Slide 1: University of Massachusetts Medical School
Commonwealth Medicine Public & Private Health Solutions
Findings from the One Care Quality of Life Surveys 2017-2019
September 2021

One Care
MassHealth+Medicare
Note: This footer appears on each of the following slides. “© 2021. The consulting and operations division of UMass Medical School. Confidential “
Slide 2: Who We Are

Founded in 1999, Commonwealth Medicine is the health care consulting and operations division of UMass Medical School.

We work with you to enhance the effectiveness of health and human service programs to improve outcomes for vulnerable populations.

Our comprehensive suite of health care solutions supports program integrity, improves member health, enhances public programs and fosters a high-quality delivery system. 

The value of our mission as one of the nation’s top medical schools is our commitment to reinvest revenue to advance research and prepare the next generation of health care providers.

Our highly skilled professionals and health care subject matter experts are carefully matched to project goals and client needs. 

We have real-time access to the latest academic research and clinical advancements in development at UMass Medical School.
Slide 3: Acknowledgments
The University of Massachusetts Medical School (UMMS) authors of this report would like to express our thanks to our UMMS colleagues Bittie Behl-Chadha, PhD, Director of the Office of Survey Research and Rossana Valencia-Hoang, MPH, former Project Director for providing their expertise in survey development and for administering this survey. Our thanks as well go to Alexis Henry, ScD, OTR/L for her previous work on this project and to Jianying Zhang, MS for her analytical support. 
Slide 4: Research Questions
•	What are members' perceptions of their physical and mental health?
•	What are members' perceptions of their life satisfaction?
•	What percentage of members need help with everyday tasks or doing things in the community.
•	How satisfied are members with the help they may have received at home or in the community?
Slide 5: Survey Sample
•	Random sample drawn from One Care members enrolled as of December of each year
–	Certain ineligible members excluded from data set (See Appendix A)
•	Respondents compared to non-respondents and weights applied to adjust for significant differences on specific variables (See Appendix B)
–	Demographic characteristics
–	Enrollment type
–	Enrollment duration
Slide 6: Survey Methodology
•	Survey administered annually in English and Spanish between 2017-2019
•	Two-wave mail protocol with up to 5 telephone follow-ups for non-respondents
•	Survey response rates
–	2017 – 38.9% (584 respondents)
–	2018 – 36.7% (551 respondents)
–	2019 – 29.9% (440 respondents)
–	When we describe a finding as “significant” we mean that it is “statistically significant”, i.e., not explained simply by chance. We used p<.05 as the level that indicates significance. 
Slide 7: RESULTS
No data, just a title slide
Slide 8: Physical and Mental Health
No data, just a title slide
Slide 9: Physical Health
Respondents were asked, “How would you rate your overall physical health?” 
•	3-5% described their physical health as excellent. 
•	10% in each year described their physical health as very good 
•	26-30% described their physical health as good. 
•	41-44% described their physical health as fair and 12-16% described their physical health as poor
There were no significant changes over the three years of the survey. 

Note: the following statistics were shown in a bar chart.

Physical health
2017
Poor=12%
Fair=44%
Good=30%
Very good=10%
Excellent=4%

2018
Poor=16%
Fair=41%
Good=30%
Very good=10%
Excellent=3%

2019
Poor=15%
Fair=44%
Good=26%
Very good=10%
Excellent=5%
Slide 10: Mental and Emotional Health
Respondents were also asked, “How would you rate your overall mental and emotional health?” 
•	A small percentage described their mental or emotional health as very good (11-15%) or excellent (5%).
•	27-32% described their mental or emotional health as good.
•	More than half rated their mental or emotional health as fair (36-44%) or poor (11-13%). 
There were no significant changes over the three years of the survey. 

Note: the following statistics were shown in a bar chart.

Mental and emotional health
2017 
Poor=13%
Fair=40%
Good=30%
Very good=11%
Excellent=5%

2018
Poor=12%
Fair=36%
Good=32%
Very good=15%
Excellent=5%

2019 
Poor=11%
Fair=44%
Good=27%
Very good=12%
Excellent=5%
Slide 11: Life Satisfaction
No data, just a title slide
Slide 12: Life Satisfaction
Respondents were asked, “How satisfied are you with your life?”
•	About half consistently described themselves as either very satisfied (10-13%) or satisfied (39-41%). 
•	About a quarter (22-30%) were neither satisfied nor dissatisfied.
•	The percentage who described themselves as either dissatisfied (13-20%) or very dissatisfied (4-6%) fell over the three years,
None of the changes over time were significant.

Note: the following statistics were shown in a bar chart.

2017
Very dissatisfied=6%
Dissatisfied=19%
Neither satisfied nor dissatisfied=26%
Satisfied =39%
Very satisfied=10%

2018
Very dissatisfied=5%
Dissatisfied=20%
Neither satisfied nor dissatisfied=22%
Satisfied =41%
Very satisfied=12%

2019
Very dissatisfied=4%
Dissatisfied=13%
Neither satisfied nor dissatisfied=30%
Satisfied=40%
Very satisfied=13%
Slide 13: Experience with Specific Aspects of Life
No data, just a title slide
Slide 14: Outlook on Life (1 o3)
Respondents were asked several questions about their outlook on life. 
•	17-19% strongly agreed and 41-46% 
     agreed that they enjoy life
•	19-21% were not sure 
•	14-18% disagreed and 4-5% strongly disagreed
•	11-13% strongly agreed and 30-35% agreed that they live life to the fullest  
•	19-23% were not sure
•	24-28% disagreed and 8-10% strongly disagreed
•	20-21% strongly agreed and 48-49% agreed that their lives have purpose
•	17-20% were not sure
•	8-10% disagreed and 3-4% strongly disagreed
Changes over time were not significant.

Note: the following statistics were shown in a bar chart.

