24.0% 26.1% Central 405 24.3% 24.8% 91 22.0% 22.5% Southwest 201 12.0% 12.9% 48 11.6% 23.9% Southeast 231 13.8% 13.6% 53 12.8% 22.9% TOTAL 1,669 100.0% 100.0% 413 99.90% 24.7% ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 17

TABLE 8: ARKids First A sample and population demographics DEMOGRAPHIC CATEGORY BENEFICIARIES SURVEYED PCT. OF TOTAL ARKIDS FIRST A POPULATION ANALYZABLE RESPONSES PCT. OF TOTAL ANALYZABLE RESPONSE RATE Gender Female 834 48.1% 48.4% 183 45.3% 21.9% Male 901 51.9% 51.6% 221 54.7% 24.5% TOTAL 1,735 100.0% 100.0% 404 100.0% 23.3% Age 0 3 348 20.1% 22.3% 69 17.1% 19.8% 4 7 415 23.9% 24.7% 82 20.3% 19.8% 8 11 421 24.3% 23.4% 102 25.2% 24.2% 12 17 551 31.8% 29.6% 151 37.4% 27.4% TOTAL 1,735 100.1% 100.0% 404 100.0% 23.3% Race White 818 47.1% 45.7% 198 49.0% 24.2% Geographic region Black/African- American American Indian or Alaska Native Hispanic or Latino 319 18.4% 19.1% 63 15.6% 19.7% 6 0.3% 0.5% 2 0.5% 33.3% 153 8.8% 9.3% 40 9.9% 26.1% Asian-American 15 0.9% 0.8% 5 1.2% 33.3% Native Hawaiian or other Pacific Islander 2 0.1% 0.3% 0 0.0% 0.0% Multiracial 36 2.1% 2.0% 2 0.5% 5.6% Unknown 386 22.2% 22.4% 94 23.3% 24.4% TOTAL 1,735 99.9% 100.1% 404 100.0% 23.3% Northwest 517 29.8% 31.1% 119 29.5% 23.0% Northeast 393 22.7% 21.1% 90 22.3% 22.9% Central 447 25.8% 25.1% 96 23.8% 21.5% Southwest 217 12.5% 12.2% 57 14.1% 26.3% Southeast 161 9.3% 10.5% 42 10.4% 26.1% TOTAL 1,735 100.1% 100.0% 404 100.1% 23.3% ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 18

Trend Analysis The following pages contain trending tables and graphs that show how the adult and child CAHPS data changes over time. The tables and graphs show specifically each composite measure, the questions that make up these composites and the overall rating questions for the current year of 2017 and the previous two surveys (2015 and 2013). Although the trending graphs show a visual representation of the trends, the trending tables show whether any trend comparisons are significantly different; any significant differences are highlighted below. Due to changes in the CAHPS survey over time, some data may not be available for comparison purposes. ADULT TREND ANALYSIS AFMC compared the 2017 adult survey results with previous years and found the following: n Getting needed care, Getting care quickly and How well doctors communicate composites improved slightly from 2015, but the difference was not statistically significant n Customer service composite has decreased from 2015; however, the difference is not statistically significant n None of the rating measures show any statistically significant difference from past years n For the Aspirin discussion measure, more adult respondents report discussing the risks and benefits of aspirin to prevent heart attack and stroke with their health care provider; however, this increase was not statistically significant CHILD TREND ANALYSIS When we compare the 2017 child survey results with previous years, we found the following: n All composite scores for 2017 are slightly lower than in 2015, but the differences were not statistically significant n Satisfaction with the Customer service composite decreased almost 11 percent from 2015 to 2017; however, this decrease is not statistically significant n Overall ratings for health care has increased from 2013 to 2015 and from 2015 to 2017, and the difference between the 2013 and 2017 ratings is now statistically significant n Health promotion and education summary question has decreased from 2015 to 2017, but the change is not statistically significant ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 19

TABLE 9: Composites, components of composites and ratings of adult beneficiary satisfaction 2017 2015 2013 SIGNIFICANCE TESTING COMPOSITE, COMPONENTS AND RATING ITEMS VALID N SUMMARY RATE VALID N SUMMARY RATE VALID N SUMMARY RATE Getting needed care 83.6% 80.7% 81.4% Q25. Seeing a specialist 180 83.3% 176 79.5% 177 80.8% Q14. Getting care, tests or treatment 327 83.8% 308 81.8% 373 82.0% Getting care quickly 82.9% 81.7% 79.6% 2017 VS. 2015 Not significant Not significant Not significant Not significant 2017 VS. 2013 Not significant Not significant Not significant Not significant Q4. Obtaining care right away for an illness/injury/condition 187 84.5% 179 83.2% 242 79.3% Not significant Not significant Q6. Obtaining care when wanted, when not needed right away 295 81.4% 283 80.2% 336 79.8% How well doctors communicate 89.3% 88.4% 88.0% Q17. Doctors explaining things in an understandable way 292 90.1% 284 89.1% 352 88.4% Q18. Doctors listening carefully to you 291 89.3% 283 88.7% 352 89.5% Q19. Doctors showing respect for what you had to say Q20. Doctors spending enough time with you 292 90.8% 283 90.8% 352 89.8% 292 87.0% 282 85.1% 351 84.3% Customer service 83.1% 85.4% 86.3% Q31. Getting help when calling customer service Q32. Treated with courtesy and respect 71 77.5% 65 78.5% 62 82.3% 71 88.7% 66 92.4% 62 90.3% Shared decision making* 75.9% 75.8% N/A Q10. Doctor discussed reasons you might want to take a medicine Q11. Doctor discussed reasons you might NOT want to take a medicine Q12. Doctor ask what you thought best for you concerning medication 146 93.2% 131 95.4% N/A N/A 142 65.5% 133 65.4% N/A N/A 145 69.0% 132 66.7% N/A N/A Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant N/A N/A N/A N/A *A test for significance on the shared decision making composite was not conducted for 2017 versus 2013 since the questions, as well as the response options, changed in 2015. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 20

TABLE 9: Composites, components of composites and ratings of adult beneficiary satisfaction (continued) 2017 2015 2013 SIGNIFICANCE TESTING COMPOSITE, COMPONENTS AND RATING ITEMS VALID N SUMMARY RATE VALID N SUMMARY RATE VALID N SUMMARY RATE Rating of personal doctor (Q23) 349 76.2% 315 74.9% 397 76.6% Rating of specialist (Q27) 169 78.1% 162 79.6% 165 77.6% Rating of health care (Q13) 329 64.4% 309 60.8% 377 63.7% 2017 VS. 2015 Not significant Not significant Not significant 2017 VS. 2013 Not significant Not significant Not significant Rating of health plan (Q35) 404 58.4% 370 58.6% 441 60.1% Health promotion and education (Q8) 325 67.4% 306 68.6% 376 67.0% Coordination of care (Q22) 169 75.1% 158 82.3% 184 74.5% Aspirin use 27 37.0% 24 37.5% 30 40.0% Aspirin discussion 56 51.8% 52 44.2% 59 40.7% Advising smokers and tobacco users to quit 159 76.1% 163 74.8% 211 71.1% Discussing cessation medications 158 44.3% 164 40.9% 208 42.3% Discussing cessation strategies 157 40.8% 164 37.2% 205 37.6% Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant Not significant ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 21

FIGURE 3. (ADULT) Trending Charts Composites and ratings of beneficiary satisfaction 2017 2015 2013 Getting needed care Getting care quickly How well doctors communicate Customer service Shared decision making Rating of personal doctor Rating of specialist Rating of health care Rating of health plan Health promotion and education Coordination of care Aspirin use 0.0% 50.0% 100.0% N/A* 37.0% 37.5% 40.0% 51.8% 64.4% 60.8% 63.7% 58.4% 58.6% 60.1% 67.4% 68.6% 67.0% 75.9% 75.8% 76.2% 74.9% 76.6% 83.6% 80.7% 81.4% 82.9% 81.7% 79.6% 78.1% 79.6% 77.6% 75.1% 74.5% 89.3% 88.4% 88.0% 83.1% 85.4% 86.3% 82.3% Aspirin discussion Advising smokers and tobacco users to quit Discussing cessation medications Discussing cessation strategies 44.2% 40.7% 44.3% 40.9% 42.3% 40.8% 37.2% 37.6% 76.1% 74.8% 71.1% *Shared decision making composite scores for 2015 are not available since the questions, as well as the response options, changed in 2015. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 22

TABLE 10: Composites, components of composites and ratings of child beneficiary satisfaction 2017 2015 2013 SIGNIFICANCE TESTING COMPOSITE, COMPONENTS AND RATING ITEMS VALID N SUMMARY RATE VALID N SUMMARY RATE VALID N SUMMARY RATE Getting needed care 84.4% 88.1% 88.8% 2017 VS. 2015 Not significant 2017 VS. 2013 Not significant Q28. Seeing a specialist 81 76.5% 82 85.4% 108 85.2% Not significant Not significant Q14. Getting care, tests or treatment 297 92.3% 281 90.7% 354 92.4% Not significant Not significant Getting care quickly 93.7% 95.2% 91.5% Not significant Not significant Q4. Obtaining care right away for an illness/injury/condition Q6. Obtaining care when wanted, when not needed right away 137 97.1% 163 96.9% 225 92.4% Not significant Not significant 246 90.2% 243 93.4% 297 90.6% Not significant Not significant How well doctors communicate 92.7% 93.5% 89.8% Not significant Not significant Q17. Doctors explaining things in an understandable way 274 92.7% 270 93.7% 324 92.9% Not significant Not significant Q18. Doctors listening carefully to you 273 94.9% 269 95.2% 324 91.7% Not significant Not significant Q19. Doctors showing respect for what you had to say Q21. Doctors explaining things in an understandable way to your child Q22. Doctors spending enough time with your child 274 96.7% 269 97.0% 324 93.8% Not significant Not significant 186 89.2% 181 91.7% 187 85.6% Not significant Not significant 271 90.0% 269 90.0% 324 85.2% Not significant Not significant Customer service 57.5% 68.3% 70.2% Not significant Not significant Q32. Getting help when calling customer service 40 45.0% 30 56.7% 39 64.1% Not significant Not significant Q33. Treated with courtesy and respect 40 70.0% 30 80.0% 38 76.3% Not significant Not significant Shared decision making* 77.3% 78.4% N/A Q10. Doctor discussed reasons you might want your child to take a medicine Q11. Doctor discussed reasons you might NOT want your child to take a medicine Q12. Doctor asked what you thought best for your child concerning medication Not significant 93 94.6% 91 94.5% N/A N/A Not significant N/A 92 63.0% 91 64.8% N/A N/A Not significant N/A 93 74.2% 91 75.8% N/A N/A Not significant N/A Rating of personal doctor (Q26) 348 84.8% 333 82.6% 380 80.0% Not significant Not significant Rating of specialist (Q30) 71 85.9% 76 81.6% 99 87.9% Not significant Not significant Rating of health care (Q13) 299 85.6% 281 81.5% 352 78.4% Not significant N/A Significantly higher Rating of health plan (Q36) 400 83.3% 376 83.8% 422 82.2% Not significant Not significant Health promotion and education (Q8) 299 61.2% 279 67.0% 350 63.7% Not significant Not significant Coordination of care (Q25) 109 79.8% 110 80.0% 157 77.1% Not significant Not significant *Test for significance on the shared decision making composite was not conducted for 2017 versus 2013 since the questions, as well as the response options, changed in 2015. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 23

FIGURE 4. (CHILD) Trending Charts Composites and ratings of beneficiary satisfaction 2017 2015 2013 0.0% 50.0% 100.0% Getting needed care Getting care quickly How well doctors communicate 84.4% 88.1% 88.8% 93.7% 95.2% 91.5% 92.7% 93.5% 89.8% Customer service 57.5% 68.3% 70.2% Shared decision making Rating of personal doctor Rating of specialist Rating of health care Rating of health plan N/A* 77.3% 78.4% 84.8% 82.6% 80.0% 85.9% 81.6% 87.9% 85.6% 81.5% 78.4% 83.3% 83.8% 82.2% Health promotion and education 61.2% 67.0% 63.7% Coordination of care 79.8% 80.0% 77.1% *Shared decision making composite scores for 2015 are not available since the questions, as well as the response options, changed in 2015. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 24

Comparisons with Benchmark Data The following tables show how the adult and child CAHPS data compare to the national Medicaid benchmarks for both adult and child populations and to the NCBD south region. To report regional benchmarks, NCBD uses the United States Census Bureau s four official regions and defines the south region as Alabama, Arkansas, Delaware, the District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia and West Virginia. The tables show specifically each composite measure, the questions that make up these composites, the overall rating questions, the question summary rates and the effectiveness of care measures for 2017 and the national and regional Medicaid benchmarks. The tables also show whether any benchmark comparisons are significantly different; any significant differences are highlighted below as well as in the tables. The benchmark data comes from the 2016 National CAHPS Benchmarking Database (NCBD). To be able to make comparisons with NCBD benchmarks, the state composites and rates shown in Table 11 and Table 12 are calculated differently than in other sections of this report. Composites are calculated using the highest value only ( Always or Yes ) and ratings are calculated as the percentage of respondents who chose a 9 or a 10 on a scale of 0 to 10. Also, the regional Shared decision making composite scores were not available and therefore not reported. COMPARISONS WITH BENCHMARK DATA ADULT SURVEY When compared with NCBD, Arkansas Medicaid scored significantly lower in the overall Rating of health plan, and Doctors listening carefully, Treated with courtesy and respect, and Doctor asked which choice was best within the How well doctors communicate, Customer service, and Shared decision making composites, respectively. When compared with other Medicaid plans within the south region, Arkansas Medicaid scored significantly lower in the Rating of health care, Rating of health plan and Health promotion and health education summary measure. Arkansas Medicaid also scored significantly lower on the Doctors listening carefully and Treated with courtesy and respect components of the How well doctors communicate and Customer service ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 25

composites, respectively. COMPARISONS WITH BENCHMARK DATA CHILD SURVEY When compared with NCBD, ARKids First A scored significantly higher on the Obtaining care right away component of the Getting care quickly composite but scored significantly lower on two components of the How well doctors communicate composite. ARKids First A scores are also significantly lower in the Customer service composite, including both components of this measure. ARKids First A also shows a significantly lower rate for Health promotion and education. When compared with other Medicaid plans within the south region, ARKids First A scored significantly lower on the Customer service composite, as well as both components of this measure and on the Getting needed care composite. ARKids First A also scored significantly lower for Health promotion and education, Rating of personal doctor, and Doctor explaining things in an understandable way and Doctor explaining things in an understandable way to your child components of the How well doctors communicate composite. The Obtaining care right away component of the Getting care quickly composite scored significantly higher. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 26

