CMS-10194 FocuGroupModeratorGuide

MODERATOR GUIDE FOR FOCUS GROUPS
EVALUATION OF SPECIAL NEEDS PLANS

A. INTRODUCTION (10 minutes)
1. Introduce Self and Other MPR Staff
a. Give names and explain roles
b. Describe MPR—an independent research company working under a contract from the
Centers for Medicare & Medicaid Services (CMS). MPR was hired by CMS to
conduct an evaluation of Medicare Advantage Special Needs Plans.
c. Most of MPR’s work is for the federal government, evaluating programs. Areas we
focus on include health care, education, welfare, and employment.
2. Purpose of Discussion
a. As part of the evaluation, we are conducting 12-15 focus groups across the country
with members of special needs plans. The main purpose of the focus groups is to get
your perspective, as plan members, on the plan’s operations and effectiveness.
b. The groups will help CMS understand how the plans are working and how they
might be improved.
c. We’ll be discussing how each of you came to participate in this plan. We’d like to
know if you feel that the benefits of being in the plan were described clearly to you
and how satisfied you are with those benefits.
d. I’m here to learn about the program from you, so please do not assume that I know a
lot about how the plan works.
3. Mechanisms of Discussion
a. Taping
- No note taking, I want to listen to discussion
- Tapes help with report
- No one outside of MPR will be given tapes. (No one at CMS or any organization
outside MPR will have access to the tapes. MPR will prepare a summary report of
the groups.
- Please speak up so that tapes can pick up what you’re saying

SNP MODERATOR GUIDE

1

b. Confidentiality
-

We want to assure you that the focus groups are confidential. We will never use
names in reports or associate names with answers. Reports that are prepared about
what we learn from focus groups will say things like, “most people felt…,”
“about half the people disagreed with …”), etc.

-

Because discussions in a focus group are (we hope) open and free-flowing, we
cannot predict the direction a particular discussion might take. Therefore, we ask
that you don’t share any personal information that you might learn about other
participants in the group with anyone outside of the group.

c. Talk one at a time. Tapes can’t pick up everything if everyone talks at once.
d. Time restrictions—moderator must move discussion along, because lots of topics to
cover; I apologize in advance if I have to shorten some discussions.
e. Offer opinion even if different than others. There are no right or wrong answers.
However, please respect each other’s opinions.
f. Offer refreshments, point out restrooms.
[START TAPES]
--------------------------------------------------------------------------------------------------------------------B. PARTICIPANT INTRODUCTIONS AND AWARENESS OF PLAN MEMBERHSIP
(15 minutes)
1. Now that I’ve told you who we are, please tell us who you are. Please say….
•
•
•

Your first name
How long you’ve been participating in this special needs plan
How you came to participate in the plan

2. How many people learned they were enrolled in the plan some time after they were first
enrolled? (SHOW OF HANDS)
3. How did you find out you were enrolled in a special needs plan?
4. How about you (POINT OUT NON-RESPONDERS)—how did you learn you were
enrolled?
5. How many of you were enrolled in a Medicare Advantage plan such as [fill in names of
local plans] before you enrolled in this plan?

SNP MODERATOR GUIDE

2

C.

DECISION TO PARTICIPATE (20 minutes)
Now I’d like to talk about your decision to sign up for/enroll in the special needs plan.
1. Did someone assist you in your decision to join the SNP? If so, who was that?
2. What types of marketing materials did you receive from the plan and what role did the
materials play in your decision to enroll?
3. If you were automatically enrolled in this plan from your previous plan, how satisfied
are you with your enrollment? Do you feel that you have been adequately informed
about how to disenroll from the plan if you wanted to?
4. Why did you choose to enroll (or, if you were automatically enrolled, why did you
choose not to disenroll)? [Prompts: special services offered, recommended by a trusted
physician; recommended by a family member or friend; plan’s affiliation with enrollee’s
medical group or hospital; location; superior drug benefit; meet specific need, for
example, heart failure, diabetes, frailty, or medical complexity]
5.

Are there steps the plan could have taken to make the decision to enroll or the
enrollment process easier?

D. AWARENESS AND USE OF PLAN BENEFITS (20 minutes)
DISTRIBUTE A SHEET DESCRIBING BENEFITS SPECIFIC TO EACH PLAN HERE.
1.

Are you aware of the plan’s special services and benefits?

2.

Are you aware that [FILL SPECIAL SERVICE OFFERED BY THE PLAN] is available to
you through the SNP?

NOTE: THESE BENEFITS WILL VARY AND WILL BE TAILORED PER PLAN…..
•
•
•
•
•
•
•
•
•
•
•
•
•
•

Home health-related services: custodial care, homemaker services, respite care
Routine foot care
Transportation
Alternative Medicine Program
Congestive Heart Program
Health Education/Wellness
Membership in health club/fitness classes
Nursing hotline
Newsletter
Nutritional training
Smoking cessation
Immunizations, routine physical, screenings/lab tests
Dental visits
Eye exams/eye wear

SNP MODERATOR GUIDE

3

•

Hearing exams/hearing aid fitting

3. Which of these special services have you used? Did a social worker, nurse practitioner, or
nurse help you access these services? Did a social worker, nurse practitioner, or nurse
provide you with extra help?
4. Have you tried to use any of these services but were unable to do so? Has the plan provided
you with extra help for your medical concerns? What happened?
5. Does someone from the plan, like a nurse or social worker, contact you on a regular basis to
check on your health or specific disease/condition or to see if you need help with getting
services?
6. What types of plan services do you use most? What services do you value most? Do you think
the plan has improved your health care?
Now I want to ask a few questions about care management:
7. Do you know who your care manager is and how to contact him or her if you have a problem?
8. Did someone from your plan evaluate your health care problems?
9. Did someone tell you what kind of services were available to help you with your health
conditions or concerns? Did someone help arrange these services for you?
E. SATISFACTION WITH PLAN BENEFITS (20 minutes)
1. Are you satisfied with the care you receive from this plan?
2. How does your care compare with that received before joining the SNP? (For example, are
you getting more preventive care such as vaccinations, mammograms, or cholesterol
screening?
PROBE: Are (services/care coordination/your understanding of your condition/etc.) better
than, the same as, or worse than before you joined the SNP?
• Do you think services are more responsive to your specific condition or disease?
• Does the plan and its providers do a better job of coordinating care among your
different doctors and helping you manage the medications you take?
• Do you think the plan does a better job explaining your health conditions and telling
you how to manage them?
• Does the plan encourage your loved ones to be involved in meeting your care needs?
• How does your overall experience with this plan differ from other Medicare plans
you’ve participated in or when you received original Medicare benefits?

SNP MODERATOR GUIDE

4

3. Is it easier to get support services like transportation or personal care?
4. Is it easier to get specialty health services like dental care or home-based wound care?
5. Are there services this SNP could provide that it is not currently providing, that you believe
would improve care?
6. Do you expect to remain enrolled in the SNP plan? (SHOW OF HANDS)
7. Has anyone contemplated disenrolling from the plan? (SHOW OF HANDS) Why?

F. WRAP-UP (5 minutes)
--Solicit questions from the group
--finish PIFs if needed
--distribute payments

SNP MODERATOR GUIDE

5