I enjoy life
2017
Strongly Agree=19%
Agree=41%
Not Sure=21%
Disagree =14%
Strongly Disagree=5%

2018
Strongly Agree=17%
Agree=46%
Not Sure=19%
Disagree =13%
Strongly Disagree=5%

2019
Strongly Agree=17%
Agree=42%
Not Sure=19%
Disagree =18%
Strongly Disagree=4%

I live my life to the fullest
2017 
Strongly Agree=13%
Agree=30%
Not Sure=23%
Disagree =25%
Strongly Disagree=8%

2018
Strongly Agree=12%
Agree=35%
Not Sure=19%
Disagree=24%
Strongly Disagree=10%

2019
Strongly Agree=11%
Agree=31%
Not Sure=22%
Disagree=28%
Strongly Disagree=8%

My life has purpose
2017 
Strongly Agree=21%
Agree=48%
Not Sure=20%
Disagree =8%
Strongly Disagree=4%

2018
Strongly Agree=20%
Agree=49%
Not Sure=19%
Disagree =9%
Strongly Disagree=3%

2019 
Strongly Agree=21%
Agree=49%
Not Sure=17%
Disagree=10%
Strongly Disagree=4%
Slide 15: Outlook on Life (2 of 3)
Respondents were asked about whether they feel good about themselves.
•	13%-14% strongly agreed and 41-42% agreed that they felt good about themselves
•	17-21% were not sure
•	18-22% disagreed and 5-6% strongly disagreed
Respondents were asked if they felt confident about the decisions they make
•	15-18% strongly agreed and 47-52% agreed that they felt confident about the decisions they make
•	21-24% were not sure
•	11% disagreed and 1-2% strongly disagreed
Changes over time were not significant.

Note: the following statistics were shown in a bar chart.

I feel good about myself
2017 – percentages don’t add up to 100%
Strongly Agree=14%
Agree=41%
Not Sure=19%
Disagree=20%
Strongly Disagree=5%

2018
Strongly Agree=13%
Agree=42%
Not Sure=21%
Disagree=18%
Strongly Disagree=6%

2019
Strongly Agree=13%
Agree=42%
Not Sure=17%
Disagree =22%
Strongly Disagree=5%

I feel confident about the decision I make
2017 
Strongly Agree=18%
Agree=49%
Not Sure=21%
Disagree=11%
Strongly Disagree=2%

2018 
Strongly Agree=16%
Agree=52%
Not Sure=20%
Disagree=11%
Strongly Disagree=1%

2019
Strongly Agree=15%
Agree=47%
Not Sure=24%
Disagree=11%
Strongly Disagree=3%
Slide 16: Outlook on Life (3 of 3)
Respondents were asked if they have an upbeat and positive attitude.
•	16-22% strongly agreed and 38-42% agreed that they had an upbeat and positive attitude
•	15-17% were not sure
•	17-22% disagreed and 6-8% strongly disagreed
Changes over time were not significant.
Respondents were asked if they felt in control of their lives.
•	19-20% strongly agreed and 41-52% agreed that they felt in control of their lives
•	14-21% were not sure
•	11-16% disagreed and 2-4% strongly disagreed
The change over time on this question was significant.

Note: the following statistics were shown in a bar chart.

I have an upbeat and positive attitude
2017
Strongly Agree=18%
Agree=42%
Not Sure=15%
Disagree=18%
Strongly Disagree=7%

2018
Strongly Agree=16%
Agree=42%
Not Sure=17%
Disagree =17%
Strongly Disagree=8%

2019
Strongly Agree=22%
Agree=38%
Not Sure=16%
Disagree =18%
Strongly Disagree=6%

I am in control of my life
2017
Strongly Agree=19%
Agree=48%
Not Sure=17%
Disagree =12%
Strongly Disagree=4%

2018
Strongly Agree=20%
Agree=52%
Not Sure=14%
Disagree =11%
Strongly Disagree=3%

2019 
Strongly Agree=19%
Agree=41%
Not Sure=21%
Disagree=16%
Strongly Disagree=2%

Slide 17: Capacities and Energy
Respondents were asked about their mobility and experience with daily or everyday tasks
•	12-13% strongly agreed and 27-33% agreed  and they need help in getting around
•	13-15% were not sure
•	30-36% disagreed and 10-12% strongly disagreed
•	9-13% strongly agreed and 34-37% agreed they had difficulty w/ daily tasks
•	15-18% were not sure
•	29-30% disagreed and 7-8% strongly disagreed
•	9-12% strongly agreed and 42-46% agreed that their everyday tasks get done
•	12-17% were not sure
•	23-28% disagreed and 5% strongly disagreed
Changes over time were not significant.

Note: the following statistics were shown in a bar chart.

I need help in getting around
2017
Strongly Agree=12%
Agree=27%
Not Sure=13%
Disagree=36%
Strongly Disagree=12%

2018
Strongly Agree=13%
Agree=33%
Not Sure=14%
Disagree=30%
Strongly Disagree=10%

2019
Strongly Agree=13%
Agree=29%
Not Sure=15%
Disagree =33%
Strongly Disagree=10%

I have difficulty performing my daily tasks
2017
Strongly Agree=12%
Agree=34%
Not Sure=18%
Disagree =29%
Strongly Disagree=8%

2018
Strongly Agree=13%
Agree=37%
Not Sure=15%
Disagree =29%
Strongly Disagree=7%

2019 
Strongly Agree=9%
Agree=37%
Not Sure=16%
Disagree =30%
Strongly Disagree=8%

My everyday tasks get done
2017
Strongly Agree=12%
Agree=42%
Not Sure=17%
Disagree=23%
Strongly Disagree=5%

2018
Strongly Agree=9%
Agree=46%
Not Sure=12%
Disagree =28%
Strongly Disagree=5%

2019
Strongly Agree=10%
Agree=43%
Not Sure=15%
Disagree =27%
Strongly Disagree=5%

Slide 18: Capacities and Energy (cont.)
Respondents were asked whether they felt energetic throughout the day
•	4-6% strongly agreed and 22-27% agreed that they felt energetic throughout the day
•	14-21% were not sure 
•	37-39% disagreed and 10-15% strongly disagreed
This change over time was significant.
Respondents were also asked if they were capable of working.
•	3-5% strongly agreed and 10-14% 
•	agreed that they were capable of working
•	15-17% were not sure 
•	35-40% disagreed and 28-33% strongly disagreed
Changes over time were not significant.