TABLE 11: Comparisons with benchmark data adult survey COMPOSITES, COMPONENTS AND RATING ITEMS ADULT SUMMARY RATE 2016 NCBD RATE NCBD SOUTH REGION ADULT VS. NCBD SIGNIFICANCE TESTING ADULT VS. REGION Getting needed care 53% 54% 56% Not significant Not significant Q25. Seeing a specialist 54% 52% 55% Not significant Not significant Q14. Getting care, tests or treatment 53% 55% 57% Not significant Not significant Getting care quickly 59% 58% 61% Not significant Not significant Q4. Obtaining care right away for an illness/injury/condition Q6. Obtaining care when wanted, not when needed right away 60% 63% 64% Not significant Not significant 57% 54% 59% Not significant Not significant How well doctors communicate 71% 74% 75% Not significant Not significant Q17. Doctors explaining things in an understandable way 71% 73% 75% Not significant Not significant Q18. Doctors listening carefully to you 70% 75% 76% Significantly lower Significantly lower Q19. Doctors showing respect for what you had to say Q20. Doctors spending enough time with you 76% 79% 80% Not significant Not significant 65% 68% 69% Not significant Not significant Customer service 61% 67% 69% Not significant Not significant Q31. Getting help when calling customer service 56% 56% 59% Not significant Not significant Q32. Treated with courtesy and respect 65% 77% 79% Significantly lower Significantly lower Shared decision making* 76% 80% N/A Not significant N/A Q10. Doctor discussed reasons you might want to take a medicine Q11. Doctor discussed reasons you might NOT want to take a medicine Q12. Doctor asked which choice was best for you 93% 92% N/A Not significant N/A 65% 69% N/A Not significant N/A 69% 78% N/A Significantly lower N/A Rating of personal doctor (Q23) 63% 65% 66% Not significant Not significant Rating of specialist (Q27) 64% 65% 67% Not significant Not significant Rating of health care (Q13) 48% 53% 54% Not significant Significantly lower Rating of health plan (Q35) 44% 57% 58% Significantly lower Significantly lower Health promotion and education (Q8) 67% 72% 73% Not significant Significantly lower Coordination of care (Q22) 51% 56% 57% Not significant Not significant Advising smokers and tobacco users to quit 38% 40% 41% Not significant Not significant Discussing cessation medications 15% 18% 18% Not significant Not significant Discussing cessation strategies 11% 15% 15% Not significant Not significant *Regional data for the Shared decision making composite is not available. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 27

FIGURE 5. (ADULT) Benchmark Comparison Chart Composites and ratings of beneficiary satisfaction Getting needed care Getting care quickly How well doctors communicate Customer service Shared decision making Rating of personal doctor Rating of specialist Rating of health care Rating of health plan Health promotion and education Coordination of care Advising smokers and tobacco users to quit Discussing cessation medications Discussing cessation strategies 0.0% 50.0% 100.0% N/A* 15.0% 18.0% 18.0% 11.0% 15.0% 15.0% 44.0% 38.0% 40.0% 41.0% 53.0% 54.0% 56.0% 48.0% 53.0% 54.0% 59.0% 58.0% 61.0% 61.0% 67.0% 69.0% 57.0% 58.0% 51.0% 56.0% 57.0% 63.0% 65.0% 66.0% 64.0% 65.0% 67.0% *Regional summary rates for the shared decision making composite are not available. 71.0% 74.0% 75.0% 67.0% 72.0% 73.0% 76.0% 80.0% 2017 NCBD South Region ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 28

TABLE 12: Comparisons with benchmark data child survey COMPOSITE, COMPONENTS AND RATING ITEMS CHILD SUMMARY RATE 2016 NCBD RATE NCBD SOUTH REGION CHILD VS. NCBD SIGNIFICANCE TESTING CHILD VS. REGION Getting needed care 56% 61% 63% Not significant Significantly lower Q28. Seeing a specialist 48% 56% 58% Not significant Not significant Q14. Getting care, tests or treatment 64% 65% 68% Not significant Not significant Getting care quickly 79% 74% 76% Not significant Not significant Q4. Obtaining care right away for an illness/injury/condition Q6. Obtaining care when wanted, when not needed right away 88% 79% 81% Significantly higher Significantly higher 70% 68% 71% Not significant Not significant How well doctors communicate 74% 78% 78% Not significant Not significant Q17. Doctors explaining things in an understandable way 75% 80% 80% Significantly lower Significantly lower Q18. Doctors listening carefully to you 80% 81% 83% Not significant Not significant Q19. Doctors showing respect for what you had to say Q21. Doctors explaining things in an understandable way to your child Q22. Doctors spending enough time with your child 84% 85% 86% Not significant Not significant 66% 74% 75% Significantly lower Significantly lower 68% 68% 68% Not significant Not significant Customer service 33% 68% 70% Significantly lower Significantly lower Q32. Getting help when calling customer service 25% 58% 60% Significantly lower Significantly lower Q33. Treated with courtesy and respect 40% 78% 79% Significantly lower Significantly lower Shared decision making* 77% 80% N/A Not significant N/A Q10. Doctor discussed reasons you might want your child taking a medicine Q11. Doctor discussed reasons you might NOT want your child taking a medicine Q12. Doctor discussed what you thought best for your child 95% 93% N/A Not significant N/A 63% 68% N/A Not significant N/A 74% 80% N/A Not significant N/A Rating of personal doctor (Q26) 70% 74% 76% Not significant Significantly lower Rating of specialist (Q30) 75% 70% 72% Not significant Not significant Rating of health care (Q13) 68% 67% 69% Not significant Not significant Rating of health plan (Q36) 69% 68% 70% Not significant Not significant Health promotion and education (Q8) 61% 71% 73% Significantly lower Significantly lower Coordination of care (Q25) 60% 58% 59% Not significant Not significant *Regional data for the Shared decision making composite is not available. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 29

FIGURE 6. (CHILD) Benchmark Comparison Chart Composites and ratings of beneficiary satisfaction 2017 NCBD South Region 0.0% 50.0% 100.0% Getting needed care Getting care quickly How well doctors communicate Customer service 33.0% 56.0% 61.0% 63.0% 68.0% 70.0% 79.0% 74.0% 76.0% 74.0% 78.0% 78.0% Shared decision making Rating of personal doctor Rating of specialist Rating of health care Rating of health plan N/A* 77.0% 80.0% 70.0% 74.0% 76.0% 75.0% 70.0% 72.0% 68.0% 67.0% 69.0% 69.0% 68.0% 70.0% Health promotion and education Coordination of care 61.0% 60.0% 58.0% 59.0% 71.0% 73.0% * Regional summary rates for the shared decision making composite are not available. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 30

Demographic Analysis At the end of each CAHPS survey, there are questions regarding the demographics of the beneficiary. The following tables show how beneficiaries in various demographic categories responded to the composites and the rating questions. Demographic analysis was performed on age, education (for the child survey, it is the parent s education), gender, race, overall health status and mental health status. Range reported is the difference between the highest and lowest value for the specific composite or rating item. TABLE 13. Adult composite, ratings and summary questions by age category AGE 18 34 35 44 45 54 55 OR OLDER COMPOSITE AND RATINGS N % N % N % N % RANGE Getting needed care 85.5% 79.8% 79.5% 88.7% 9.2% Getting care quickly 76.4% 81.2% 80.7% 89.7% 13.3% How well doctors communicate 88.5% 89.6% 86.7% 91.8% 5.1% Customer service 82.1% 83.3% 87.0% 76.3% 10.7% Shared decision making 74.1% 79.2% 71.9% 79.7% 7.8% Rating of personal doctor 96 75.0% 66 71.2% 86 74.4% 94 80.9% 9.7% Rating of specialist 35 65.7% 29 75.9% 56 78.6% 47 87.2% 21.5% Rating of health care 83 62.7% 57 61.4% 84 63.1% 98 68.4% 7.0% Rating of health plan 114 58.8% 73 56.2% 97 53.6% 113 61.9% 8.3% Health promotion and education 83 59.0% 55 72.7% 83 72.3% 97 68.0% 13.7% Coordination of care 39 66.7% 29 69.0% 50 80.0% 48 79.2% 13.3% Aspirin use 0 0.0% 0 0.0% 9 0.0% 18 55.6% 55.6% Aspirin discussion 0 0.0% 0 0.0% 17 41.2% 39 56.4% 56.4% Advising smokers and tobacco users to quit 25 60.0% 34 73.5% 47 78.7% 52 84.6% 24.6% Discussing cessation medications 25 36.0% 34 41.2% 46 41.3% 52 53.8% 17.8% Discussing cessation strategies 25 44.0% 34 41.2% 46 34.8% 51 43.1% 9.2% Of the composites, the Getting care quickly composite recorded the largest range with a difference of 13.3 percent. Of the ratings, the overall Rating of specialist had the largest range with a difference of 21.5 percent. Health promotion and education had the wider range of 13.7 percentage points on the summary questions. Of the effectiveness of care measures, Aspirin use and Aspirin discussion had ranges of more than 50.0 percent; however, very few beneficiaries are included on this measure ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 31

and caution should be exercised when making conclusions based on small numbers. The Advising smokers and tobacco users to quit measure recorded a range of 24.6 percent, with a much higher percentage of 55 or older smokers indicating that they were advised to quit, when compared with smokers in the 18 34 age category. TABLE 14. Adult composite, ratings and summary questions by age category EDUCATION HIGH SCHOOL GRADUATE OR LESS SOME COLLEGE OR MORE COMPOSITE AND RATINGS N % N % RANGE Getting needed care 84.9% 77.0% 7.9% Getting care quickly 82.1% 83.0% 0.9% How well doctors communicate 89.4% 88.5% 0.9% Customer service 84.4% 77.5% 6.9% Shared decision making 73.6% 82.9% 9.3% Rating of personal doctor 266 76.3% 68 72.1% 4.2% Rating of specialist 121 79.3% 42 71.4% 7.9% Rating of health care 254 66.5% 61 52.5% 14.0% Rating of health plan 306 57.2% 82 56.1% 1.1% Health promotion and education 251 64.9% 60 78.3% 13.4% Coordination of care 121 79.3% 40 62.5% 16.8% Aspirin use 20 40.0% 5 20.0% 20.0% Aspirin discussion 42 52.4% 12 50.0% 2.4% Advising smokers and tobacco users to quit 121 76.0% 36 80.6% 4.6% Discussing cessation medications 120 41.7% 36 55.6% 13.9% Discussing cessation strategies 119 36.1% 36 55.6% 19.5% Of the composites, Shared decision making had the largest range with a difference of 9.3 percent. Of the ratings, the overall Rating of health care recorded the largest difference of 14.0 percent. Of the summary questions, the Coordination of care measure had the greatest range with a difference of 16.8 percent. Respondents with an education level of high school graduate or less rated their personal doctor, specialist, health care and health plan consistently higher than respondents with an education level of some college or more. Of the effectiveness of care measures, Aspirin use had the widest range with a difference of 20.0 percent; however, very few beneficiaries are included on this measure, with only five indicating an education level of Some college or more. Respondents with an education level of some college or more rated all of the smoking measures higher than respondents with an education level of high school graduate or less. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 32

TABLE 15. Adult composite, ratings and summary questions by gender GENDER MALE FEMALE COMPOSITE AND RATINGS N % N % RANGE Getting needed care 85.5% 82.3% 3.2% Getting care quickly 86.3% 80.5% 5.8% How well doctors communicate 92.7% 87.2% 5.5% Customer service 87.0% 80.4% 6.6% Shared decision making 83.2% 72.4% 10.8% Rating of personal doctor 132 78.0% 211 74.4% 3.6% Rating of specialist 52 78.8% 115 77.4% 1.4% Rating of health care 126 69.0% 196 61.2% 7.8% Rating of health plan 157 59.2% 241 57.3% 1.9% Health promotion and education 124 62.1% 195 70.8% 8.7% Coordination of care 54 77.8% 112 73.2% 4.6% Aspirin use 20 30.0% 7 57.1% 27.1% Aspirin discussion 33 48.5% 23 56.5% 8.0% Advising smokers and tobacco users to quit 64 70.3% 94 80.9% 10.6% Discussing cessation medications 64 39.1% 93 48.4% 9.3% Discussing cessation strategies 64 37.5% 92 42.4% 4.9% Of the composites, Shared decision making had the greatest range with a difference of 10.8 percent. Of the ratings, the overall Rating of health care had the greatest range with a difference of 7.8 percent. Of the summary questions, Health promotion and education had a higher range with a difference of 8.7 percent. Male respondents rated all rating questions and the composites consistently higher than female respondents. Of the effectiveness of care measures, Aspirin use had the largest difference of 27.1 percentage points between males and females, with only 27 beneficiaries included in this measure. There are more female smokers in this population than male smokers, and a higher proportion of females reported being advised to quit and/or discussing cessation medications and strategies with their providers. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 33

TABLE 16. Adult composite, ratings and summary questions by race RACE WHITE BLACK OTHER COMPOSITE AND RATINGS N % N % N % RANGE Getting needed care 84.8% 87.8% 60.4% 27.4% Getting care quickly 83.2% 85.5% 69.2% 16.3% How well doctors communicate 88.7% 92.8% 81.3% 11.5% Customer service 81.4% 89.6% 57.1% 32.5% Shared decision making 74.5% 81.1% 76.2% 6.6% Rating of personal doctor 226 75.2% 89 78.7% 28 71.4% 7.3% Rating of specialist 114 81.6% 37 73.0% 15 60.0% 21.6% Rating of health care 211 66.4% 86 65.1% 25 40.0% 26.4% Rating of health plan 257 59.1% 105 61.9% 34 32.4% 29.5% Health promotion and education 210 66.7% 84 69.0% 24 66.7% 2.3% Coordination of care 112 77.7% 40 70.0% 14 64.3% 13.4% Aspirin use 19 31.6% 8 50.0% 0 0.0% 50.0% Aspirin discussion 36 47.2% 17 58.8% 3 66.7% 19.5% Advising smokers and tobacco users to quit 110 74.5% 36 77.8% 12 91.7% 17.2% Discussing cessation medications 109 45.0% 36 44.4% 12 41.7% 3.3% Discussing cessation strategies 109 41.3% 36 38.9% 11 36.4% 4.9% The Customer service composite registered the widest range of 32.5 percent; however, only seven beneficiaries in the Other race group are included on this composite (number not shown in table). Black/African-American respondents gave slightly higher scores on all composites when compared to white beneficiaries. The Rating of health plan recorded the largest difference of 29.5 percent between the groups. In the effectiveness of care measures, Aspirin use had the greatest range with a difference of 50.0 percent between groups with a very low number of respondents included in this measure. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 34

