Survey Cover Letter

LETTER TO:

FROM:

DATE:

PAGE: 0

January 10, 2007

Dear [insert Facility Director’s Name]:

As you may know, Congress has required the Centers for Medicare & Medicaid Services (CMS) to carry out a study of Medicare Advantage Special Needs Plans (SNPs) to assess the impact of SNPs on participant health outcomes and healthcare utilization. As part of this analysis, CMS has contracted with Mathematica Policy Research, Inc. (MPR) to conduct a survey of all SNPs that were approved to operate in 2006. The survey is designed to learn more about how plans are structured, the types of established arrangements between SNPs and medical providers, the nature of care coordination and disease management interventions provided to participants with special needs, and the effects of SNP participation on beneficiary health outcomes and satisfaction.

You have received this questionnaire because you were named as the contact person for the SNP or SNPs listed below. If you were listed as contact person for several types of SNPs or SNPs in two or more states, you may have received more than one questionnaire. Please complete each questionnaire for the SNPs listed on that questionnaire’s cover letter. In doing so, you should feel free to forward the questionnaire to the person in your organization most qualified to respond.

Your participation in this survey is voluntary, but very important to CMS’s evaluation of Special Needs Plans. Please complete the enclosed questionnaire for your organization and return it in the self-addressed, stamped envelope by [fill DATE].

Individual responses to this survey will be kept confidential. Answers from all responding entities will be tabulated and provided to CMS in aggregate form. Responses will not be linked to individual programs or persons.

Please take the time to complete the enclosed questionnaire. If you have questions about the program, please feel free to call [insert CONTACT NAME] at [insert TELEPHONE NUMBER]. For specific survey questions, you should call Todd Ensor, Mathematica’s Survey Director toll free at (609) 275-2326. We look forward to receiving your valuable input.

Sincerely,

Enclosures: survey questionnaire [insert PRIVACY OFFICER]

Centers for Medicare & Medicaid Services