Note: the following statistics were shown in a bar chart.

I feel energetic through the day
2017 
Strongly Agree=6%
Agree=22%
Not Sure=21%
Disagree =37%
Strongly Disagree=13%

2018 
Strongly Agree=4%
Agree=27%
Not Sure=14%
Disagree=39%
Strongly Disagree=15%

2019 
Strongly Agree=6%
Agree=27%
Not Sure=19%
Disagree=39%
Strongly Disagree=10%

I am capable of working
2017
Strongly Agree=5%
Agree=14%
Not Sure=17%
Disagree =36%
Strongly Disagree=28%

2018
Strongly Agree=3%
Agree=14%
Not Sure=15%
Disagree =35%
Strongly Disagree=33%

2019 
Strongly Agree=5%
Agree=10%
Not Sure=15%
Disagree=40%
Strongly Disagree=31%
Slide 19: Everyday Tasks Get Done – Comparison by Age
Respondents were asked whether their everyday tasks get done. The results were compared by age group, but the differences between the groups were not significant over time.

Ages 21-44
•	7-14% strongly agreed that their everyday tasks get done.
•	42-48% agreed
•	12-19% neither agreed nor disagreed
•	22-27% disagreed
•	3-6% strongly disagreed

Age 45+
•	9-13% strongly agreed that their everyday tasks get done. 
•	42-47% agreed
•	12-17% neither agreed nor disagreed
•	23-28% disagreed
•	5% strongly disagreed

Note: the following statistics were shown in a bar chart.

2017, ages 21-44
Strongly Agree=11%
Agree=42%
Not Sure=19%
Disagree =22%
Strongly Disagree=6%

2017, ages 45+
Strongly Agree=13%
Agree=42%
Not Sure=17%
Disagree =23%
Strongly Disagree=5%

2018, ages 21-44
Strongly Agree=7%
Agree=48%
Not Sure=12%
Disagree =27%
Strongly Disagree=6%

2018, ages 45+ 
Strongly Agree=9%
Agree=47%
Not Sure=12%
Disagree =28%
Strongly Disagree=5%

2019, ages 21-44 
Strongly Agree=14%
Agree=42%
Not Sure=16%
Disagree =24%
Strongly Disagree=3%

2019, ages 45+ 
Strongly Agree=9%
Agree=43%
Not Sure=14%
Disagree =28%
Strongly Disagree=5%
Slide 20: Mood & Concentration
Respondents were asked about their mood 
and concentration
•	15-18% strongly agreed and 34-38% agreed that they felt low on a regular basis. 
•	13-19% were not sure
•	24-25% disagreed and 8-10% strongly disagreed
•	13-17% strongly agreed and 37-38% agreed that had difficulty concentrating 
•	14-15% were not sure
•	23-27% disagreed and 8% strongly disagreed
•	13-17% strongly agreed and 33-35% agreed that they frequently forget where they put things.
•	11-13% were not sure
•	27-30% disagreed and 9-11% strongly disagreed.
Changes over time were not significant.

I feel low on a regular basis
2017 
Strongly Agree=18%
Agree=35%
Not Sure=13%
Disagree =25%
Strongly Disagree=10%

2018
Strongly Agree=15%
Agree=38%
Not Sure=14%
Disagree =25%
Strongly Disagree=8%

2019
Strongly Agree=15%
Agree=34%
Not Sure=19%
Disagree =24%
Strongly Disagree=8%

I have difficulty concentrating
2017
Strongly Agree=17%
Agree=37%
Not Sure=15%
Disagree =23%
Strongly Disagree=8%

2018 
Strongly Agree=17%
Agree=37%
Not Sure=14%
Disagree =25%
Strongly Disagree=8%

2019
Strongly Agree=13%
Agree=38%
Not Sure=14%
Disagree =27%
Strongly Disagree=8%

I frequently forget where I put things
2017
Strongly Agree=17%
Agree=35%
Not Sure=11%
Disagree =27%
Strongly Disagree=10%

2018
Strongly Agree=16%
Agree=33%
Not Sure=13%
Disagree =29%
Strongly Disagree=9%

2019
Strongly Agree=13%
Agree=33%
Not Sure=13%
Disagree=30%
Strongly Disagree=11%
Slide 21: Social Relationships
Respondents were asked whether they get together with people on a regular basis.
•	9-13% strongly agreed and 37-41% agreed that they got together with people on a regular basis.
•	7-11% were not sure
•	30-31% disagreed and 11-13% strongly disagreed
Respondents were asked if they had friends they could count on. 
•	16-22% strongly agreed and 38-42% agreed that they had friends they can count on. 
•	15-17% were not sure.
•	17-18% disagreed and 6-8% strongly disagreed.
Changes over time were not significant.

Note: the following statistics were shown in a bar chart.