TABLE 17. Adult composite, ratings and summary questions by overall health status OVERALL HEALTH STATUS EXCELLENT/VERY GOOD GOOD FAIR/POOR COMPOSITE AND RATINGS N % N % N % RANGE Getting needed care 86.6% 84.4% 81.8% 4.8% Getting care quickly 81.1% 80.7% 83.8% 3.1% How well doctors communicate 98.5% 84.6% 89.9% 13.9% Customer service 100.0% 75.0% 81.4% 25.0% Shared decision making 80.0% 71.8% 77.6% 8.2% Rating of personal doctor 52 84.6% 108 69.4% 183 77.0% 15.2% Rating of specialist 18 83.3% 42 71.4% 107 79.4% 11.9% Rating of health care 46 80.4% 93 63.4% 185 60.0% 20.4% Rating of health plan 65 81.5% 124 52.4% 210 54.3% 29.1% Health promotion and education 46 56.5% 91 62.6% 183 71.6% 15.1% Coordination of care 16 75.0% 48 72.9% 102 75.5% 2.6% Aspirin use 0 0.0% 8 12.5% 19 47.4% 47.4% Aspirin discussion 1 0.0% 14 42.9% 41 56.1% 56.1% Advising smokers and tobacco users to quit 18 61.1% 35 80.0% 104 76.9% 18.9% Discussing cessation medications 18 33.3% 35 45.7% 103 45.6% 12.4% Discussing cessation strategies 18 44.4% 35 45.7% 102 38.2% 7.5% The Customer service composite had the widest range of ratings with a difference of 25.0 percent. The Rating of health plan had the widest range of ratings with a difference of 29.1 percent. Of the summary questions, the Health promotion and education measure had the larger difference of 15.1 percent. Those respondents who perceived their health status to be Excellent/very good rated their personal doctor, specialist, health plan and health care better than respondents who perceived their health status to be Good or Fair/poor. Of the effectiveness of care measures, both aspirin measures recorded large ranges of 47.4 percent and 56.1 percent, but had a very low number of respondents, especially in the Excellent/very good category. On the smoking measures, a higher proportion of respondents who perceived their health status to be Good reported they were advised to quit and that their provider discussed cessation medications and/or strategies with them. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 35

TABLE 18. Adult composite, ratings and summary questions by overall mental health status MENTAL HEALTH STATUS EXCELLENT/VERY GOOD GOOD FAIR/POOR COMPOSITE AND RATINGS N % N % N % RANGE Getting needed care 81.7% 82.5% 84.9% 3.2% Getting care quickly 83.9% 77.7% 85.6% 7.9% How well doctors communicate 92.9% 86.9% 89.8% 6.0% Customer service 90.0% 76.0% 85.7% 14.0% Shared decision making 70.6% 74.4% 78.5% 7.9% Rating of personal doctor 70 82.9% 112 68.8% 165 78.2% 14.1% Rating of specialist 25 88.0% 54 70.4% 90 80.0% 17.6% Rating of health care 61 73.8% 104 63.5% 162 61.7% 12.1% Rating of health plan 80 66.3% 130 59.2% 192 55.2% 11.1% Health promotion and education 61 62.3% 104 65.4% 158 70.9% 8.6% Coordination of care 30 80.0% 57 68.4% 82 78.0% 11.6% Aspirin use 4 25.0% 7 14.3% 16 50.0% 35.7% Aspirin discussion 6 50.0% 14 57.1% 36 50.0% 7.1% Advising smokers and tobacco users to quit 23 69.6% 39 82.1% 97 75.3% 12.5% Discussing cessation medications 23 34.8% 39 56.4% 96 41.7% 21.6% Discussing cessation strategies 23 34.8% 39 38.5% 95 43.2% 8.4% The Customer service composite measure had the widest range of 14.0 percentage points. The Rating of specialist measure had the largest range of 17.6 percent. Of the summary questions, the Coordination of care measure had the greatest change in range with a difference of 11.6 percent. Both Aspirin use and Aspirin discussion measures of effectiveness had a very low number of respondents with more than half with a fair/poor perception of their overall mental health status. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 36

TABLE 19. Child composite, ratings and summary questions by child s age CHILD S AGE 0 3 4 7 8 11 12 OR OLDER COMPOSITE AND RATINGS N % N % N % N % Getting needed care 89.8% 88.5% 76.5% 85.1% 13.3% Getting care quickly 97.8% 97.0% 91.1% 92.7% 6.7% How well doctors communicate 93.7% 90.8% 92.2% 92.4% 2.9% Customer service 72.2% 50.0% 50.0% 62.5% 22.2% Shared decision making 79.2% 68.9% 75.8% 80.3% 11.4% Rating of personal doctor 62 90.3% 63 82.5% 85 82.4% 127 85.8% 7.9% Rating of specialist 10 90.0% 12 75.0% 13 92.3% 32 87.5% 17.3% Rating of health care 54 94.4% 58 84.5% 74 82.4% 104 85.6% 12.0% Rating of health plan 68 86.8% 74 86.5% 97 84.5% 150 79.3% 7.5% Health promotion and education 54 74.1% 58 51.7% 74 71.6% 104 53.8% 22.4% Coordination of care 22 86.4% 19 84.2% 26 80.8% 36 75.0% 11.4% RANGE The Customer service composite recorded the largest range of ratings with a difference of 22.2 percent. The Rating of specialist had the largest range of ratings with a difference of 17.3 percent. Health promotion and education had the wider range of 22.4 percentage points in the summary questions. Parent/caregiver respondents for child beneficiaries in 0 3 age group rated their personal doctor and health care better than parent/caregiver respondents with children in the other age groups. TABLE 20. Child composite, ratings and summary questions by parent s education level PARENT S EDUCATION HIGH SCHOOL GRADUATE OR LESS SOME COLLEGE OR MORE COMPOSITE AND RATINGS N % N % Getting needed care 80.0% 85.7% 5.7% Getting care quickly 92.5% 94.3% 1.8% How well doctors communicate 91.9% 93.7% 1.8% Customer service 59.1% 60.0% 0.9% Shared decision making 79.5% 75.2% 4.3% Rating of personal doctor 174 82.2% 160 87.5% 5.3% Rating of specialist 25 92.0% 42 81.0% 11.0% Rating of health care 151 84.8% 137 85.4% 0.6% Rating of health plan 210 85.2% 172 80.2% 5.0% Health promotion and education 151 58.9% 138 64.5% 5.6% Coordination of care 44 77.3% 60 81.7% 4.4% RANGE The Getting needed care composite has the largest range of ratings with a difference of 5.7 percent. The Rating of specialist recorded the largest difference of ratings of 11.0 percent. Of the summary questions, the Health promotion and education measure had the larger range with a difference of 5.6 percent. Parent/caregiver respondents of ARKids First A beneficiaries with Some college or more education level gave slightly higher scores to all composites except for Shared decision making. Parents with Some college or more indicated higher satisfaction for both summary questions. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 37

TABLE 21. Child composite, ratings and summary questions by gender CHILD S GENDER MALE FEMALE COMPOSITE AND RATINGS N % N % RANGE Getting needed care 89.5% 77.4% 12.1% Getting care quickly 93.6% 94.5% 0.9% How well doctors communicate 91.7% 94.0% 2.3% Customer service 60.9% 52.9% 8.0% Shared decision making 78.4% 75.8% 2.6% Rating of personal doctor 191 88.0% 155 81.3% 6.7% Rating of specialist 42 81.0% 28 92.9% 11.9% Rating of health care 172 86.0% 125 85.6% 0.4% Rating of health plan 218 83.0% 180 83.3% 0.3% Health promotion and education 171 60.2% 126 63.5% 3.3% Coordination of care 57 84.2% 51 76.5% 7.7% The Getting needed care composite had the greatest range of ratings with a difference of 12.1 percent. Parent/caregiver respondents of male ARKids First A beneficiaries are more satisfied with the Getting needed care, Customer service and Shared decision making composites. The Rating of specialist had the greatest range of ratings with a difference of 11.9 percent. Parent/caregiver respondents of male beneficiaries gave higher ratings to their personal doctor. Of the summary questions, the Coordination of care measure had a higher range with a difference of 7.7 percent. TABLE 22. Child composite, ratings and summary questions by child s race CHILD S RACE WHITE BLACK OTHER COMPOSITE AND RATINGS N % N % N % RANGE Getting needed care 84.6% 86.5% 79.5% 7.0% Getting care quickly 95.7% 92.1% 86.7% 9.0% How well doctors communicate 94.0% 91.0% 89.6% 4.4% Customer service 56.8% 60.0% 59.1% 3.2% Shared decision making 75.7% 80.0% 88.9% 13.2% Rating of personal doctor 224 86.2% 66 86.4% 48 77.1% 9.3% Rating of specialist 49 83.7% 10 90.0% 10 90.0% 6.3% Rating of health care 194 87.1% 51 88.2% 45 77.8% 10.4% Rating of health plan 248 85.1% 78 85.9% 61 72.1% 13.8% Health promotion and education 195 60.0% 51 62.7% 45 68.9% 8.9% Coordination of care 74 78.4% 20 90.0% 12 75.0% 15.0% The Shared decision making composite registered the widest range of 13.2 percent; however, only nine beneficiaries in the Other race group are included on this composite (number not shown in table). The Rating of health plan recorded the largest difference of 13.8 percent between the groups. A lower proportion of parent/caregiver respondents of white beneficiaries gave positive scores on the Health promotion and education measure. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 38

TABLE 23. Child composite, ratings and summary questions by overall health status CHILD S OVERALL HEALTH STATUS EXCELLENT/VERY GOOD GOOD FAIR/POOR COMPOSITE AND RATINGS N % N % N % Getting needed care 84.0% 81.8% 91.0% 9.2% Getting care quickly 93.5% 94.2% 92.9% 1.3% How well doctors communicate 94.4% 86.6% 91.7% 7.8% Customer service 51.9% 83.3% 56.3% 31.4% Shared decision making 77.4% 75.8% 79.5% 3.7% Rating of personal doctor 261 85.4% 60 88.3% 27 70.4% 17.9% Rating of specialist 45 86.7% 16 87.5% 10 80.0% 7.5% Rating of health care 212 90.1% 61 80.3% 26 61.5% 28.6% Rating of health plan 294 85.7% 73 82.2% 33 63.6% 22.1% Health promotion and education 213 60.1% 60 63.3% 26 65.4% 5.3% RANGE Coordination of care 76 84.2% 20 70.0% 13 69.2% 15.0% The Customer service composite had the widest range of ratings with a difference of 31.4 percent. However, this composite had a very low number of respondents (<10) in both the Good and Fair/poor category (number not reported on table). The Rating of health care had the widest range of ratings, with a difference of 28.6 percent. Of the question summaries, the Coordination of care measure had the larger range of 15.0 percent. Respondents who perceive their child s overall health status to be Excellent/very good rated their child s personal doctor, specialist, child s health care and health plan better than respondents who perceived their child s overall health as Fair/poor. The same is true on the Coordination of care summary measure. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 39

TABLE 24. Child composite, ratings and summary questions by mental health status CHILD S MENTAL HEALTH STATUS EXCELLENT/VERY GOOD GOOD FAIR/POOR COMPOSITE AND RATINGS N % N % N % Getting needed care 85.5% 80.8% 82.6% 4.7% Getting care quickly 92.7% 96.1% 95.9% 3.4% How well doctors communicate 93.9% 90.2% 90.6% 3.7% Customer service 63.0% 50.0% 50.0% 13.0% Shared decision making 74.4% 76.5% 84.4% 10.0% Rating of personal doctor 240 86.3% 65 86.2% 43 74.4% 11.9% Rating of specialist 42 95.2% 13 76.9% 16 68.8% 26.4% Rating of health care 200 88.0% 57 87.7% 42 71.4% 16.6% Rating of health plan 273 87.5% 76 75.0% 51 72.5% 15.0% Health promotion and education 201 64.7% 56 46.4% 42 64.3% 18.3% Coordination of care 65 81.5% 25 76.0% 19 78.9% 5.5% RANGE The Customer service composite registered the widest range with a difference of 13.0 percent but had a low number of respondents in each of the Good and Fair/poor overall mental health categories (number not reported on table). Respondents who perceive their child s mental health status to be Excellent/very good gave more positive ratings to their child s personal doctor, specialist, health care and health plan compared to respondents who perceive their child s mental health status to be Good or Fair/poor. In addition, the former are also the most satisfied with their child s Health promotion and education and Coordination of care. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 40

State and Regional Analysis Overall mean ratings and utilization of services are further reported by geographic regions of the state. The map below shows the five regions and the counties that lie within them. GEOGRAPHICAL REGIONS n Northwest: Baxter, Benton, Boone, Carroll, Conway, Crawford, Franklin, Johnson, Logan, Madison, Marion, Newton, Pope, Scott, Searcy, Sebastian, Van Buren, Washington and Yell counties n Northeast: Clay, Cleburne, Craighead, Crittenden, Cross, Fulton, Greene, Independence, Izard, Jackson, Lawrence, Mississippi, Poinsett, Randolph, Sharp, Stone, White and Woodruff counties n Central: Faulkner, Garland, Grant, Lonoke, Perry, Pulaski and Saline counties n Southwest: Calhoun, Clark, Columbia, Dallas, Hempstead, Hot Spring, Howard, Lafayette, Little River, Miller, Montgomery, Nevada, Ouachita, Pike, Polk, Sevier and Union counties n Southeast: Arkansas, Ashley, Bradley, Chicot, Cleveland, Desha, Drew, Jefferson, Lee, Lincoln, Monroe, Phillips, Prairie and St. Francis counties Northwest Northeast Central Southwest Southeast BENTON WASHINGTON CARROLL BOONE MADISON NEWTON MARION SEARCY BAXTER STONE FULTON RANDOLPH CLAY IZARD SHARP GREENE LAWRENCE CRAIGHEAD INDEPENDENCE MISSISSIPPI CRAWFORD FRANKLIN JOHNSON VAN BUREN CLEBURNE JACKSON POPE CONWAY SEBASTIAN LOGAN WHITE FAULKNER WOODRUFF YELL PERRY SCOTT PRAIRIE PULASKI LONOKE MONROE SALINE MONTGOMERY GARLAND POLK POINSETT CROSS CRITTENDEN ST. FRANCIS LEE PHILLIPS SEVIER LITTLE RIVER HOWARD PIKE HEMPSTEAD HOT SPRING GRANT JEFFERSON CLARK DALLAS LINCOLN CLEVELAND NEVADA OUACHITA BRADLEY CALHOUN DREW ARKANSAS DESHA MILLER LAFAYETTE COLUMBIA UNION ASHLEY CHICOT ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 41

