Client Satisfaction – The Voice of the Customer

Every year, Behavioral Science Research Corp. administers a comprehensive, tri-language, confidential face-to-face survey of 500+ Ryan White Part A/Minority AIDS Initiative Program clients.

Survey participants are selected from clients who have been actively enrolled in Ryan White Program Medical Case Management services for at least three months prior to the survey date.

The survey produces quantitative descriptions of client satisfaction with Ryan White Program Services:

    • Medical Case Management (MCM)
    • Outpatient/Ambulatory Health Services (OAHS)
    • Mental Health Services
    • Oral Health Care
    • Substance Abuse Outpatient Care and Substance Abuse Residential Services
    • Pharmaceutical Assistance (both Ryan White Part A and ADAP)

BSR’s statistical analyses links client characteristics to treatment satisfaction, barriers to care, and other care-related issues, to provide insights into service improvement measures and ways to improve client retention and treatment adherence.

Survey data are used to inform one or more related Plan-Do-Study-Act cycles and identify opportunities for Quality Improvement projects, capacity building, and interventions in response to service shortfalls among Ryan White Program subrecipients.

Needs Assessment

The Needs Assessment of the Miami-Dade County HIV/AIDS service system is a comprehensive annual data collection and analysis and HRSA-mandated activity of Ryan White Program Planning Councils.

Since 2005, BSR has performed these functions in support of the annual service prioritization and resource allocation process:

    • Create comprehensive profiles of the Ryan White Program clients in care, including demographic characteristics, risk factors, co-occurring condition, and use of Medicare, Medicaid and other insurance programs in conjunction with the Ryan White Program.
    • Conduct surveys, focus groups, community forums, and key-informant interviews with Ryan White Program clients and other people with HIV to determine unmet need and to identify areas of potential weakness in service delivery.
    • Analyze Ryan White Program service utilization and expenditure data, providing five-year analysis of changes in utilization, average cost per client, and patterns of service delivery.
    • Analyze funding streams for HIV/AIDS care and treatment outside the Ryan White Program.
    • Identify and analyze disparities in health care use and status.
    • Quantify unmet needs, service gaps, and demand for services.
    • Estimate the numbers of HIV-positive persons not in care.
    • Ensure committee members understand all data prior to decision-making.

Findings are presented to the Miami-Dade HIV/AIDS Partnership’s Care and Treatment Committee to inform decisions on Priority Setting and Resource Allocation of Ryan White Program services and funding.

Women-Centered Care Study

The objective of the Women-Centered Care Study is to identify effective provider and system women-centered HIV care practices within the Ryan White Program that positively influence HIV care retention and viral suppression among women experiencing sociocultural challenges.

By examining patient intake and billing data from women enrolled in the Miami-Dade County Ryan White Program; conducting in-depth interviews with case managers, health care providers, administrators, and women living with HIV; and conducting a survey of 600 women living with HIV in the Miami-Dade County Ryan White Program, the study seeks to:

    • Identify sociocultural factors that influence HIV care retention and viral suppression, including those unique to women and those having a differential impact on African American, Haitian, and Latina women
    • Ascertain current and potential health care provider and system women-centered HIV care practices that may mitigate the effect of adverse sociocultural factors on HIV care retention and antiretroviral therapy adherence
    • Identify specific health care provider and system women-centered HIV care practices that most strongly influence HIV care retention, adherence, and viral suppression among all women and in African American, Haitian, and Latina women

The Study began in 2019 and is ongoing for five years.

Patient-Centered Care Study

The objective of the Patient-Centered Care Study is to identify HIV provider patient centered care factors related to access, cultural competency, communication, health literacy, coordination, patient self-management, and respectful and courteous staff that buffer the effect of changes in individual characteristics on retention in care and viral suppression while considering neighborhood social determinants and medical case management site factors and that, if included in a system-wide implementation, could result in the greatest improvement in retention in HIV care and viral suppression and reduce health disparities.

A survey of almost 1700 male and female clients receiving medical case management and medical care through the Miami-Dade County Ryan White Program will be conducted to address the objectives of the study. The survey will include questions on cultural competency and health literacy drawn from the CAHPS Clinician & Group Survey, and will be administered as part of the annual RWP Client Satisfaction Survey.

The study began in 2019 and is ongoing for three years.