I get together with people on a regular basis
2017
Strongly Agree=10%
Agree=37%
Not Sure=11%
Disagree =30%
Strongly Disagree=12%

2018 
Strongly Agree=9%
Agree=41%
Not Sure=7%
Disagree =31%
Strongly Disagree=13%

2019 
Strongly Agree=13%
Agree=38%
Not Sure=9%
Disagree=30%
Strongly Disagree=11%

I have friends I can count on
2017
Strongly Agree=18%
Agree=42%
Not Sure=15%
Disagree =18%
Strongly Disagree=7%

2018
Strongly Agree=16%
Agree=42%
Not Sure=17%
Disagree =17%
Strongly Disagree=8%

2019
Strongly Agree=22%
Agree=38%
Not Sure=16%
Disagree=18%
Strongly Disagree=6%
Slide 22: Getting Together with People – Comparison By Age
Respondents were asked whether they get together with people on a regular basis. The results were compared by age group, but the differences between the groups were not significant over time.

Ages 21-44
•	9-13% strongly agreed they get together with people regularly
•	32-41% agreed
•	9-13% were not sure
•	21-35% disagreed
•	14-15% strongly disagreed
Age 45+
•	8-13% strongly agreed they get together with people regularly
•	38-41% agreed
•	6-11% were not sure
•	29-32% disagreed
•	10-12% strongly disagreed

Note: the following statistics were shown in a bar chart.

2017, ages 21-44
Strongly Agree=14%
Agree=32%
Not Sure=13%
Disagree =32%
Strongly Disagree=9%

2017, ages 45+ 
Strongly Agree=11%
Agree=29%
Not Sure=11%
Disagree =38%
Strongly Disagree=10%

2018, ages 21-44
Strongly Agree=15%
Agree=21%
Not Sure=10%
Disagree=41%
Strongly Disagree=13%

2018, ages 45+
Strongly Agree=12%
Agree=32%
Not Sure=6%
Disagree =41%
Strongly Disagree=8%

2019, ages 21-44
Strongly Agree=14%
Agree=35%
Not Sure=9%
Disagree =31%
Strongly Disagree=11%

2019, ages 45+
Strongly Agree=10%
Agree=30%
Not Sure=9%
Disagree=38%
Strongly Disagree=13%
Slide 23: Have Friends Can Count On – Comparison by Age
Respondents were asked whether they have friends they can count on. The results were compared by age group, but the differences between the groups were not significant over time.

Ages 21-44
•	19-29% strongly agreed they have friends they can count on.
•	29-38% agreed
•	13-17% were not sure
•	19-24% disagreed
•	6-7% strongly disagreed
Age 45+
•	17-21% strongly agreed they have friends they can count on.
•	39-44% agreed
•	15-17% were not sure
•	17% disagreed
•	6-8% strongly disagreed

Note: the following statistics were shown in a bar chart.

2017, ages 21-44
Strongly Agree=7%
Agree=24%
Not Sure=13%
Disagree=37%
Strongly Disagree=19%

2017, ages 45+
Strongly Agree=7%
Agree=17%
Not Sure=15%
Disagree=44%
Strongly Disagree=17%

2018, ages 21-44
Strongly Agree=6%
Agree=19%
Not Sure=17%
Disagree=38%
Strongly Disagree=19%

2018, ages 45+
Strongly Agree=8%
Agree=17%
Not Sure=17%
Disagree=43%
Strongly Disagree=15%
2019, ages 21-44 
Strongly Agree=6%
Agree=20%
Not Sure=15%
Disagree=29%
Strongly Disagree=29%

2019, ages 45+
Strongly Agree=6%
Agree=17%
Not Sure=17%
Disagree =39%
Strongly Disagree	=1%
Slide 24: Home and Environment
Respondents were asked whether they feel safe where they live
•	33-34% strongly agreed and 49-50% agreed that they felt save where they live 
•	8-9% were not sure
•	5-6% disagreed and 2-4% strongly disagreed
Respondents were asked whether their home had everything the need
•	19-22% strongly agreed and 48-55% agreed everything that their home had everything they need. 
•	8-13% were not sure
•	13-15% disagreed and 4-5% strongly disagreed
Changes over time were not significant.

Note: the following statistics were shown in a bar chart.

I feel safe where I live
2017
Strongly Agree=33%
Agree=49%
Not Sure=9%
Disagree=6%
Strongly Disagree=3%

2018
Strongly Agree=33%
Agree=49%
Not Sure=9%
Disagree=5%
Strongly Disagree=4%

2019
Strongly Agree=34%
Agree=50%
Not Sure=8%
Disagree=6%
Strongly Disagree=2%

My home has everything I need
2017
Strongly Agree=22%
Agree=51%
Not Sure=8%
Disagree=14%
Strongly Disagree=5%

2018
Strongly Agree=19%
Agree=55%
Not Sure=8%
Disagree=13%
Strongly Disagree=5%

2019 
Strongly Agree=21%
Agree=48%
Not Sure=13%
Disagree=15%
Strongly Disagree=4%
Slide 25: Spirituality and Support
Respondents were asked if they would like more support from other people. 
•	12-14% strongly agreed and 37-41% that they would like more support from other people. 
•	20-23% were not sure
•	19-24% disagreed and 4-5% strongly disagreed
Respondents were also asked whether their spirituality or religious faith was important to them.
•	29-33% strongly agreed and 36-39% agreed that their spirituality or religious faith was important to them.
•	12-13% were not sure
•	12-13% disagreed and 6-7% strongly disagreed.
Changes over time were not significant.

Note: the following statistics were shown in a bar chart.

I would like more support from other people
2017 
Strongly Agree=14%
Agree=41%
Not Sure=20%
Disagree=22%
Strongly Disagree=4%

2018 
Strongly Agree=14%
Agree=39%
Not Sure=23%
Disagree =19%
Strongly Disagree=4%

2019
Strongly Agree=12%
Agree=37%
Not Sure=22%
Disagree =24%
Strongly Disagree=5%

My spirituality or religious faith is important
2017 
Strongly Agree=31%
Agree=36%
Not Sure=13%
Disagree=13%
Strongly Disagree=7%

2018 
Strongly Agree=29%
Agree=39%
Not Sure=12%
Disagree=13%
Strongly Disagree=6%

2019
Strongly Agree=33%
Agree=36%
Not Sure=13%
Disagree=12%
Strongly Disagree=6%
Slide 26: Loneliness
In 2019, for the first time, respondents were asked whether they often feel lonely. 
•	11% strongly agreed and 35% agreed that they often felt lonely.
•	14% were not sure
•	31% disagreed and 9% strongly disagreed.