OVERALL MEAN RATINGS The overall mean ratings are based on individual questions that ask beneficiaries to rate their personal doctor, specialist, health care and health plan on a scale of 0 to 10, where 0 represents the worst possible and 10 represents the best possible. The following tables show the mean ratings by region compared to the state mean, as well as the number of beneficiaries who responded to the question. TABLE 25. Overall mean ratings for adult beneficiaries CENTRAL NORTHWEST NORTHEAST SOUTHWEST SOUTHEAST STATEWIDE MEAN RATINGS N MEAN N MEAN N MEAN N MEAN N MEAN N MEAN Personal doctor 74 8.1 107 8.4 84 8.4 41 8.5 43 8.6 349 8.4 Specialist 36 8.6 58 8.5 41 9.1 17 9.1 17 7.9 169 8.6 Health care 70 7.8 98 7.9 82 8.1 40 7.6 39 7.9 329 7.9 Health plan 89 7.1 121 7.2 96 7.8 46 7.9 52 7.8 404 7.5 TABLE 26. Overall mean ratings for child beneficiaries CENTRAL NORTHWEST NORTHEAST SOUTHWEST SOUTHEAST STATEWIDE CHILD S MEAN RATINGS N MEAN N MEAN N MEAN N MEAN N MEAN N MEAN Personal doctor 77 9.0 108 8.5 81 8.9 49 9.1 33 8.9 348 8.8 Specialist 18 8.6 20 9.2 16 9.3 8 9.3 9 8.4 71 9.0 Health care 65 9.0 88 8.6 70 8.7 45 9.0 31 9.3 299 8.9 Health plan 95 8.7 119 8.6 88 8.8 57 9.1 41 9.3 400 8.8 Mean of the ratings for specialist are highest statewide for both adult and child beneficiaries. The smallest mean rating is 7.1 for health plan from adult beneficiaries in the central region of the state. The range of means across all categories is 7.1 9.1 on the adult survey. The smallest mean rating on the child survey is 8.4 in the specialist category from parent/caregivers of child beneficiaries in the southeast region of the state. The range of means across all categories is 8.4 9.3 on the child survey. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 42

UTILIZATION OF SERVICES The questionnaire contained several questions asking whether or not beneficiaries used various health care services in the previous six months. The following tables show the percent of respondents who utilized these various health care services. TABLE 27. Utilization of services by adult beneficiaries CENTRAL NORTHWEST NORTHEAST SOUTHWEST SOUTHEAST STATEWIDE UTILIZATION OF SERVICES N % N % N % N % N % N % Visiting the doctor at least once 90 81% 122 81% 99 87% 46 87% 53 77% 410 83% Three or more visits to doctor 90 47% 122 46% 99 60% 46 54% 53 47% 410 50% Visiting personal doctor at least once Three or more visits to personal doctor 71 79% 107 85% 84 89% 41 95% 42 88% 345 86% 71 31% 107 39% 84 45% 41 56% 42 50% 345 42% Seeking routine medical care 91 77% 120 81% 99 81% 47 79% 53 83% 410 80% Needing medical care for illness/ injury 91 53% 120 53% 97 51% 46 54% 53 51% 407 52% Seeking specialist care 90 49% 122 50% 96 50% 47 40% 53 36% 408 47% TABLE 28. Utilization of services by child beneficiaries CENTRAL NORTHWEST NORTHEAST SOUTHWEST SOUTHEAST STATEWIDE CHILD S UTILIZATION OF SERVICES N % N % N % N % N % N % Visiting the doctor at least once 96 69% 119 78% 89 81% 56 84% 42 79% 402 77% Three or more visits to doctor 96 34% 119 38% 89 38% 56 38% 42 36% 402 37% Visiting personal doctor at least once Three or more visits to personal doctor 78 74% 107 73% 81 86% 49 86% 33 79% 348 79% 78 27% 107 30% 81 32% 49 33% 33 33% 348 30% Seeking routine medical care 96 67% 119 67% 90 77% 56 71% 42 69% 403 70% Needing medical care for illness/ injury 96 40% 118 39% 90 44% 55 49% 41 41% 400 42% Seeking specialist care 96 22% 119 22% 89 20% 57 18% 42 31% 403 22% For adult beneficiaries statewide, Visiting personal doctor at least once recorded the highest utilization rate at 86.0 percent, followed by Visiting the doctor at least once at 83.0 percent. On the other hand, Three or more visits to personal doctor and Seeking specialist care were the least utilized services, with rates of 42.0 percent and 47.0 percent, respectively. Regionally, Three or more visits to personal doctor registered the most variability, with the highest utilization rate of 56.0 percent in the southwest and lowest utilization rate of 31.0 percent in the central region of the state. Similar to the adult survey, parent/caregivers of child beneficiaries statewide reported the highest utilization rate of 79.0 percent for Visiting personal doctor at least once followed ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 43

by Visiting the doctor at least once item at 77.0 percent. Also, Seeking specialist care and Three or more visits to personal doctor were the least utilized services with rates of 22.0 percent and 30.0 percent, respectively. Regionally, Visiting the doctor at least once registered the most variability, with the highest utilization rate of 84.0 percent in the southwest and lowest utilization rate of 69.0 percent in the central region of the state. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 44

Comparison of ARKids First A with ARKids First B The following table shows how the ARKids First A data compares with the ARKids First B data. Specifically, the table shows each composite measure, the questions that make up these composites, rating questions and summary questions for 2017. The table also shows whether any comparisons are significantly different; any significant differences are highlighted below. The ARKids First A data comes from this summary, while the ARKids First B data comes from the 2017 ARKids First B Beneficiary Satisfaction Survey executive summary conducted by AFMC between February and May. When compared with 2017 ARKids First B, ARKids First A indicates a significantly lower score in the Customer service composite as well as both its components. However, ARKids First A s Rating of health plan is significantly higher than for ARKids First B. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 45

TABLE 29: Comparison of ARKids First A and ARKids First B COMPOSITE, COMPONENTS AND RATING ITEMS 2017 ARKIDS A 2017 ARKIDS B VALID N SUMMARY RATE VALID N SUMMARY RATE ARKIDS FIRST A VS. ARKIDS FIRST B Getting needed care 84.4% 85.7% Not significant Seeing a specialist 81 76.5% 105 81.0% Not significant Getting care, tests or treatment 297 92.3% 359 90.5% Not significant Getting care quickly 93.7% 92.8% Not significant Obtaining care right away for an illness/injury/condition 137 97.1% 197 93.9% Not significant Obtaining care when wanted, not when needed right away 246 90.2% 287 91.6% Not significant How well doctors communicate 92.7% 96.0% Not significant Doctors explaining things in an understandable way 274 92.7% 316 96.2% Not significant Doctors listening carefully to you 273 94.9% 315 97.1% Not significant Doctors showing respect for what you had to say 274 96.7% 315 98.1% Not significant Doctors explaining things in an understandable way to your child 186 89.2% 238 94.1% Not significant Doctors spending enough time with your child 271 90.0% 313 94.2% Not significant Customer service 57.5% 87.3% Significantly lower Getting help when calling customer service 40 45.0% 75 82.7% Significantly lower Treated with courtesy and respect 40 70.0% 75 92.0% Significantly lower Shared decision making 77.3% 75.9% Not significant Doctor discussed reasons you might want your child to take a medicine 93 94.6% 99 94.9% Not significant Doctor discussed reasons you might not want your child to take a medicine 92 63.0% 98 62.2% Not significant Doctor asked what you thought best for your child 93 74.2% 98 70.4% Not significant Rating of personal doctor 348 84.8% 425 86.4% Not significant Rating of Specialist 71 85.9% 96 88.5% Not significant Rating of health care 299 85.6% 359 83.3% Not significant Rating of health care pre-arkids First B N/A N/A 262 68.3% N/A Rating of health plan 400 83.3% 474 76.8% Significantly higher Rating of dental care N/A N/A 334 89.5% N/A Health promotion and education 299 61.2% 358 64.8% Not significant Coordination of care 109 79.8% 118 83.9% Not significant ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 46

Tables and Comments CONNECTCARE SURVEY FREQUENCIES Medicaid Adult Survey Frequencies Q1) Our records show that you are now in Medicaid s ConnectCare program. Is that right? Q1 Yes 391 100.00 391 100.00 Q3) In the last 6 months, did you have an illness, injury or condition that needed care right away in a clinic, emergency room, or doctor s office? Q3 Yes 213 52.33 213 52.33 No 194 47.67 407 100.00 Q4) In the last 6 months, when you needed care right away, how often did you get care as soon as you needed? Q4 Never 3 1.60 3 1.60 Sometimes 26 13.90 29 15.51 Usually 46 24.60 75 40.11 Always 112 59.89 187 100.00 Q5) In the last 6 months, did you make any appointments for a check-up or routine care at a doctor s office or clinic? Q5 Yes 328 80.00 328 80.00 No 82 20.00 410 100.00 Q6) In the last 6 months, how often did you get an appointment for a check-up or routine care at a doctor s office or clinic as soon as you needed? Q6 Never 5 1.69 5 1.69 Sometimes 50 16.95 55 18.64 Usually 71 24.07 126 42.71 Always 169 57.29 295 100.00 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 47

Q7) In the last 6 months, not counting the times you went to an emergency room, how many times did you go to a doctor s office or clinic to get health care for yourself? Q7 None 71 17.32 71 17.32 1 time 51 12.44 122 29.76 2 81 19.76 203 49.51 3 67 16.34 270 65.85 4 46 11.22 316 77.07 5-9 65 15.85 381 92.93 10 or more times 29 7.07 410 100.00 Q8) In the last 6 months, did you and a doctor or other health provider talk about specific things you could do to prevent illness? Q8 Yes 219 67.38 219 67.38 No 106 32.62 325 100.00 Q9) In the last 6 months, did you and a doctor or other health provider talk about starting or stopping a prescription medicine? Q9 Yes 152 46.48 152 46.48 No 175 53.52 327 100.00 Q10) Did you and a doctor or other health provider talk about the reasons you might want to take a medicine? Q10 Yes 136 93.15 136 93.15 No 10 6.85 146 100.00 Q11) Did you and a doctor or other health provider talk about the reasons you might not want to take a medicine? Q11 Yes 93 65.49 93 65.49 No 49 34.51 142 100.00 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 48

Q12) When you talked about starting or stopping a prescription medicine, did a doctor or other health provider ask you what you thought was best for you? Q12 Yes 100 68.97 100 68.97 No 45 31.03 145 100.00 Q13) 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 health care in the last 6 months? Q13 0 = Worst health care possible 2 0.61 2 0.61 1 1 0.30 3 0.91 2 5 1.52 8 2.43 3 5 1.52 13 3.95 4 9 2.74 22 6.69 5 33 10.03 55 16.72 6 28 8.51 83 25.23 7 34 10.33 117 35.56 8 53 16.11 170 51.67 9 43 13.07 213 64.74 10 = Best health care possible 116 35.26 329 100.00 Q14) In the last 6 months, how often was it easy to get the care, tests, or treatment you needed? Q14 Never 4 1.22 4 1.22 Sometimes 49 14.98 53 16.21 Usually 101 30.89 154 47.09 Always 173 52.91 327 100.00 Q15) A personal doctor is the one you would see if you need a check-up, want advice about a health problem, or get sick or hurt. Do you have a personal doctor? Q15 Yes 371 90.27 371 90.27 No 40 9.73 411 100.00 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 49

Q16) In the last 6 months, how many times did you visit your personal doctor to get care for yourself? Q16 None 47 13.62 47 13.62 1 time 64 18.55 111 32.17 2 88 25.51 199 57.68 3 50 14.49 249 72.17 4 38 11.01 287 83.19 5-9 46 13.33 333 96.52 10 or more times 12 3.48 345 100.00 Q17) In the last 6 months, how often did your personal doctor explain things in a way that was easy to understand? Q17 Never 9 3.08 9 3.08 Sometimes 20 6.85 29 9.93 Usually 55 18.84 84 28.77 Always 208 71.23 292 100.00 Q18) In the last 6 months, how often did your personal doctor listen carefully to you? Q18 Never 6 2.06 6 2.06 Sometimes 25 8.59 31 10.65 Usually 57 19.59 88 30.24 Always 203 69.76 291 100.00 Q19) In the last 6 months, how often did your personal doctor show respect for what you had to say? Q19 Never 4 1.37 4 1.37 Sometimes 23 7.88 27 9.25 Usually 44 15.07 71 24.32 Always 221 75.68 292 100.00 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 50

Q20) In the last 6 months, how often did your personal doctor spend enough time with you? Q20 Never 9 3.08 9 3.08 Sometimes 29 9.93 38 13.01 Usually 63 21.58 101 34.59 Always 191 65.41 292 100.00 Q21) In the last 6 months, did you get care from a doctor or other health provider besides your personal doctor? Q21 Yes 174 59.59 174 59.59 No 118 40.41 292 100.00 Q22) In the last 6 months, how often did your personal doctor seem informed and up-to-date about the care you got from these doctors or other health providers? Q22 Never 15 8.88 15 8.88 Sometimes 27 15.98 42 24.85 Usually 40 23.67 82 48.52 Always 87 51.48 169 100.00 Q23) 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 personal doctor? Q23 0 = Worst personal doctor possible 7 2.01 7 2.01 1 3 0.86 10 2.87 2 5 1.43 15 4.30 3 9 2.58 24 6.88 4 2 0.57 26 7.45 5 14 4.01 40 11.46 6 19 5.44 59 16.91 7 24 6.88 83 23.78 8 46 13.18 129 36.96 9 49 14.04 178 51.00 10 = Best personal doctor possible 171 49.00 349 100.00 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 51

Q24) 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 make any appointments to see a specialist? Q24 Yes 191 46.81 191 46.81 No 217 53.19 408 100.00 Q25) In the last 6 months, how often did you get an appointment to see a specialist as soon as you needed? Q25 Never 8 4.44 8 4.44 Sometimes 22 12.22 30 16.67 Usually 53 29.44 83 46.11 Always 97 53.89 180 100.00 Q26) How many specialists have you seen in the last 6 months? Q26 None 6 3.35 6 3.35 1 specialist 80 44.69 86 48.04 2 50 27.93 136 75.98 3 26 14.53 162 90.50 4 8 4.47 170 94.97 5 or more specialists 9 5.03 179 100.00 Q27) We want to know your rating of the specialist you 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? Q27 0 = Worst specialist possible 0 0.00 0 0.00 1 2 1.18 2 1.18 2 1 0.59 3 1.78 3 2 1.18 5 2.96 4 1 0.59 6 3.55 5 7 4.14 13 7.69 6 6 3.55 19 11.24 7 18 10.65 37 21.89 8 23 13.61 60 35.50 9 24 14.20 84 49.70 10 = Best specialist possible 85 50.30 169 100.00 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 52

