EXCLUSIVE CARE PLAN – WE CARE WHAT YOU THINK ABOUT US!

Our number one goal is to provide quality health care services at the lowest cost to you and your enrolled family members. Please help us understand what we are doing well and the areas where we can do better by taking a few minutes to rate our physicians, hospitals, health care providers, and our Exclusive Care staff. All responses will be kept completely CONFIDENTIAL.
 
About You
 
1. Which of the following best describes you?
In-Home Support Services (IHSS) of Riverside County
Riverside County active employee, EPO Member
Riverside County active employee, POS Plan Member
Riverside County retiree
City of Ventura retiree
Orange County retiree
 
2. In which city/area in Riverside County do you receive medical care?
Banning
Blythe
Corona
Hemet/Idyllwild
Indio
Lake Elsinore
Moreno Valley
Palm Springs
Perris
Riverside
Temecula
Not applicable—I receive medical care outside Riverside County
 
3. Why did you enroll in Exclusive Care? (check all that apply)
Good Reputation
Personal physician network
Network specialists
Network hospitals
Cost of plan
Benefit levels
Quality of care
Type of plan
Other: 
 
4. What is your age bracket?
Under 30
30 – 39
40 – 49
50 – 59
60 – 69
70 or older
 
5. What is your sex?
Male
Female
 
6. How long have you been a member of Exclusive Care?
Less than 1 year
1 to 3 years
More than 3 years
 
7. If you were to switch to another health plan next year, what would be the reason(s) for changing? (check all that apply)
Personal physician network
Network specialists
Network hospitals
Cost of plan
Benefit levels
Quality of care
Need flexibility to access non-network providers
Quality of service
Other: 
 
8. Tell us how important each Exclusive Care feature is.
1=Very Important, 2=Important, 3=Undecided, 4=Unimportant, 5= Very Unimportant
1 2 3 4 5
Choice of network personal physicians
Choice of network hospitals
Network urgent care centers
Choice of network specialists
Information provided over the telephone by Exclusive Care staff
Cost of plan
Plan's benefit levels (medical coverage)
Clear and understandable communication materials about my benefits
 
9. Tell us how satisfied you are with each feature.
1=Very Satisfied, 2=Satisfied, 3=Undecided, 4=Unsatisfied, 5= Very Unsatisfied
1 2 3 4 5 N/A
Choice of network personal physicians
Choice of network hospitals
Network urgent care centers
Choice of network specialists
Information provided over the telephone by Exclusive Care staff
Cost of plan
Plan's benefit levels (medical coverage)
Clear and understandable communication materials about my benefits
 
ABOUT EXCLUSIVE CARE URGENT CARE, EMERGENCY CARE, AND HOSPITAL SERVICES
 
10. Have you received medical care at an Exclusive Care urgent care center in 2010?
Yes
No (Skip Q11, go to Q12)
 
11. What was the reason(s) you used an urgent care center instead of visiting your personal physician’s office? (check all that apply)
My personal physician couldn’t see me within a reasonable amount of time and referred me to the urgent care center
I needed medical care when my personal physician’s office was closed (at night or on the weekend)
The urgent care center is more convenient for me to use
Other: 
 
12. Which Exclusive Care network emergency room(s) have you received care from in 2010? (check all that apply)
Desert Regional Medical Center
Eisenhower Medical Center
JFK Memorial Hospital
Palo Verde Hospital
Riverside County Regional Medical Center
Other network facility
None of the above [Skip Q13, Go to Q14]
 
13. What was the reason(s) you went to the emergency room instead of visiting an urgent care center? (check all that apply)
My personal physician couldn’t see me within a reasonable amount of time and referred me to the emergency room
The emergency room is more convenient
I don’t know where the closest urgent center is
The urgent care center was closed
I wasn’t sure whether my health situation was considered urgent or an emergency
Other: 
 
14. Which Exclusive Care network hospitals have you received inpatient services from in 2010? (check all that apply)
Desert Regional Medical Center
Eisenhower Medical Center
JFK Memorial Hospital
Palo Verde Hospital
Riverside County Regional Medical Center
Other network facility
None of the above [Skip Q15, Go to Q16]
 
15. Rate your last hospital visit.
1=Excellent, 2=Good, 3=Fair, 4=Poor, 5=Undecided
1 2 3 4 5
Desert Regional Medical Center
Eisenhower Medical Center
JFK Memorial Hospital
Palo Verde Hospital
Riverside County Regional Medical Center
Other network facility
None of the above [Skip Q12, Go to Q13]
 
ABOUT EXCLUSIVE CARE PHYSICIANS
 
16. Indicate your general level of satisfaction with the following:
1=Very Satisfied, 2=Satisfied, 3=Undecided/Don't Know, 4=Disastisfied, 5=Very Dissatisfied
1 2 3 4 5
Courtesy and professionalism of your personal physician’s office and nursing staff
Your personal physician’s “bedside manner” – the way he/she communicates with you and your confidence in that advice
Available appointment time with your personal physician (number of days to be seen)
Waiting time in personal physician’s office before being seen by your personal physician
Referrals by your personal physician to a network specialist when appropriate
Available appointment time for specialists (number of days to be seen)
Waiting time in specialist’s office before being seen by the specialist
 
ABOUT THE EXCLUSIVE CARE PLANS’ SPECIAL SERVICES
 
17. Exclusive Care offers comprehensive diabetes care through its Center for Optimal Health located in Rubidoux. Have you heard about it?
Yes
No
 
18. Exclusive Care offers comprehensive pharmacy services at the Rubidoux Pharmacy. Which of the following services would you be willing to use? (check all that apply)
Ordering medication over the phone
Ordering medication through the mail-order program
Ordering medication online
Purchasing medication on-site
None of the above. The Rubidoux Pharmacy is not convenient to me
 
19. Is there anything else you would like to share about Exclusive Care? Please use this space below to explain any of your above answers or bring specific concerns to our attention.
 
If you would like to receive information about Exclusive Care through email, please print your name and email address below. [OPTIONAL]
 
20. Member Name:
 
21. Email Address:
Survey Provided By: County of Riverside - Human Resource Department