Table 3.

California (CA) versus Non-CA Differences in CAHPS Scores for Medicare Beneficiaries in Medicare Advantage (MA) Plans and Fee-for-Service (FFS), with Standard and Full Case Mix Adjustments, 2008^†

	Difference: CA−Non-CA
	Standard Case Mix‡		Full Adjustment Ethnicity Urban§
CAHPS Outcomes	MA	FFS	MA	FFS
Physician services
Global rating of personal physician or nurse	−0.93***	−0.68**	−0.80***	−0.55*
Global rating of specialist	−1.53***	−0.09	−1.17***	0.13
Global rating of health care	−0.89***	−0.39	−0.39*	0.01
Doctor communication (four-item composite)	−1.13***	−0.88***	−0.79***	−0.52*
Ease of getting needed care (two-item composite)	−2.47***	−0.69*	−1.47***	0.28
Immunizations
Getting a flu shot in the previous year	3.36***	−2.18***	3.91***	−1.27*
Getting a pneumonia shot	1.43***	−6.22***	3.31***	−3.35***
Plan services
Global rating of MA plan or Medicare (if FFS)	0.35*	−0.86***	0.50***	−0.88**
Getting care quickly (two-item composite)	0.90***	0.12	1.94***	1.06**
Ease of paperwork (stand-alone report item)	1.75***	−2.49*	2.32***	−1.66
Customer service (three-item composite)	0.01	−1.79*	0.43	−0.97
Part D prescription drugs
Global rating of prescription drug coverage	1.57***	−0.7*	1.77***	−0.28
Ease of getting needed drugs (three-item composite)	1.43***	−2.82***	2.17***	−0.90**
Getting information on drugs (two-item composite)	1.13**	−2.31***	1.82***	−1.20

^†Response scores are linearly rescaled to a 0–100 possible range to facilitate comparisons across measures.

^‡Case mix adjusted using the standard CAHPS case mix adjustments.

^§Case mix adjusted using the standard CAHPS adjustments plus adjustments for race/ethnicity and urbanicity.

^*p<.05

^**p<.01

^***p<.001.

CAHPS, Consumer Assessment of Healthcare Providers and Systems.