Q28) In the last 6 months, did you look for any information in written materials or on the Internet about how your health plan works? Q28 Yes 69 16.91 69 16.91 No 339 83.09 408 100.00 Q29) In the last 6 months, how often did the written materials or the Internet provide the information you needed about how your health plan works? Q29 Never 7 10.61 7 10.61 Sometimes 26 39.39 33 50.00 Usually 9 13.64 42 63.64 Always 24 36.36 66 100.00 Q30) In the last 6 months, did you get information or help from your health plan s customer service? Q30 Yes 75 18.47 75 18.47 No 331 81.53 406 100.00 Q31) In the last 6 months, how often did your health plan s customer service give you the information or help you needed? Q31 Never 2 2.82 2 2.82 Sometimes 14 19.72 16 22.54 Usually 15 21.13 31 43.66 Always 40 56.34 71 100.00 Q32) In the last 6 months, how often did your health plan s customer service staff treat you with courtesy and respect? Q32 Never 2 2.82 2 2.82 Sometimes 6 8.45 8 11.27 Usually 17 23.94 25 35.21 Always 46 64.79 71 100.00 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 53

Q33) In the last 6 months, did your health plan give you any forms to fill out? Q33 Yes 83 20.49 83 20.49 No 322 79.51 405 100.00 Q34) In the last 6 months, how often were the forms from your health plan easy to fill out? Q34 Never 1 1.28 1 1.28 Sometimes 17 21.79 18 23.08 Usually 24 30.77 42 53.85 Always 36 46.15 78 100.00 Q35) 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 health plan? Q35 0 = Worst health plan possible 7 1.73 7 1.73 1 2 0.50 9 2.23 2 10 2.48 19 4.70 3 15 3.71 34 8.42 4 14 3.47 48 11.88 5 53 13.12 101 25.00 6 28 6.93 129 31.93 7 39 9.65 168 41.58 8 59 14.60 227 56.19 9 52 12.87 279 69.06 10 = Best health plan possible 125 30.94 404 100.00 Q36) In general, how would you rate your overall health? Q36 Excellent 25 6.16 25 6.16 Very good 44 10.84 69 17.00 Good 125 30.79 194 47.78 Fair 147 36.21 341 83.99 Poor 65 16.01 406 100.00 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 54

Q37) In general, how would you rate your overall mental or emotional health? Q37 Excellent 32 7.82 32 7.82 Very good 50 12.22 82 20.05 Good 131 32.03 213 52.08 Fair 139 33.99 352 86.06 Poor 57 13.94 409 100.00 Q38) Have you had either a flu shot or flu spray in the nose since July 1, 2016? Q38 Yes 137 33.83 137 33.83 No 245 60.49 382 94.32 Don't know 23 5.68 405 100.00 Q39) Do you now smoke cigarettes or use tobacco every day, some days or not at all? Q39 Every day 111 27.14 111 27.14 Some days 54 13.20 165 40.34 Not at all 237 57.95 402 98.29 Don t know 7 1.71 409 100.00 Q40) In the last 6 months, how often were you advised to quit smoking or using tobacco by a doctor or other health provider in your plan? Q40 Never 38 23.90 38 23.90 Sometimes 29 18.24 67 42.14 Usually 31 19.50 98 61.64 Always 61 38.36 159 100.00 Q41) In the last 6 months, how often was medication recommended or discussed by a doctor or health provider to assist you with quitting smoking or using tobacco? Examples include: nicotine gum, patch, nasal spray, inhaler or prescription medication. Q41 Never 88 55.70 88 55.70 Sometimes 27 17.09 115 72.78 Usually 20 12.66 135 85.44 Always 23 14.56 158 100.00 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 55

Q42) In the last 6 months, how often did your doctor or health provider discuss or provide methods and strategies other than medication to assist you with quitting smoking or using tobacco? Examples include: telephone helpline, individual or group counseling. Q42 Never 93 59.24 93 59.24 Sometimes 30 19.11 123 78.34 Usually 16 10.19 139 88.54 Always 18 11.46 157 100.00 Q43) Do you take aspirin daily or every other day? Q43 Yes 102 25.06 102 25.06 No 300 73.71 402 98.77 Don't know 5 1.23 407 100.00 Q44) Do you have a health problem or take medication that makes taking aspirin unsafe for you? Q44 Yes 38 9.43 38 9.43 No 299 74.19 337 83.62 Don't know 66 16.38 403 100.00 Q45) Has a doctor or health provider ever discussed with you the risks and benefits of aspirin to prevent heart attack or stroke? Q45 Yes 159 39.75 159 39.75 No 241 60.25 400 100.00 Q46) Are you aware that you have any of the following conditions? Mark one or more. Utilization Rate High cholesterol 112 26.79 41.48 High blood pressure 186 44.50 68.89 Parent or sibling with heart attack before the age of 60 120 28.71 44.44 Q47) Has a doctor ever told you that you have any of the following conditions? Mark one or more. Utilization Rate A heart attack 38 18.81 26.21 Angina or coronary heart disease 36 17.82 24.83 A stroke 34 16.83 23.45 Any kind of diabetes or high blood sugar 94 46.53 64.83 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 56

Q48) In the last 6 months, did you get health care 3 or more times for the same condition or problem? Q48 Yes 167 41.85 167 41.85 No 232 58.15 399 100.00 Q49) Is this a condition or problem that has lasted for at least 3 months? Do not include pregnancy or menopause. Q49 Yes 123 80.39 123 80.39 No 30 19.61 153 100.00 Q50) Do you now need or take medicine prescribed by a doctor? Do not include birth control. Q50 Yes 306 78.46 306 78.46 No 84 21.54 390 100.00 Q51) Is this medicine to treat a condition that has lasted for at least 3 months? Do not include pregnancy or menopause. Q51 Yes 259 91.52 259 91.52 No 24 8.48 283 100.00 Q52) What is your age? Q52 18 to 24 64 15.84 64 15.84 25 to 34 53 13.12 117 28.96 35 to 44 74 18.32 191 47.28 45 to 54 99 24.50 290 71.78 55 to 64 98 24.26 388 96.04 65 to 74 11 2.72 399 98.76 75 or older 5 1.24 404 100.00 Q53) Are you male or female? Q53 Male 160 39.51 160 39.51 Female 245 60.49 405 100.00 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 57

Q54) What is the highest grade or level of school that you have completed? Q54 8th grade or less 45 11.39 45 11.39 Some high school, but did not graduate 107 27.09 152 38.48 High school graduate or GED 160 40.51 312 78.99 Some college or 2-year degree 66 16.71 378 95.70 4-year college graduate 12 3.04 390 98.73 More than 4-year college degree 5 1.27 395 100.00 Q55) Are you of Hispanic or Latino origin or descent? Q55 Yes, Hispanic or Latino 12 3.13 12 3.13 No, not Hispanic or Latino 372 96.88 384 100.00 Q56) What is your race? Mark one or more. Q56 White 260 64.52 260 64.52 Black or African-American 109 27.05 369 91.56 Asian 1 0.26 370 91.81 American Indian or Alaska Native 6 1.49 376 93.30 Other 10 2.48 386 95.78 Multiracial 17 4.22 403 100.00 Q57) Did someone help you complete this survey? Q57 Yes 140 34.74 140 34.74 No 263 65.26 403 100.00 Q58) How did that person help you? Mark one or more. Utilization Rate Read the questions to me 58 30.53 14.04 Wrote down the answers I gave 49 25.79 11.86 Answered the questions for me 60 31.58 14.53 Translated the questions into my language 8 4.21 1.94 Helped in some other way 15 7.89 3.63 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 58

CONNECTCARE SURVEY COMMENTS *All identifying information has been replaced with an asterisk Level of satisfaction Overall health status Age Education Comments 0-4 Fair 35 to 44 High school graduate or GED 0-4 Fair 9 4-year college graduate 0-4 Poor 45 to 54 0-4 Poor 45 to 54 5-7 Fair 25 to 34 5-7 Poor 45 to 54 5-7 Poor 55 to 64 Some high school, but did not graduate High school graduate or GED High school graduate or GED Some college or 2-year degree IT WOULD BE GREAT FOR PEOPLE WITH VARIOUS ILLNESS TO HAVE MORE THAN 12 DOCTOR VISIT'S. WHAT HAPPENS WHEN WE REALLY NEED CARE? WE JUST SUFFER THE PROBLEM IS NOT WITH THE DOCTORS IT IS MEDICAID THAT IS THE PROBLEM. IF YOU REALLY WANT TO KNOW WHAT IS WRONG WITH MEDICAID THAN HAVE A SURVEY WHICH IS ASKING ABOUT MEDICAID, NOT THE DOCTORS. SERIOUSLY, IF YOU ARE GOING TO PAY A COMPANY TO DESIGN A SURVEY-DEAL WITH THE REAL ISSUES, LIKE QUESTIONS ABOUT YOUR COVERAGE. OR THE FACT THAT AFTER 10 YEARS OF COVERING A MEDICINE, MEDICAID DECIDES NOT TO EVER COVER IT AGAIN-OR THE DENTAL ISSUE YOU ARE NOT ALLOWED A REGULAR TOOTH CLEANING IF YOU HAVE PERIDONTAL DISEASE. THIS REQUIRES 3 DEEP CLEANINGS WHICH ARE $500.00 PER CLEANING. I MAKE 735.00 A MONTH FROM SSI. MEDICAID MIGHT COVER THESE DEEP CLEANINGS BUT IT MAY TAKE UP TO 6 MONTHS TO EVEN GET AN ANSWER FROM THE PRIOR AUTHORIZATION IN THE MEANTIME, YOUR JAWS IS ROTTING OFF AND TEETH ARE DYING...OH WELL, I GUESS POOR PEOPLE HAVE TO DEAL WITH IT. THAT IS MESSED UP. I KNOW OF SEVERAL INDIVIDUALS WHO DIED BECAUSE OF UNTREATED ABCESS TEETH. THE INFECTION WENT TO THEIR BRAIN AND THEY DIED.; Q14) I NEED SPECIFIC DENTAL WORK WHICH REQUIRES PRIOR AUTHORIZ FROM MEDICAID HAVE NOT HEARD BACK AND ITS BEEN 3 MONTHS IN THE MEANTIME MY JAW IS DETERIORATING; ENCLOSURE) HIS MEDICADE IS NOT PAYING FOR ALOT. MOSTLY HIS LAB WORK THAT THE DR SENDS HIM TO GET BECAUSE OF HIS LITIUM LEVEL & SUGAR LEVEL. HE DOESN'T GET ALOT SO HE HAS TROUBLE PAYING FOR THEM HIS LEGAL GUARDIAN POWER OF ATTORNEY * Q35) I OWE A LOT OF MONEY MORE THAN A $1000.00 ON DOCTOR BILLS, BECAUSE MY LIMIT HAD BEEN REACHED AND I DIDN'T KNOW IT. (ON MY MEDICAID) I LIVE ON A FIXED INCOME NOW I CAN'T SEE THE SPECIALIST UNTIL I PAY THE BILL DUE.; Q17) DON'T UNDERSTAND MEDICAIL TERMS. BACK COVER) NEED TO BE ALLOWED TO GET MORE PRESCRIPTIONS FILLED I'M SUPPOSED TO BE ON 21 KINDS OF MEDS AND HAVE TO PICK AND CHOOSE WHICH MEDS TO TAKE AND STILL LEAVE SLOTS OPEN IN CASE I NEED ANTIBIOTICS-3-6 PRESCIPTIONS SLOTS IS NOT ENOUGH 8th grade or less MORE BENEFITS FOR LAB WORK WOULD BE VERY HELPFUL ALSO MORE FOR MEDS; ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 59

Level of satisfaction Overall health status Age Education Comments 5-7 Poor 55 to 64 5-7 Very good 55 to 64 8-10 Fair 45 to 54 Some high school, but did not graduate Some college or 2-year degree Q21) MY PCD DIDNT DO ANY THING TO HELP ME EXCEPT USED MEDICAID UP WITH USELESS APPTS HE'S ALREADY STARTED- 1ST VISIT ANT OUT NO TO QUESTION I C NO ONE BUT DR. * IN CLINTON HE IS A VERY GOOD DR. HE REALLY CARES WHAT HIS PEOPLE ALL OF THEM!!!; BACK COVER) SORRY, I DON'T GET MY MAIL MOST TIME, WHEN I DO, ITS BEEN OPENED. PUT OUT TO WHERE I SEE IT 3 TO 4 WKS LATER & SOEMTIMES NOT AT ALL. SO IF YOU DON'T RECIEVE THATS MEER'S I HAVEN'T GOT IT YET OR MAYBE LATE LATER SORRY * MY INTOFORMATION GIVE DR'S OR ANY KIND OF GOV. MATTERS NO ONE ELSE PERIOD!!! Q4) HAD TO WAIT 3MTH FOR DR APPT 9 THIS SURVEY WAS DUMB; INSIDE FRONT COVER) I AM SORRY THIS SURVEY DOES NOT ASK THE WRIGHT QUESTIONS LIKE HOW CAN WE MAKE THIS BETTER OR HOW CAN WE HELP ON MEDICATIONS OR I EYE GLASSES OR HEARING AIDS OR THING THAT MIGHT HELP THE PERSON ON MEDICAID OR MEDICARE OR HELP FOR YOUNG PEOPLE WHO LIVE WITH THERE PARENTS THAT NEED HELP ON DENTAL AND VISON THAT THEY NEED MY ANSWERS WILL BE THE SAME ON THIS SURVEY. SO HELP ME AND HELP THE PEOPLE I WILL TALK TO SOMEONE. FROM THE SURVEY DEPARTEMENT 8-10 Poor 9 9 Q11) IM ONLY ALLOWED 6 MED A MONTH; Q35) THEY COULD ALLOW MORE THE 6 MEDICENIS 8-10 Good 25 to 34 8-10 Very good 25 to 34 8-10 Fair 35 to 44 8-10 Fair 45 to 54 High school graduate or GED Some high school, but did not graduate High school graduate or GED Some high school, but did not graduate * HAS HAD PREVENTIVE DENTAL CARE YEARLY THROUGH THIS PROGRAM. Q12) DIDN'T DISCUSS IT CAUSE DON'T TAKE MEDS! * I'M THE MOTHER OF * AND UNABLE TO FILL OUT THE SURVEY, HIMSELF. I AM GRATEFUL FOR MEDICADE, MY HEALTH IS CRONIC HIV, CHEP! I'D BE DEAD WITHOUT A VERY EXPENSIVE MED. THAT MEDICADE PAYS FOR. MY DOCTOR'S ALL ARE WOONDERFUL; FRONT OF LETTER) THANKS FOR ASKING MY OPINON ABOUT MY VIEWS MY PCP I'VE BEEN WITH FOR 17 YEARS. (*) HIV OVER 20 YEARS. DR. * ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 60

ARKIDS FIRST A SURVEY FREQUENCIES Q1) Our records show that your child is now in Medicaid's ARKids First A program. Is that right? Q1 Yes 402 100.00 402 100.00 Q3) 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 Yes 168 42.00 168 42.00 No 232 58.00 400 100.00 Q4) In the last 6 months, when your child needed care right away, how often did your child get care as soon as he or she needed? Q4 Never 0 0.00 0 0.00 Sometimes 4 2.92 4 2.92 Usually 13 9.49 17 12.41 Always 120 87.59 137 100.00 Q5) In the last 6 months, did you make any appointments for a checkup or routine care for your child at a doctor's office or clinic? Q5 Yes 282 69.98 282 69.98 No 121 30.02 403 100.00 Q6) In the last 6 months, when you made an appointment for a check-up or routine care for your child at a doctor's office or clinic, how often did you get an appointment as soon as your child needed? Q6 Never 0 0.00 0 0.00 Sometimes 24 9.76 24 9.76 Usually 49 19.92 73 29.67 Always 173 70.33 246 100.00 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 61