Note: the following statistics were shown in a bar chart.

I often feel lonely
Strongly Agree=11%
Agree=35%
Not Sure=14%
Disagree=31%
Strongly Disagree=9%
Slide 27: Often Feel Lonely – Comparison by Age

In 2019, respondents were asked whether they often feel lonely. The results were compared by age group. The differences between groups were not significant.

Ages 21-44
•	15% strongly agreed that they often feel lonely.
•	30% agreed
•	15% were not sure
•	26% disagreed
•	13% strongly disagreed
Age 45+
•	10% strongly agreed that they often feel lonely.
•	35% agreed
•	14% were not sure
•	32% disagreed
•	8% strongly disagreed

Note: the following statistics were shown in a bar chart.

21-44
Strongly Agree=13%
Agree=26%
Not Sure=15%
Disagree=30%
Strongly Disagree=15%

45+
Strongly Agree=8%
Agree=32%
Not Sure=14%
Disagree=35%
Strongly Disagree=10%
Slide 28: Nutrition
Respondents were asked if they eat nutritious meals every day.
 
•	12-13% strongly agreed that they ate nutritious meals every day. 
•	42-44% of respondents agreed that they ate nutritious meals every day.
•	13-16% were not sure that they ate nutritious meals every day.
•	22-25% disagreed and a small percentage (6-8%) strongly disagreed with this statement.
The change over the three years was not significant.

Note: the following statistics were shown in a bar chart.

I eat nutritious meals every day
2017
Strongly Agree=12%
Agree=44%
Not Sure=15%
Disagree=22%
Strongly Disagree=7%

2018
Strongly Agree=13%
Agree=44%
Not Sure=13%
Disagree=22%
Strongly Disagree=8%

2019
Strongly Agree=12%
Agree=42%
Not Sure=16%
Disagree=25%
Strongly Disagree=6%
Slide 29: Access to Services
Respondents were asked whether they had good relationships with their healthcare and other providers.
•	28-32% strongly agreed and 52-57% agreed they had good relationships with their providers. 
•	9-10% were not sure
•	3-5% disagreed and 1-2% strongly disagreed
Respondents were also asked whether they can easily get the medical services they need.
•	21-24% strongly agreed and 54-58% agreed that they could easily get the medical services they need
•	10-11% were not sure
•	7-10% disagreed and 2-4% strongly disagreed and
Changes over time were not significant.

Note: the following statistics were shown in a bar chart.

I have good relationships with my providers
2017
Strongly Agree=32%
Agree=53%
Not Sure=10%
Disagree=3%
Strongly Disagree=2%

2018
Strongly Agree=28%
Agree=57%
Not Sure=9%
Disagree=5%
Strongly Disagree=1%

2019
Strongly Agree=32%
Agree=52%
Not Sure=10%
Disagree =4%
Strongly Disagree=2%

I can easily get the medial services I need
2017 
Strongly Agree=24%
Agree=54%
Not Sure=11%
Disagree=8%
Strongly Disagree=4%

2018
Strongly Agree=21%
Agree=58%
Not Sure=11%
Disagree =7%
Strongly Disagree=3%

2019
Strongly Agree=21%
Agree=57%
Not Sure=10%
Disagree =10%
Strongly Disagree=2%
Slide 30: Access to Services (cont.)
Respondents were asked whether they can easily get the transportation they need.
•	20-26% strongly agreed and 45-53% agreed that they could get the transportation they need. 
•	9-12% were not sure
•	11-13% disagreed and 3-4% strongly disagreed
The changes over time were not significant.

Note: the following statistics were shown in a bar chart.
years below are in opposite order, should they be changed?

I can easily get the transportation I need
2017 
Strongly Agree=21%
Agree=53%
Not Sure=9%
Disagree =12%
Strongly Disagree=4%

2018
Strongly Agree=20%
Agree=53%
Not Sure=13%
Disagree=11%
Strongly Disagree=3%

2019
Strongly Agree=26%
Agree=45%
Not Sure=12%
Disagree=13%
Strongly Disagree=4%

Slide 31: Need for Assistance
No data, just a title slide
Slide 32: Help Doing Day-to-Day Tasks at Home
Need help (at Home)
Respondents were asked, “How much help do you need in doing your day-to-day tasks at home (such as dressing, bathing or cooking.” 
•	15-17% reported needing a lot of help with doing day-to-day tasks. 
•	31-39% reported needing some help.
•	44-54% reported needing no help. 
These changes were not significant.

Note: the following statistics were shown in a bar chart.

2017
None=54%
Some=31%
A lot=15%

2018
None=44%
Some=39%
A lot=17%

2019
None=53%
Some=30%
A lot=16%

Getting needed help*
Those who reported needing help were asked, “Are you getting the help you need at home with your day-to-day tasks?” 
•	42-51% said they get a lot of the help they need 
•	37-40% said they get some help. 
•	12-18% reported getting no help.
These changes were not significant.
*Those asked if they were getting needed help were a subset of those who need help

Note: the following statistics were shown in a bar chart.