Q7) 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 the doctor s office or clinic to get health care? Q7 None 91 22.64 91 22.64 1 time 81 20.15 172 42.79 2 82 20.40 254 63.18 3 73 18.16 327 81.34 4 35 8.71 362 90.05 5-9 32 7.96 394 98.01 10 or more times 8 1.99 402 100.00 Q8) In the last 6 months, 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 Yes 183 61.20 183 61.20 No 116 38.80 299 100.00 Q9) In the last 6 months, did you and your child's doctor or other health provider talk about starting or stopping a prescription medicine for your child? Q9 Yes 99 33.33 99 33.33 No 198 66.67 297 100.00 Q10) Did you and a doctor or other health provider talk about the reasons you might want to take a medicine? Q10 Yes 88 94.62 88 94.62 No 5 5.38 93 100.00 Q11) Did you and a doctor or other health provider talk about the reasons you might not want your child to take a medicine? Q11 Yes 58 63.04 58 63.04 No 34 36.96 92 100.00 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 62

Q12) When you talked about your child starting or stopping a prescription medicine, did a doctor or other health provider ask you what you thought was best for your child? Q12 Yes 69 74.19 69 74.19 No 24 25.81 93 100.00 Q13) 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? Q13 0 = Worst health care possible 1 0.33 1 0.33 1 0 0.00 1 0.33 2 1 0.33 2 0.67 3 4 1.34 6 2.01 5 6 2.01 12 4.01 6 16 5.35 28 9.36 7 15 5.02 43 14.38 8 52 17.39 95 31.77 9 56 18.73 151 50.50 10 = Best health care possible 148 49.50 299 100.00 Q14) In the last 6 months, how often was it easy to get care, tests or treatment your child needed? Q14 Never 4 1.35 4 1.35 Sometimes 19 6.40 23 7.74 Usually 83 27.95 106 35.69 Always 191 64.31 297 100.00 Q15) A personal doctor is the one your child would see if he or she needs a checkup, has a health problem or gets sick or hurt. Does your child have a personal doctor? Q15 Yes 371 92.29 371 92.29 No 31 7.71 402 100.00 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 63

Q16) In the last 6 months, how many times did your child visit his or her personal doctor for care? Q16 None 74 21.26 74 21.26 1 time 74 21.26 148 42.53 2 94 27.01 242 69.54 3 57 16.38 299 85.92 4 27 7.76 326 93.68 5-9 19 5.46 345 99.14 10 or more times 3 0.86 348 100.00 Q17) In the last 6 months, how often did your child's personal doctor explain things about your child's health in a way that was easy to understand? Q17 Never 3 1.09 3 1.09 Sometimes 17 6.20 20 7.30 Usually 48 17.52 68 24.82 Always 206 75.18 274 100.00 Q18) In the last 6 months, how often did your child's personal doctor listen carefully to you? Q18 Never 2 0.73 2 0.73 Sometimes 12 4.40 14 5.13 Usually 41 15.02 55 20.15 Always 218 79.85 273 100.00 Q19) In the last 6 months, how often did your child's personal doctor show respect for what you had to say? Q19 Never 2 0.73 2 0.73 Sometimes 7 2.55 9 3.28 Usually 36 13.14 45 16.42 Always 229 83.58 274 100.00 Q20) Is your child able to talk with doctors about his or her health care? Q20 Yes 191 69.71 191 69.71 No 83 30.29 274 100.00 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 64

Q21) 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? Q21 Never 5 2.69 5 2.69 Sometimes 15 8.06 20 10.75 Usually 44 23.66 64 34.41 Always 122 65.59 186 100.00 Q22) In the last 6 months, how often did your child's personal doctor spend enough time with your child? Q22 Never 5 1.85 5 1.85 Sometimes 22 8.12 27 9.96 Usually 59 21.77 86 31.73 Always 185 68.27 271 100.00 Q23) In the last 6 months, did your child's personal doctor talk with you about how your child is feeling, growing, or behaving? Q23 Yes 221 80.95 221 80.95 No 52 19.05 273 100.00 Q24) In the last 6 months, did your child get care from a doctor or other health provider besides his or her personal doctor? Q24 Yes 113 41.54 113 41.54 No 159 58.46 272 100.00 Q25) 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 providers? Q25 Never 11 10.09 11 10.09 Sometimes 11 10.09 22 20.18 Usually 22 20.18 44 40.37 Always 65 59.63 109 100.00 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 65

Q26) 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? Q26 0 = Worst personal doctor possible 2 0.57 2 0.57 1 1 0.29 3 0.86 2 1 0.29 4 1.15 3 4 1.15 8 2.30 4 1 0.29 9 2.59 5 15 4.31 24 6.90 6 11 3.16 35 10.06 7 18 5.17 53 15.23 8 52 14.94 105 30.17 9 60 17.24 165 47.41 10 = Best personal doctor possible 183 52.59 348 100.00 Q27) 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? Q27 Yes 88 21.84 88 21.84 No 315 78.16 403 100.00 Q28) In the last 6 months, how often did you get an appointment for your child to see a specialist as soon as you needed? Q28 Never 6 7.41 6 7.41 Sometimes 13 16.05 19 23.46 Usually 23 28.40 42 51.85 Always 39 48.15 81 100.00 Q29) How many specialists has your child seen in the last 6 months? Q29 None 9 11.11 9 11.11 1 specialist 47 58.02 56 69.14 2 13 16.05 69 85.19 3 7 8.64 76 93.83 4 2 2.47 78 96.30 5 or more specialists 3 3.70 81 100.00 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 66

Q30) 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? Q30 0 = Worst specialist possible 0 0.00 0 0.00 1 1 1.41 1 1.41 2 0 0.00 1 1.41 3 1 1.41 2 2.82 4 0 0.00 2 2.82 5 1 1.41 3 4.23 6 1 1.41 4 5.63 7 6 8.45 10 14.08 8 8 11.27 18 25.35 9 14 19.72 32 45.07 10 = Best specialist possible 39 54.93 71 100.00 Q31) In the last 6 months, did you try to get information or help from customer service at your child's health plan? Q31 Yes 43 10.72 43 10.72 No 358 89.28 401 100.00 Q32) 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 Never 10 25.00 10 25.00 Sometimes 12 30.00 22 55.00 Usually 8 20.00 30 75.00 Always 10 25.00 40 100.00 Q33) In the last 6 months, how often did customer service staff at your child's health plan treat you with courtesy and respect? Q33 Never 2 5.00 2 5.00 Sometimes 10 25.00 12 30.00 Usually 12 30.00 24 60.00 Always 16 40.00 40 100.00 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 67

Q34) In the last 6 months, did your child's health plan give you any forms to fill out? Q34 Yes 74 18.59 74 18.59 No 324 81.41 398 100.00 Q35) In the last 6 months, how often were the forms from your child's health plan easy to fill out? Q35 Never 2 2.74 2 2.74 Sometimes 17 23.29 19 26.03 Usually 18 24.66 37 50.68 Always 36 49.32 73 100.00 Q36) 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 0 = Worst health plan possible 3 0.75 3 0.75 1 2 0.50 5 1.25 2 1 0.25 6 1.50 3 4 1.00 10 2.50 4 4 1.00 14 3.50 5 17 4.25 31 7.75 6 12 3.00 43 10.75 7 24 6.00 67 16.75 8 57 14.25 124 31.00 9 54 13.50 178 44.50 10 = Best health plan possible 222 55.50 400 100.00 Q37) In general, how would you rate your child's overall health? Q37 Excellent 154 38.12 154 38.12 Very good 143 35.40 297 73.51 Good 74 18.32 371 91.83 Fair 29 7.18 400 99.01 Poor 4 0.99 404 100.00 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 68

Q38) In general, how would you rate your child's overall mental or emotional health? Q38 Excellent 173 42.82 173 42.82 Very good 104 25.74 277 68.56 Good 76 18.81 353 87.38 Fair 37 9.16 390 96.53 Poor 14 3.47 404 100.00 Q39) What is your child's age? Q39 Less than 1 year old 14 3.57 14 3.57 1 year old 18 4.59 32 8.16 2 years old 17 4.34 49 12.50 3 years old 19 4.85 68 17.35 4 years old 15 3.83 83 21.17 5 years old 16 4.08 99 25.26 6 years old 23 5.87 122 31.12 7 years old 20 5.10 142 36.22 8 years old 21 5.36 163 41.58 9 years old 26 6.63 189 48.21 10 years old 31 7.91 220 56.12 11 years old 20 5.10 240 61.22 12 years old 26 6.63 266 67.86 13 years old 22 5.61 288 73.47 14 years old 26 6.63 314 80.10 15 years old 21 5.36 335 85.46 16 years old 31 7.91 366 93.37 17 years old 22 5.61 388 98.98 18 years old 4 1.02 392 100.00 Q40) Is your child male or female? Q40 Male 221 54.98 221 54.98 Female 181 45.02 402 100.00 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 69

Q41) Is your child of Hispanic or Latino origin or descent? Q41 Yes, Hispanic or Latino 58 14.50 58 14.50 No, not Hispanic or Latino 342 85.50 400 100.00 Q42) What is your child's race? Mark one or more. Q42 White 250 63.94 250 63.94 Black or African-American 80 20.46 330 84.40 Asian 4 1.02 334 85.42 American Indian or Alaska Native 3 0.77 337 86.19 Other 34 8.70 371 94.88 Multiracial 20 5.12 391 100.00 Q43) What is your age? Q43 Under 18 42 10.69 42 10.69 18 to 24 23 5.85 65 16.54 25 to 34 125 31.81 190 48.35 35 to 44 95 24.17 285 72.52 45 to 54 57 14.50 342 87.02 55 to 64 36 9.16 378 96.18 65 to 74 11 2.80 389 98.98 75 or older 4 1.02 393 100.00 Q44) Are you male or female? Q44 Male 40 10.15 40 10.15 Female 354 89.85 394 100.00 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 70

Q45) What is the highest grade or level of school that you have completed? Q45 8th grade or less 22 5.70 22 5.70 Some high school, but did not graduate 48 12.44 70 18.13 High school graduate or GED 142 36.79 212 54.92 Some college or 2-year degree 126 32.64 338 87.56 4-year college graduate 25 6.48 363 94.04 More than 4-year college degree 23 5.96 386 100.00 Q46) How are you related to the child? Q46 Mother or father 325 86.44 325 86.44 Grandparent 36 9.57 361 96.01 Aunt or uncle 2 0.53 363 96.54 Other relative 1 0.27 364 96.81 Legal guardian 11 2.93 375 99.73 Someone else 1 0.27 376 100.00 Q47) Did someone help you complete this survey? Q47 Yes 23 5.84 23 5.84 No 371 94.16 394 100.00 Q48) How did that person help you? Mark one or more. Utilization Rate Read the questions to me 11 33.33 47.83 Wrote down the answers I gave 7 21.21 30.43 Answered the questions for me 4 12.12 17.39 Translated the questions into my language 9 27.27 39.13 Helped in some other way 2 6.06 8.70 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 71

ARKIDS FIRST A SURVEY COMMENTS *All identifying information has been replaced with an asterisk Level of satisfaction Overall health status of child Parent's age Parent's education level 0-4 Good 55 to 64 Some high school, but did not graduate 5-7 Fair 35 to 44 Some college or 2-year degree 5-7 Excellent 35 to 44 More than 4-year college degree Comments Q5) CAUSE HER DR. NEEDED A CARD SO SHE HAS NOT BEEN TO HER DR. SINCE 2015; Q31) TIMES & CALLED GOVERNORS OFFICE 4 & COMPLAINED, THEY CONTACKED YALL & YOU CALLED BUT STILL NO CARD; ENCLOSURE: PLEASE FORGIVE ME, I'M NOT BEING MEAN BUT IT WAS VERY UPSETTING THE WAY YOU GUYS HANDLED * INS. SHE WAS SUPPOSE TO GO TO HER DOCTOR EVERY 3 MONTHS FOR A SHOT, BUT BECAUSE OF YALL NOT SENDING ME A CARD FOR HER SHE HASNT BEEN ABLE TO GO. HER MOM PASSED IN SEPT. 2015- I REAPLIED IN DIDNT GET A CARD TILL MARCH 2017 & THEN I WAS ABLE TO TAKE HER. BUT SERVICE WAS ALWAYS GOOD WHEN HER MOM WAS HER. THANK YOU * MY CHILD NEEDS TO HAVE TESTS RUN ON HER BRAIN & ARKIDS WON'T PAY. UNACCEPTABLE Q36) *COULD BE BETTER IF ALL PHYSICIANS AND SPECIALIST OFFICES ACCEPTED ARKIDS- GOVERMENT HEALTH CARE SHOULD BE MANDATORY FOR THEM TO ACCEPT NOT VOULENTARY! 8-10 Very good - - Q33) NEVER GET A PERSON ON THE PHONE, BUT DO GET MESSAGES THAT USUALLY ANSWER MY QUESTIONS; Q35) HAD TO FILL OUT SAME FORM TWICE BUT IT WAS SIMPLE TO FILL OUT 8-10 Fair 25 to 34 Some college or 2-year degree ATTACHED NOTE) TO WHOM IT CONCERNS: * HAS PEDIATRIC HEADACHES AND ASTHMA THAT HE HAS TO BE ON MEDICINE FOR. HE ALSO HAS TO SEE A PEDIATRIC NEUROLOGY SPECIALIST. THANK YOU * 8-10 Fair - - Q12) THEY TOLD ME WHAT WOULD BE BEST FOR MY CHILD. 8-10 Poor 25 to 34 8th grade or less Q47) I USED MY COMPUTER TRASLATOR. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 72

APPENDIX A: ConnectCare Survey Letters and Postcard ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 73

THIS PAGE INTENTIONALLY LEFT BLANK ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 74

CONNECTCARE ADVANCE LETTER (FRONT) ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 75

CONNECTCARE ADVANCE LETTER (BACK) ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 76

CONNECTCARE FIRST COVER LETTER (FRONT) ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 77

CONNECTCARE FIRST COVER LETTER (BACK) ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 78

CONNECTCARE SECOND COVER LETTER (FRONT) ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 79

CONNECTCARE SECOND COVER LETTER (BACK) ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 80