2017
Not at all=18%
Somewhat=40%
Yes=42%

2018
Not at all=15%
Somewhat=38%
Yes=47%

2019
Not at all=12%
Somewhat=37%
Yes=51%
Slide 33: Satisfaction with Help Doing Day-to-Day Tasks
Respondents who reported receiving help were asked, “How satisfied are you with the help you are getting for your day-to-day tasks?” 
•	22-30% were very satisfied with the help they received for doing day-to-day tasks. 
•	38%-45% were satisfied with the help they received.
•	7-10% were dissatisfied and no respondents (0%) were very dissatisfied.
None of the changes over time were significant.

Note: the following statistics were shown in a bar chart.

2017
Very dissatisfied=0%
Dissatisfied=7%
Neither satisfied nor dissatisfied=26%
Satisfied=45%
Very satisfied=22%

2018
Very dissatisfied=0%
Dissatisfied=10%
Neither satisfied nor dissatisfied=22%
Satisfied=43%
Very satisfied=24%

2019
Very dissatisfied=0%
Dissatisfied=8%
Neither satisfied nor dissatisfied=4%
Satisfied=38%
Very satisfied=30%
Slide 34: Help Doing Things in the Community
Need help (Community)
Respondents were asked, “How much help do you need to do things in the community (such as shopping, working, or socializing)?
•	23-27% said that they needed a lot of help.  
•	40-43% said that they needed some help to do things in the community.
•	31-35% said they needed no help. 
The changes were not significant.

Note: the following statistics were shown in a bar chart.

2017
None=35%
Some=42%
A lot=23%

2018
None=31%
Some=43%
A lot=26%

2019 
None=34%
Some=40%
A lot=27%

Getting needed help*
Those who needed help were asked, “Are you getting the help you need to do things in the community?” 
•	30-37% said they were getting the help they need to do things in the community.
•	The percentage (40-43%) said they were getting some of the help they need. 
•	23-28% said they were getting no help at all.
The changes were not significant.
*Those asked if they were getting needed help were a subset of those who need help

Note: the following statistics were shown in a bar chart.

2017 
Not at all=28%
Somewhat=43%
Yes=30%

2018
Not at all=25%
Somewhat=40%
Yes=35%

2019
Not at all=23%
Somewhat=41%
Yes=37%
Slide 35: Getting Needed Help – Comparison by Age
Those who needed help doing things in the community were asked, “Are you getting the help you need to do things in the community?” The results were compared by age group, but the differences between the groups were not significant over time:

Ages 21-44 
•	31-35% agreed they got the needed help
•	41-49% said that they got needed help somewhat 
•	20-26% said they did not get needed help at all
Ages 45+
•	29-37% agreed they got the needed help
•	40-42% said that they got needed help somewhat 
•	22-29% said they did not get needed help at all

2017, ages 21-44
Not at all=20%
Somewhat=49%
Yes=31%

2017, ages 45+
Not at all=29%
Somewhat=42%
Yes=29%

2018, ages 21-44
Not at all=26%
Somewhat=41%
Yes=33%

2018, ages 45+
Not at all=25%
Somewhat=40%
Yes=35%

2019, ages 21-44
Not at all=21%
Somewhat=45%
Yes=35%

2019, ages 45+ 
Not at all=22%
Somewhat=40%
Yes=37%
Slide 36: Satisfaction with Help Doing Things in the Community
Respondents were asked, “How satisfied are you with the help you are getting to do things in the community?” Among those who reported receiving help doing things in the community: 
•	14-21% reported they were very satisfied with the help they received.
•	43-44% were satisfied with the help they received. 
•	26-36% were neither satisfied nor dissatisfied
•	6-9% were dissatisfied and 0-2% were very dissatisfied.
The percentage of these respondents increased over time, but the change was not significant.  

Note: the following statistics were shown in a bar chart.

2017 
Very dissatisfied=2%
Dissatisfied=6%
Neither=36%
Satisfied=43%
Very satisfied=14%

2018 
Very dissatisfied=0%
Dissatisfied =6%
Neither=34%
Satisfied=44%
Very satisfied=15%

2019 
Very dissatisfied=1%
Dissatisfied=9%
Neither=26%
Satisfied=44%
Very satisfied=21%
Slide 37: Conclusions
Physical Health, Mental and Emotional Health and Life Satisfaction
About half of respondents reported being satisfied with their lives, even though similar percentages reported being in fair or poor physical and mental health.

Outlook on Life
Many respondents reported a positive outlook on life, although the percentage who reported that they were in control of their lives decreased significantly.

Energy and Capacities
The percentage who reported feeling energetic throughout the day increased significantly, however, many reported ongoing challenges with mobility, completing everyday tasks and with mood and concentration.

Social Relationships, Support, Spirituality, and Loneliness
Respondents’ answers to questions about social relationships and loneliness suggest that a substantial number experience social isolation and would like more support from other people. Many reported that their spirituality or religious faith was important to them. 
Slide 38: Conclusions (cont.)
Home and Environment and Nutrition
Most respondents reported that they felt safe where they live and that their home had everything they needed, but only about half reported eating nutritious meals every day.

Access to Services
Most respondents reported having good relationships with their providers and that they could easily get the medical services they needed. About two-thirds reported being able to get needed transportation.

Help at Home and in the Community
The percentage who reported getting needed help with day-to-day tasks and doing things in the community steadily increased, but the change was not significant.

Younger vs. Older Adults
On measures where their responses were compared, there were no significant differences between younger (21-44) and older (45+) adults
Slide 39: Contacts
Linda Long-Bellil, PhD, JD
Research & Evaluation
linda.long@umassmed.edu
508-856-8417

Yara Halasa-Rappel, DMD, PhD
Research & Evaluation
yara.halasa@umassmed.edu
781-330-9015

Ying (Elaine) Wang, PhD
Research & Evaluation
ying.wang@umassmed.edu
508-856-3268

Commonwealth Medicine
University of Massachusetts Medical School
333 South Street, Shrewsbury, MA, 01545
Slide 40:  Appendices
Slide 41: Appendix A Ineligible and Excluded Members
Slide 42: Ineligible and Excluded Members
•	Ineligible members
–	Unable to complete survey
–	Language difficulties*
–	Not a legal guardian for One Care enrollee
–	Deceased
•	Excluded members:
–	Invalid contact information
–	Reside outside MA
–	Primary language not English or Spanish
–	Enrolled in MH for less than 90 days
–	Selected for Member Experience survey

*Survey administered in English and Spanish in print or on telephone.
Slide 43: Appendix B Non-Response Analysis
Slide 44: Non-Response Analyses
For the 2017 survey there were statistically significantly differences between respondents and non-respondents in most characteristics except for sex, race, and region.
For the 2018 survey there were statistically significantly differences between respondents and non-respondents in most characteristics except for sex, race, region, primary language, and duration of enrollment.
For the 2019 survey there were statistically significant differences between respondents and non-respondents in most characteristics except for sex and race.
This analysis was performed in order to create weights to be used to ensure the results reflected the One Care population as a whole. 

Note: the following information was shown in a table on this slide.

PY2017	Non-Respondents	Respondents	
Sex: Female	53%	48%	
Sex: Male	47%	52%	
Chi-square pvalue	0.5129		
Race: White	37%	38%	
Race: Hispanic	12%	11%	
Race: Black	13%	10%	
Race: Others	38%	42%	
Chi-square pvalue	0.2073		
Age category: <=34	7%	2%	
Age category: 35-44	16%	12%	
Age category: 45-54	26%	19%	
Age category: 55-64	35%	47%	
Age category: 65+	15%	20%	
Chi-square pvalue	<0.0001		
MassHealth region: Western	19%	23%	
MassHealth region: Central	26%	27%	
MassHealth region: Northeast	11%	10%	
MassHealth region: Metro West	7%	9%	
MassHealth region: Southeast	4%	3%	
MassHealth region: Boston	34%	27%	
Chi-square pvalue	0.0371		
Primary language: English	95%	92%	
Primary language: Spanish	5%	8%	
Chi-square pvalue	0.404		
Rating category: C1	25%	24%	
Rating category: C2A	33%	33%	
Rating category: C2B	9%	5%	
Rating category: C3A	33%	37%	
Rating category: C3B	0%	1%	
Rating category: Others	1%	0%	
Chi-square p-value	0.0047		
One care plan: CCA	64%	71%	
One care plan: Tufts	36%	29%	
Chi-square pvalue	0.0030		
Enrollment method: missing	52%	61%	
Enrollment method: passive	36%	21%	
Enrollment method: self-enrolled	12%	18%	
Chi-square pvalue	<0.0001		
Enrollment duration <1 months	5%	7%	
Enrollment duration 1-2 months	2%	3%	
Enrollment duration 3-6 months	9%	12%	
Enrollment duration 7-12 months	14%	16%	
Enrolled for more than 1 year	70%	63%	
Chi-square p-value	0.0544		

PY2018	Non-Respondents	Respondents	
Sex: Female	52%	53%	
Sex: Male	48%	47%	
Chi-square pvalue	0.7222		
Race: White	36%	36%	
Race: Hispanic	12%	12%	
Race: Black	12%	9%	
Race: Others	40%	43%	
Chi-square pvalue	0.1403		
Age category: <=34	9%	5%	
Age category: 35-44	20%	10%	
Age category: 45-54	26%	20%	
Age category: 55-64	35%	44%	
Age category: 65+	11%	20%	
Chi-square pvalue	<0.0001		
MassHealth region: Western	21%	22%	
MassHealth region: Central	21%	23%	
MassHealth region: Northeast	17%	17%	
MassHealth region: Metro West	7%	11%	
MassHealth region: Southeast	3%	3%	
MassHealth region: Boston	30%	24%	
Chi-square pvalue	0.1132		
Primary language: English	94%	93%	
Primary language: Spanish	6%	7%	
Chi-square pvalue	0.4105		
Rating category: C1	23%	21%	
Rating category: C2A	37%	31%	
Rating category: C2B	7%	5%	
Rating category: C3A	32%	41%	
Rating category: C3B	1%	2%	
Rating category: Others	0%	0%	
Chi-square pvalue	0.0008		
One care plan: CCA	65%	71%	
One care plan: Tufts	35%	29%	
Chi-square pvalue	0.0112		
Enrollment method: missing	47%	51%	
Enrollment method: passive	43%	34%	
Enrollment method: self-enrolled	10%	15%	
Chi-square pvalue	0.0003		
Enrollment duration <1 months	2%	4%	
Enrollment duration 1-2 months	2%	3%	
Enrollment duration 3-6 months	13%	11%	
Enrollment duration 7-12 months	25%	23%	
Enrolled for more than 1 year	57%	59%	
Chi-square pvalue	0.3289		