CONNECTCARE SURVEY REMINDER CARD We need your help! Recently, we sent you a short survey about your health care. Your answers will help to improve the services we provide. The survey will also help other people learn more about health care plans, but it will help only if everyone who gets the survey sends it back. After you finish the survey, please return it in the pre-paid envelope to AFMC, a research firm working with us on this survey. If you did not get the survey, or if you misplaced it, please call AFMC at the toll-free number 1-844-493-8763 and they will mail you another one. You can also call that number if you have any questions. If you have already sent in your survey, thank you! You can ignore this reminder. Thanks again for your help! Si gusta recibir la versión en español de esta encuesta, favor llamar al 1-844-493-8763. 1020 W 4TH ST STE 300 LITTLE ROCK AR 72201-2024 NONPROFIT ORG. U.S. POSTAGE PAID LITTLE ROCK, AR PERMIT NO. 2234 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 81

THIS PAGE INTENTIONALLY LEFT BLANK ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 82

APPENDIX B: ARKids First A Survey Letters and Postcard ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 83

THIS PAGE INTENTIONALLY LEFT BLANK ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 84

ARKIDS FIRST A ADVANCE LETTER (FRONT) ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 85

ARKIDS FIRST A ADVANCE LETTER (BACK) ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 86

ARKIDS FIRST A COVER LETTER (FRONT) ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 87

ARKIDS FIRST A COVER LETTER (BACK) ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 88

ARKIDS FIRST A SECOND COVER LETTER (FRONT) ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 89

ARKIDS FIRST A SECOND COVER LETTER (BACK) ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 90

ARKIDS FIRST A SURVEY REMINDER CARD We need your help! Recently, we sent you a short survey about your child s health care. Your answers will help to improve the services we provide to children. The survey will also help other people learn more about health care plans, but it will help only if everyone who gets the survey sends it back. After you finish the survey, please return it in the pre-paid envelope to AFMC, a research firm working with us on this survey. If you did not get the survey, or if you misplaced it, please call AFMC at the toll-free number 1-844-493-8763 and they will mail you another one. You can also call that number if you have any questions. If you have already sent in your survey, thank you! You can ignore this reminder. Thanks again for your help! Si gusta recibir la versión en español de esta encuesta, favor llamar al 1-844-493-8763. 1020 W 4TH ST STE 300 LITTLE ROCK AR 72201-2024 NONPROFIT ORG. U.S. POSTAGE PAID LITTLE ROCK, AR PERMIT NO. 2234 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 91

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APPENDIX C: ConnectCare Survey Tools ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 93

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ENGLISH SURVEY A Program of Arkansas Department of Human Services, Division of Medical Services 2017 ADULT HEDIS CAHPS Health Plan Survey Si gusta recibir la versión en español de esta encuesta, favor llamar al 1-844-493-8763. DATA COLLECTION AND ANALYSIS BY THIS QUESTIONNAIRE WAS ADAPTED FROM CAHPS, WHICH IS A CONSORTIUM OF HARVARD MEDICAL SCHOOL, RAND AND THE RESEARCH TRIANGLE INSTITUTE. QUESTION DEVELOPMENT BY THE AGENCY FOR HEALTH CARE POLICY AND RESEARCH. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 95

ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 96

Survey Instructions IMPORTANT: Please read before answering questions! Answer all the questions by checking the box to the left of your answer. You are sometimes told to skip over some questions in this survey. When this happens you will see an arrow with a note that tells you what question to answer next, like this: 1 Yes Go to next question 2 No Go to question 13 You may notice a number on the cover of this survey. This number is ONLY used to let us know if you returned your survey so we don t have to send you reminders. If you have questions about this survey, please call toll-free 1-844-493-8763. All information that would let someone identify you or your family will be kept private. AFMC will not share your personal information with anyone without your OK. We appreciate your help in completing the survey. If you choose not to, however, it will not affect the benefits you get. If you have questions or want to know more about this study, please call toll-free 1-844-493-8763. Si gusta recibir la versión en español de esta encuesta, favor llamar al 1-844-493-8763 1 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 97

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1) Our records show that you are now in Medicaid s ConnectCare program. Is that right? 1 Yes Go to Question 3 2 No 2) What is the name of your health plan? (Please print.) YOUR HEALTH CARE IN THE LAST 6 MONTHS These questions ask about your own health care. Do not include care you got when you stayed overnight in a hospital. Do not include the times you went for dental care visits. 3) In the last 6 months, did you have an illness, injury or condition that needed care right away in a clinic, emergency room or doctor s office? 1 Yes 2 No Go to Question 5 4) In the last 6 months, when you needed care right away, how often did you get care as soon as you needed? 1 Never 2 Sometimes 3 Usually 4 Always 5) In the last 6 months, did you make any appointments for a check-up or routine care at a doctor s office or clinic? 1 Yes 2 No Go to Question 7 3 6) In the last 6 months, how often did you get an appointment for a check-up or routine care at a doctor s office or clinic as soon as you needed? 1 Never 2 Sometimes 3 Usually 4 Always 7) In the last 6 months, not counting the times you went to an emergency room, how many times did you go to a doctor s office or clinic to get health care for yourself? 0 None Go to Question 15 1 1 time 2 2 3 3 4 4 5 5 to 9 6 10 or more times 8) In the last 6 months, did you and a doctor or other health provider talk about specific things you could do to prevent illness? 1 Yes 2 No 9) In the last 6 months, did you and a doctor or other health provider talk about starting or stopping a prescription medicine? 1 Yes 2 No Go to Question 13 10) Did you and a doctor or other health provider talk about the reasons you might want to take a medicine? 1 Yes 2 No ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 99

11) Did you and a doctor or other health provider talk about the reasons you might not want to take a medicine? 1 Yes 2 No 12) When you talked about starting or stopping a prescription medicine, did a doctor or other health provider ask you what you thought was best for you? 1 Yes 2 No 13) 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 health care in the last 6 months? 00 0 Worst health care possible 01 1 02 2 03 3 04 4 05 5 06 6 07 7 08 8 09 9 10 10 Best health care possible 14) In the last 6 months, how often was it easy to get the care, tests or treatment you needed? 1 Never 2 Sometimes 3 Usually 4 Always 4 YOUR PERSONAL DOCTOR 15) A personal doctor is the one you would see if you need a check-up, want advice about a health problem, or get sick or hurt. Do you have a personal doctor? 1 Yes 2 No Go to Question 24 16) In the last 6 months, how many times did you visit your personal doctor to get care for yourself? 0 None Go to Question 23 1 1 time 2 2 3 3 4 4 5 5 to 9 6 10 or more times 17) In the last 6 months, how often did your personal doctor explain things in a way that was easy to understand? 1 Never 2 Sometimes 3 Usually 4 Always 18) In the last 6 months, how often did your personal doctor listen carefully to you? 1 Never 2 Sometimes 3 Usually 4 Always 19) In the last 6 months, how often did your personal doctor show respect for what you had to say? 1 Never 2 Sometimes 3 Usually 4 Always ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 100

20) In the last 6 months, how often did your personal doctor spend enough time with you? 1 Never 2 Sometimes 3 Usually 4 Always GETTING HEALTH CARE FROM SPECIALISTS When you answer the next questions, do not include dental visits or care you got when you stayed overnight in a hospital. 21) In the last 6 months, did you get care from a doctor or other health provider besides your personal doctor? 1 Yes 2 No Go to Question 23 22) In the last 6 months, how often did your personal doctor seem informed and up-to-date about the care you got from these doctors or other health providers? 1 Never 2 Sometimes 3 Usually 4 Always 23) 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 personal doctor? 00 0 Worst personal doctor possible 01 1 02 2 03 3 04 4 05 5 06 6 07 7 08 8 09 9 10 10 Best personal doctor possible 24) 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 make any appointments to see a specialist? 1 Yes 2 No Go to Question 28 25) In the last 6 months, how often did you get an appointment to see a specialist as soon as you needed? 1 Never 2 Sometimes 3 Usually 4 Always 26) How many specialists have you seen in the last 6 months? 0 None Go to Question 28 1 1 specialist 2 2 3 3 4 4 5 5 or more specialists 5 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 101

27) We want to know your rating of the specialist you 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? 00 0 Worst specialist possible 01 1 02 2 03 3 04 4 05 5 06 6 07 7 08 8 09 9 10 10 Best specialist possible YOUR HEALTH PLAN The next questions ask about your experience with your health plan. 28) In the last 6 months, did you look for any information in written materials or on the Internet about how your health plan works? 1 Yes 2 No Go to Question 30 29) In the last 6 months, how often did the written materials or the Internet provide the information you needed about how your health plan works? 1 Never 2 Sometimes 3 Usually 4 Always 30) In the last 6 months, did you get information or help from your health plan s customer service? 1 Yes 2 No Go to Question 33 31) In the last 6 months, how often did your health plan s customer service give you the information or help you needed? 1 Never 2 Sometimes 3 Usually 4 Always 32) In the last 6 months, how often did your health plan s customer service staff treat you with courtesy and respect? 1 Never 2 Sometimes 3 Usually 4 Always 33) In the last 6 months, did your health plan give you any forms to fill out? 1 Yes 2 No Go to Question 35 34) In the last 6 months, how often were the forms from your health plan easy to fill out? 1 Never 2 Sometimes 3 Usually 4 Always 6 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 102

35) 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 health plan? 00 0 Worst health plan possible 01 1 02 2 03 3 04 4 05 5 06 6 07 7 08 8 09 9 10 10 Best health plan possible 39) Do you now smoke cigarettes or use tobacco every day, some days or not at all? 1 Every day 2 Some days 3 Not at all Go to Question 43 4 Don t know Go to Question 43 40) In the last 6 months, how often were you advised to quit smoking or using tobacco by a doctor or other health provider in your plan? 1 Never 2 Sometimes 3 Usually 4 Always ABOUT YOU 36) In general, how would you rate your overall health? 1 Excellent 2 Very good 3 Good 4 Fair 5 Poor 37) In general, how would you rate your overall mental or emotional health? 1 Excellent 2 Very good 3 Good 4 Fair 5 Poor 38) Have you had either a flu shot or flu spray in the nose since July 1, 2016? 1 Yes 2 No 3 Don t know 7 41) In the last 6 months, how often was medication recommended or discussed by a doctor or health provider to assist you with quitting smoking or using tobacco? Examples of medication are: nicotine gum, patch, nasal spray, inhaler, or prescription medication. 1 Never 2 Sometimes 3 Usually 4 Always 42) In the last 6 months, how often did your doctor or health provider discuss or provide methods and strategies other than medication to assist you with quitting smoking or using tobacco? Examples of methods and strategies are: telephone helpline, individual or group counseling, or cessation program. 1 Never 2 Sometimes 3 Usually 4 Always 43) Do you take aspirin daily or every other day? 1 Yes 2 No 3 Don t know ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 103

44) Do you have a health problem or take medication that makes taking aspirin unsafe for you? 1 Yes 2 No 3 Don t know 45) Has a doctor or health provider ever discussed with you the risks and benefits of aspirin to prevent heart attack or stroke? 1 Yes 2 No 46) Are you aware that you have any of the following conditions? Mark one or more. A High cholesterol B High blood pressure C Parent or sibling with heart attack before the age of 60 50) Do you now need or take medicine prescribed by a doctor? Do not include birth control. 1 Yes 2 No Go to Question 52 51) Is this medicine to treat a condition that has lasted for at least 3 months? Do not include pregnancy or menopause. 1 Yes 2 No 52) What is your age? 1 18 to 24 2 25 to 34 3 35 to 44 4 45 to 54 5 55 to 64 6 65 to 74 7 75 or older 47) Has a doctor ever told you that you have any of the following conditions? Mark one or more. A A heart attack B Angina or coronary heart disease C A stroke D Any kind of diabetes or high blood sugar 48) In the last 6 months, did you get health care 3 or more times for the same condition or problem? 1 Yes 2 No Go to Question 50 53) Are you male or female? 1 Male 2 Female 54) What is the highest grade or level of school that you have completed? 1 8th grade or less 2 Some high school, but did not graduate 3 High school graduate or GED 4 Some college or 2-year degree 5 4-year college graduate 6 More than 4-year college degree 49) Is this a condition or problem that has lasted for at least 3 months? Do not include pregnancy or menopause. 1 Yes 2 No 55) Are you of Hispanic or Latino origin or descent? 1 Yes, Hispanic or Latino 2 No, not Hispanic or Latino 8 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 104

56) What is your race? Mark one or more. A White B Black or African-American C Asian D Native Hawaiian or other Pacific Islander E American Indian or Alaska Native F Other 57) Did someone help you complete this survey? 1 Yes Go to Question 58 2 No Thank you. Please return the completed survey in the postage-paid envelope. 58) How did that person help you? Mark one or more. A Read the questions to me B Wrote down the answers I gave C Answered the questions for me D Translated the questions into my language E Helped in some other way THANK YOU! Please return the completed survey in the postage-paid envelope. 9 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 105

DATA COLLECTION AND ANALYSIS BY THIS MATERIAL WAS PREPARED BY THE ARKANSAS FOUNDATION FOR MEDICAL CARE INC. (AFMC) UNDER CONTRACT WITH THE ARKANSAS DEPARTMENT OF HUMAN SERVICES, DIVISION OF MEDICAL SERVICES. THE CONTENTS PRESENTED DO NOT NECESSARILY REFLECT ARKANSAS DHS POLICY. THE ARKANSAS DEPARTMENT OF HUMAN SERVICES IS IN COMPLIANCE WITH TITLES VI AND VII OF THE CIVIL RIGHTS ACT. MP3-CAHPS.CSVY,4/16 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 106

SPANISH SURVEY Un Programa del Departamento de Servicios Humanos de Arkansas, División de Servicios Médicos 2017 ADULTOS HEDIS CAHPS Encuesta Sobre el Plan de salud Si gusta recibir la versión en español de esta encuesta, favor llamar al 1-844-493-8763. ESTE CUESTIONARIO FUE ADAPTADO DE CAHPS, QUE ES UN CONSORCIO DE ESCUELA DE MEDICINA HARVARD, RAND Y EL RESEARCH TRIANGLE INSTITUTE. DESARROLLO DE LAS PREGUNTAS POR LA AGENCIA PARA LA POLÍTICA Y LA INVESTIGACIÓN DE SALUD RECOLECCIÓN Y ANÁLISIS DE DATOS POR ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 107

ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 108

Instrucciones para la Encuesta IMPORTANTE: Lea antes de responder a las preguntas! Conteste todas las preguntas marcando la casilla a la izquierda de su respuesta. A veces se le pide que se salte algunas preguntas en esta encuesta. Cuando esto ocurra, verá una flecha con una nota que le indica cual pregunta responder a continuación, como esto: 1 SÍ Pase a la pregunta siguiente 2 NO Pase a la pregunta 13 Usted puede notar un número en la portada de esta encuesta. Este número se utiliza SOLAMENTE para hacernos saber si usted devolvió su encuesta para que no tengamos que enviarle recordatorios. Si tiene preguntas sobre esta encuesta, llame gratis al 1-844-493-8763. Toda la información que permitiría que alguien le identifique a usted o a su familia será mantenida privada. AFMC no compartirá su información personal con nadie sin su autorización. Apreciamos su ayuda para completar la encuesta. Si decide no hacerlo, sin embargo, eso no afectará los beneficios que usted obtiene. Si tiene preguntas o desea saber más sobre este estudio, llame gratis al 1-844-493-8763. Si quiere recibir la versión en español de esta encuesta, favor llamar al 1-844-493-8763 1 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 109