PY2019	Non-Respondents	Respondents	
Sex: Female	53%	56%	
Sex: Male	47%	44%	
Chi-square pvalue	0.2836		
Race: White	34%	34%	
Race: Hispanic	13%	10%	
Race: Black	11%	9%	
Race: Others	43%	46%	
Chi-square pvalue	0.4181		
Age category: <=34	12%	4%	
Age category: 35-44	19%	11%	
Age category: 45-54	24%	21%	
Age category: 55-64	38%	55%	
Age category: 65+	8%	9%	
Chi-square pvalue	<0.0001		
MassHealth region: Western	20%	24%	
MassHealth region: Central	21%	22%	
MassHealth region: Northeast	18%	15%	
MassHealth region: Metro West	9%	10%	
MassHealth region: Southeast	5%	7%	
MassHealth region: Boston	27%	23%	
Chi-square pvalue	0.2685		
Primary language: English	95%	90%	
Primary language: Spanish	5%	10%	
Chi-square pvalue	0.0013		
Rating category: C1	32%	24%	
Rating category: C2A	27%	29%	
Rating category: C2B	5%	4%	
Rating category: C3A	32%	37%	
Rating category: C3B	1%	2%	
Rating category: Others	3%	5%	
Chi-square pvalue	0.0124		
One care plan: CCA	64%	71%	
One care plan: Tufts	36%	29%	
Chi-square pvalue	0.0123		
Enrollment method: missing	45%	57%	
Enrollment method: passive	42%	26%	
Enrollment method: self-enrolled	12%	18%	
Chi-square pvalue	<0.0001		
Enrollment duration <1 months	2%	5%	
Enrollment duration 1-2 months	3%	6%	
Enrollment duration 3-6 months	20%	17%	
Enrollment duration 7-12 months	15%	15%	
Enrolled for more than 1 year	59%	57%	
Chi-square pvalue	0.0025		
Slide 45: Adjustment for Non-Response Bias and Analysis
Inverse probability weighting was used to address potential bias due to non-response (Seaman, 2013; Little, 1986) by certain subpopulations. A binary variable was created to differentiate respondents from non-respondents. A logistic regression model estimated the probability of response based on the individual level covariates, e.g., demographics, enrollment type and duration, and type of One Care plan. 

Non-response weights were generated as the inverse of the probability of response (1/p). To mitigate extreme weights, these weights were stabilized by dividing the mean weight in the sample by each observation weight value (Austin & Stuart 2015). 
We report results of descriptive analyses by year and report the year over year differences between base performance year (2017) and subsequent performance years. Weighted percentages are presented separately by performance year (2017, 2018 and 2019), along with the difference between base performance year (2017) and subsequent performance years.

References: Austin, P.C. and Stuart, E.A. 2015. Moving towards best practice when using inverse probability of treatment weighting (IPTW) using the propensity score to estimate causal treatment effects in observed studies. Statistics in Medicine. 34: 3661-3679. DOI: 10.1002/sim.6607; Little, RJA. Survey nonresponse adjustments for estimates of means. International Statistical Review, 1986. 54(2):139-157; Seaman SR, White IR. Review of inverse probability weighting for dealing with missing data. Stat Methods Med Res. 2013 Jun;22(3):278-95. 
Slide 46: Appendix C Respondent Demographics
Slide 47: Respondent Characteristics: Age
The majority of respondents (56%-61%) were in the 55-64 age group, while about a quarter (26-29%) were in the 45-54 age category. The smallest percentage of respondents were in the 21-34 age category (4%-5%). There were no significant changes in the distribution of age among One Care respondents over the three survey years.

Note: the following statistics were shown in a bar chart.

2017
Ages 24-34=5%
Ages 35-44=10%
Ages 45-54=29%
Age 55+=55%

2018
Ages 24-34=4%
Ages 35-44=7%
Ages 45-54=26%
Age 55+=63%

2019
Ages 24-34=4%
Ages 35-44=8%
Ages 45-54=28%
Age 55+=60%
Slide 48: Respondent Characteristics: Race and Ethnicity
A solid majority of respondents identified themselves as White (69-76%) and about a quarter of respondents identified themselves as Hispanic (23-28%).
17-23% of respondents identified as Black/African American. 
The “other race/ethnicity” category made up 4% to 8% of the sample. 
There were no significant changes in the distribution of respondents by race over the three survey years. 

Note: the following statistics were shown in a bar chart.

2017
White=74%
Hispanic=23%
Black/African American=17%
Other=8%

2018
White=69%
Hispanic=23%
Black/African American=23%
Other=8%

2019
White=76%
Hispanic=28%
Black/African American=20%
Other=4%
Slide 49: Respondent Characteristics: Education and Gender
Education
Most respondents had either a high school education, or a GED (36-40%), or at least some college education (36-40%). The change in respondents’ educational attainment across the three survey years was not significant.

Note: the following statistics were shown in a bar chart.

2017
Less than high school=23%
High school or GED=38%
Some college or more=40%

2018
Less than high school=24%
High school or GED=36%
Some college or more=40%

2019
Less than high school=25%
High school or GED=40%
Some college or more=36%

Gender
Over the three survey years, the distribution of respondents who identified as male or female changed significantly. The percentage of female respondents increased over the three survey years from 45% to 57% and the percentage of male respondents fell from (54% to 41%). 

Note: the following statistics were shown in a bar chart.

2017
Male=54%
Female=45%

2018
Male=46%
Female=54%

2019
Male=41%
Female=57%
Slide 50: Respondent Characteristics: Work and Homelessness

The percentage of respondents who worked for pay in the last 12 months fell significantly from 20% to 13% over the three survey years.
The percentage of respondents who reported being homeless at some time during the previous 12 months remained relatively stable at less than 10 percent. The change over the three survey years was not significant.

Note: the following statistics were shown in a line graph.

2017
Worked for pay in last 12 months=20%
Homelessness=7%
2018
Worked for pay in last 12 months=14%
Homelessness=7%
2019
Worked for pay in last 12 months=13%
Homelessness=9%
Slide 51: Respondent Characteristics:  Disabilities or Health Conditions

There were no significant changes in the distribution of types of disability or health condition during the three years of the survey. The most common disabling conditions reported were physical disabilities and mental or psychiatric conditions followed by long-term illness. The least common disabling conditions were developmental disabilities and alcohol or drug use. 

Disabilities/Health Condition (self-reporting) / Average Percent 2017-2019
Physical disability=61%
Mental or psychiatric=70%
Long-term illness=47%
Blindness/visual impairment=25%
Learning disability=23%
Hearing loss/deafness=15%
Developmental disability=9%
Alcohol/drug use=8%
Other=38%
Slide 52: Appendix D Quality of Life Survey
Slide 53-59: Note: slides 53-59 contain the pages of the 2019 One Care Quality of Life Survey.