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1) Nuestros registros indican que usted está ahora en el programa de Medicaid ConnectCare. Correcto? 1 SÍ Pase a la pregunta 3 2 No 2) Cuál es el nombre de su plan de salud? (Por favor escriba en mayúsculas.) SU CUIDADO DE SALUD EN LOS ÚLTIMOS 6 MESES Estas preguntas son acerca de su propia atención médica. No incluya la atención que recibió cuando pasó la noche en un hospital. No incluya las veces que fue a visitas de atención dental. 6) En los últimos 6 meses, con qué frecuencia consiguió una cita para un chequeo o cuidado de rutina en el consultorio del médico o en una clínica tan pronto como lo necesitaba? 1 Nunca 2 A veces 3 Por lo general 4 Siempre 7) En los últimos 6 meses, sin contar las veces que fue a una sala de emergencia, cuántas veces fue a un consultorio médico o clínica para recibir atención de salud? 0 NINGUNA Pase a la pregunta 15 1 1 vez 2 2 3 3 4 4 5 5 a 9 6 10 o más veces 3) En los últimos 6 meses, tuvo usted una enfermedad, lesión o condición que necesitó atención inmediata en una clínica, sala de emergencias o consultorio médico? 1 Sí 2 NO Pase a la pregunta 5 8) En los últimos 6 meses, habló con un médico u otro profesional de la salud sobre cosas específicas que usted podría hacer para prevenir una enfermedad? 1 Sí 2 No 4) En los últimos 6 meses, cuando necesitó atención inmediata, con qué frecuencia recibió atención tan pronto como la necesitaba? 1 Nunca 2 A veces 3 Por lo general 4 Siempre 9) En los últimos 6 meses, habló con un médico u otro profesional de la salud acerca de cómo comenzar a tomar o suspender un medicamento con receta? 1 Sí 2 NO Pase a la pregunta 13 5) En los últimos 6 meses, hizo alguna cita para un chequeo o cuidado de rutina en el consultorio del médico o en una clínica? 1 Sí 2 NO Pase a la pregunta 7 3 10) Hablaron usted y un médico u otro proveedor de salud acerca de las razones por las que usted podría querer tomar un medicamento? 1 Sí 2 No ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 111

11) Hablaron usted y un médico u otro proveedor de salud acerca de las razones por las que usted podría NO querer tomar un medicamento? 1 Sí 2 No 12) Cuando usted habló acerca de comenzar a tomar o suspender un medicamento con receta, le preguntó un doctor u otro profesional de la salud sobre lo que usted pensaba era lo mejor? 1 Sí 2 No 13) Usando un número del 0 al 10, donde 0 es la peor atención médica posible y el 10 la mejor atención médica posible, qué número usaría para calificar toda su atención médica en los últimos 6 meses? 00 0 Peor atención médica posible 01 1 02 2 03 3 04 4 05 5 06 6 07 7 08 8 09 9 10 10 Mejor atención médica posible SU MÉDICO PERSONAL 15) Un médico personal es el que vería si necesita un chequeo, quiere consejo sobre un problema de salud, o se enferma o lesiona. Usted tiene un médico personal? 1 Sí 2 NO Pase a la pregunta 24 16) En los últimos 6 meses, cuántas veces visitó a su médico personal para recibir atención para usted mismo? 0 NINGUNA Pase a la pregunta 23 1 1 vez 2 2 3 3 4 4 5 5 a 9 6 10 o más veces 17) En los últimos 6 meses, con qué frecuencia su médico personal le explicó cosas de una manera que le fue fácil de entender? 1 Nunca 2 A veces 3 Por lo general 4 Siempre 14) En los últimos 6 meses, con qué frecuencia le fue fácil conseguir la atención médica, las pruebas o el tratamiento que necesitaba? 1 Nunca 2 A veces 3 Por lo general 4 Siempre 18) En los últimos 6 meses, con qué frecuencia su médico personal lo escuchó con atención? 1 Nunca 2 A veces 3 Por lo general 4 Siempre 4 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 112

19) En los últimos 6 meses, con qué frecuencia su médico personal mostró respeto por lo que usted tenía que decir? 1 Nunca 2 A veces 3 Por lo general 4 Siempre 20) En los últimos 6 meses, con qué frecuencia su médico personal pasó suficiente tiempo con usted? 1 Nunca 2 A veces 3 Por lo general 4 Siempre 23) Usando un número del 0 al 10, donde 0 es el peor médico personal posible y el 10 el mejor médico personal posible, qué número usaría para calificar a su médico personal? 00 0 Peor médico posible 01 1 02 2 03 3 04 4 05 5 06 6 07 7 08 8 09 9 10 10 Mejor médico personal posible 21) En los últimos 6 meses, recibió atención de un médico u otro profesional de la salud, además de su médico personal? 1 Sí 2 NO Pase a la pregunta 23 22) En los últimos 6 meses, con qué frecuencia su médico personal pareció informado y actualizado sobre la atención que usted recibió de otros médicos y profesionales de la salud? 1 Nunca 2 A veces 3 Por lo general 4 Siempre CÓMO OBTENER ATENCIÓN DE SALUD DE ESPECIALISTAS Al responder a las siguientes preguntas, no incluya las visitas al dentista o la atención que usted recibió cuando pasó la noche en un hospital. 24) Los especialistas son médicos como cirujanos, cardiólogos, alergólogos, dermatólogos, y otros médicos que se especializan en un área del cuidado de la salud. En los últimos 6 meses, hizo usted alguna cita para ver a un especialista? 1 Sí 2 NO Pase a la pregunta 28 25) En los últimos 6 meses, con qué frecuencia consiguió una cita para ver a un especialista tan pronto como lo necesitaba? 1 Nunca 2 A veces 3 Por lo general 4 Siempre 5 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 113

26) Cuántos especialistas ha visto en los últimos 6 meses? 0 NINGUNO Pase a la pregunta 28 1 1 especialista 2 2 3 3 4 4 5 5 o más especialistas 29) En los últimos 6 meses, con qué frecuencia los folletos impresos o la Internet le proporcionaron la información necesaria acerca de cómo funciona su plan de salud? 1 Nunca 2 A veces 3 Por lo general 4 Siempre 27) Queremos saber cómo califica al especialista que vio con mayor frecuencia en los últimos 6 meses. Usando un número del 0 al 10, donde 0 es el peor especialista posible y 10 es el mejor especialista posible, qué número usaría para calificar a ese especialista? 00 0 Peor especialista posible 01 1 02 2 03 3 04 4 05 5 06 6 07 7 08 8 09 9 10 10 Mejor especialista posible SU PLAN DE SALUD Las siguientes preguntas son acerca de su experiencia personal con su plan de salud. 28) En los últimos 6 meses, buscó alguna información en folletos impresos o en la Internet acerca de cómo funciona su plan de salud? 1 Sí 2 NO Pase a la pregunta 30 30) En los últimos 6 meses, recibió información o ayuda del servicio al cliente de su plan de salud? 1 Sí 2 NO Pase a la pregunta 33 31) En los últimos 6 meses, con qué frecuencia el servicio al cliente de su plan de salud le dio la información o ayuda que necesitaba? 1 Nunca 2 A veces 3 Por lo general 4 Siempre 32) En los últimos 6 meses, con qué frecuencia el personal del servicio al cliente del plan de salud lo trató con cortesía y respeto? 1 Nunca 2 A veces 3 Por lo general 4 Siempre 33) En los últimos 6 meses, su plan de salud le entregó formularios para llenar? 1 Sí 2 NO Pase a la pregunta 35 6 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 114

34) En los últimos 6 meses, con qué frecuencia los formularios de su plan de salud fueron fáciles de llenar? 1 Nunca 2 A veces 3 Por lo general 4 Siempre 35) Usando un número del 0 al 10, donde 0 es el peor plan de salud posible y 10 es el mejor plan de salud posible, qué número usaría para calificar su plan de salud? 00 0 Peor plan de salud posible 01 1 02 2 03 3 04 4 05 5 06 6 07 7 08 8 09 9 10 10 Mejor plan de salud posible 38) Ha recibido una vacuna contra la gripe o aerosol nasal contra la gripe desde el 1 de Julio de 2016? 1 Sí 2 No 3 No sabe 39) Usted fuma cigarrillos o usa tabaco todos los días, algunos días o nunca? 1 Todos los días 2 Algunos días 3 Ninguna vez Pase a la pregunta 43 4 No sabe Pase a la pregunta 43 40) En los últimos 6 meses, con qué frecuencia un médico u otro profesional de la salud de su plan le aconsejó dejar de fumar o de usar tabaco? 1 Nunca 2 A veces 3 Por lo general 4 Siempre ACERCA DE USTED 36) En general, cómo calificaría su salud en general? 1 Excelente 2 Muy buena 3 Buena 4 Aceptable 5 Pobre 41) En los últimos 6 meses, con qué frecuencia se le recomendó medicación o platicó con su médico o profesional de la salud para ayudarle a dejar de fumar o usar tabaco? Algunos ejemplos de medicamentos son: chicles de nicotina, parches, spray nasal, inhalador o medicamento con receta. 1 Nunca 2 A veces 3 Por lo general 4 Siempre 37) En general, cómo calificaría su salud mental o emocional general? 1 Excelente 2 Muy buena 3 Buena 4 Aceptable 5 Pobre 7 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 115

42) En los últimos 6 meses, con qué frecuencia su médico o profesional de la salud discutió con usted o le proporcionó métodos y estrategias diferentes a los medicamentos para ayudarle a dejar de fumar o usar tabaco? Ejemplos de métodos y estrategias son: línea telefónica de ayuda, consejería individual o de grupo, o un programa de cesación. 1 Nunca 2 A veces 3 Por lo general 4 Siempre 43) Toma aspirina todos los días o día por medio? 1 Sí 2 No 3 No sabe 44) Tiene un problema de salud o toma una medicina que haga peligroso el también tomar aspirina? 1 Sí 2 No 3 No sabe 45) Alguna vez un médico o profesional de la salud le habló sobre los riesgos y los beneficios de la aspirina para prevenir un ataque cardíaco o un derrame cerebral? 1 Sí 2 No 46) Sabe si tiene alguna de las siguientes condiciones? Marque una o más. A Nivel de colesterol alto B Presión arterial alta C Padres o hermanos con un ataque al corazón antes de los 60 años D Algún tipo de diabetes o glucosa alta en la sangre 8 47) Alguna vez un médico le ha dicho que usted tiene alguna de las siguientes condiciones? Marque una o más. A Ataque al corazón B Angina de pecho o enfermedad cardiaca coronaria C Accidente cerebrovascular (derrame cerebral) D Cualquier tipo de diabetes o alto nivel de azúcar 48) En los últimos 6 meses, recibió atención médica 3 o más veces por la misma enfermedad o problema? 1 Sí 2 NO Pase a la pregunta 50 49) Es ésta una condición o problema que ha durado al menos 3 meses? No incluya el embarazo o la menopausia. 1 Sí 2 No 50) Usted necesita ahora o toma medicamentos recetados por un médico? No incluya el control de la natalidad. 1 Sí 2 NO Pase a la pregunta 52 51) Es este medicamento para tratar una condición que ha durado por lo menos 3 meses? No incluya el embarazo o la menopausia. 1 Sí 2 No ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 116

52) Cuál es su edad? 1 18 a 24 años 2 25 a 34 3 35 a 44 4 45 a 54 5 55 a 64 6 65 a 74 7 75 años o más 53) Es hombre o mujer? 1 Hombre 2 Mujer 54) Cuál es el más alto grado o nivel de educación que usted ha completado? 1 8º grado o menos 2 2 años de secundaria, pero sin graduarse 3 Graduado de secundaria o GED 4 Algo de universidad o título de 2 años 5 Título de universidad de 4 años 6 Más de los cuatro años de universidad 55) Es usted de origen o descendencia hispana/latina? 1 Sí, hispano o latino 2 No, hispano o latino 56) Cuál es su raza? Marque una o más. A Blanca B Negro o afroamericano C Asiático D Nativo de Hawái o de otra Isla del Pacífico E Indio Americano o Nativo de Alaska F Otro 57) Le ayudó alguien a completar esta encuesta? 1 SÍ Pase a la pregunta 58 2 No Muchas gracias. Por favor devuelva la encuesta completada en el sobre con franqueo pagado. 58) Cómo le ayudó esa persona? Marque una o más. A Me leyó las preguntas B Anotó las respuestas que le di C Contestó las preguntas por mí D Tradujo las preguntas a mi idioma E Ayudó de alguna otra manera MUCHAS GRACIAS! Por favor, devuelva la encuesta completada en el sobre con franqueo pagado. 9 ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 117

RECOLECCIÓN Y ANÁLISIS DE DATOS POR ESTE MATERIAL FUE PREPARADO POR LA FUNDACIÓN DE ARKANSAS PARA LA ATENCION MEDICA INC. (AFMC) BAJO CONTRATO CON EL DEPARTAMENTO DE SERVICIOS HUMANOS DE ARKANSAS, DIVISIÓN DE SERVICIOS MÉDICOS. LOS CONTENIDOS PRESENTADOS NO REFLEJAN NECESARIAMENTE LA POLÍTICA DEL DHS DE ARKANSAS. EL DEPARTAMENTO DE SERVICIOS HUMANOS DE ARKANSAS CUMPLE CON LOS TÍTULOS VI Y VII DE LA LEY DE DERECHOS CIVILES. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 118

APPENDIX D: ARKids First A Survey Tools ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 119

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ENGLISH SURVEY A Program of the Arkansas Department of Human Services, Division of Medical Services 2017 CHILD HEDIS CAHPS Health Plan Survey Si gusta recibir la versión en español de esta encuesta, favor llamar al 1-844-493-8763. DATA COLLECTION AND ANALYSIS BY THIS QUESTIONNAIRE WAS ADAPTED FROM CAHPS, WHICH IS A CONSORTIUM OF HARVARD MEDICAL SCHOOL, RAND AND THE RESEARCH TRIANGLE INSTITUTE. QUESTION DEVELOPMENT BY THE AGENCY FOR HEALTH CARE POLICY AND RESEARCH. ARKANSAS MEDICAID HEDIS CAHPS HEALTH PLAN SURVEY, ADULT AND CHILD 2017 BENEFICIARY SATISFACTION SURVEY RESULTS PAGE 121