CMS-R-268.Supporting Statement-Part A-Final

Supporting Statement – Part A

Collection of Assessment Information

The purpose of this submission is to request a revision of 0938-0756 (CMS-R-268) to continue to collect information from Internet users as they exit from the Websites Medicare.gov and CMS.hhs.gov. As part of the revised collection we are combining the content from the collection 0938-0900 that was discontinued on 5/31/2007. The packages are being combined to eliminate a duplication of effort. The Websites, developed by the Centers for Medicare & Medicaid Services (CMS), went live September 13, 2001. The Websites were produced in concert with the current administration's goal of providing better customer service to all constituents. The underlying principle of the sites are to have a single unified Internet presence for the Agency that contains authoritative, accurate, and up‑to‑date information.

It is critical for this agency to obtain feedback from users of the Websites so that the agency can continually revise the sites to respond to the needs of its users. As part of the effort to determine how these Websites can serve Medicare’s audience best, we are requesting approval from OMB for an internet survey tool. Internet users will fill out a satisfaction survey tool after visiting either Website. The results of this survey will be compiled and studied so that future revisions to the Websites are guided by the needs and preferences of the people who use the Websites.

We are requesting a three-year clearance, so that the feedback received through the survey can be used continually to update and improve the sites. The purpose of this submission is to request OMB authorization to collect information from users of these sites via the survey tool. This package contains the data collection instrument and information supporting its use for Medicare.gov and CMS.hhs.gov. A copy of the survey is included as Appendix B

The survey has the following objectives:

Assess the key components of these sites, specifically: site content, navigability, functionality, appearance, interactivity and privacy policy.

Employ a methodology capable of identifying the drivers of visitor satisfaction and loyalty isolating specific site features where changes will yield the greatest improvements.

Serve visitors using assistive technologies, such as screen readers, and visitors who are not JavaScript enabled.

• Meet 508 ADA compliance regulations.

A. BACKGROUND

The Medicare.gov and CMS.hhs.gov Websites provides the following topics for its Internet users:

• Home Page (Opens at this page upon clicking on Medicare.gov or CMS.hhs.gov)

Headlines

Frequently Asked Questions

Programs (Medicare, Medicaid, SCHIP, HIPAA, CLIA)

Coverage and Laws, Regulations, State Waivers

Initiatives

Screen Reader

Research, Statistics, Data & Systems

Outreach & Education

Compare Tools

Publications

Resources: Acronyms, Contacts, Forms, Glossary, Provider Update,

Publications, Manuals

• Consumers

Medicare, Medicaid, SCHIP, HIPAA, CLIA

Breast and Cervical Cancer (BCCPTA)

• Professionals

General Information

Clinical Labs

CMS Contractors

Health Plans

IT Organizations

Partnerships

Physicians and Health Care Practitioners

Providers

Suppliers

States

Researchers

Tribal Governments

Breast and Cervical Cancer (BCCPTA)

• Public Affairs

Press Releases

Fact Sheets

Testimony

Department of Health and Human Services Media

Nursing Home Quality Initiative Print Ads

• About CMS

Introducing CMS, CMS at a Glance, Programs

Mission, Vision, Goals and Objectives

Agency Structure

Performance Plan

CMS / HCFA History

Contact Information

Careers with CMS

FOIA Requests

• Send Feedback

Feedback & Customer Service

FAQ

Search Engine

Contact information for program questions

Link to www.medicare.gov or www.cms.hhs.gov

www.medicare.gov or www.cms.hhs.gov (FAQS)

1-800-MEDICARE

• Receive Updates (Electronic mailing list service)

CMS Mailing Lists

What’s New on Medicare.gov or CMS.hhs.gov?

Medicare Coverage Determinations

Careers with CMS (Newsletter)

CMS Press Releases & Fact Sheets

Medicare Learning Network

• Careers with CMS

Current Openings

Agency Information and Work Life

Positions at CMS

Application Information

Special Programs

Career Success Stories

What’s the Latest?

There will be ongoing changes to the Websites. This continuous quality improvement survey, which obtains feedback from site visitors, is used to identify areas needing refinement.

Website Survey Tool

To ensure that we gather information about user reactions to the Websites, we have developed a survey tool that users can complete when they exit either site or by accessing a link on the bottom bar on the page. The responses on this survey tool will help CMS to make appropriate changes to the Websites in the future. The survey tool contains questions about the information that visitors are seeking from the sites, the degree to which either site was useful to them, the improvements that they would like to see in the sites, and their general comments.

B. JUSTIFICATION

1) Need and Legal Basis

The Balanced Budget Act of 1997 states that the Secretary of Health and Human Services shall maintain a Website to provide information about CMS activities, programs and topics related to its services. The present request is for OMB authorization to collect data on the reactions of users of the Websites through the survey tool. We will use the data to improve the Websites so that they can best serve the needs of their users.

2) Information users

The purpose of the survey tool is to provide feedback to CMS which sponsors the Websites. The information collected through the survey tool will be used in conjunction with other feedback received. The combined information will guide future improvements to the sites’ content and navigation through their pages. There is no plan to disseminate the information, other than through public health, medical, or other professional journals, in which we may report the results. Information collected from the survey will be used to make improvements to the sites to make them more user friendly.

3) Improved information technology

There are no barriers or obstacles that prohibit the use of improved technology for this information collection activity. This survey tool is in compliance with Section 508 of the Americans with Disabilities Act. The survey tool is in text format. It will be located directly on the Websites. For most questions, the respondents would click on the box that represents their response. For any open ended questions, the respondents would type their responses in the space provided. We have attempted to keep the format of the questions as simple as possible, because multi-part or scaled questions can often appear confusing when they are presented over the Internet. Instead, we have included mostly multiple-choice questions.

Since the evaluation will be conducted electronically through the Medicare.gov and CMS.hhs.gov Websites, there is no paperwork burden.

4) Duplication and similar information

Users of the Websites may provide their opinions about each Website by sending an electronic message to the Webmaster of the site. The data that will be collected in our survey tool is not available elsewhere. This survey does not duplicate the mechanism whereby visitors to these sites can ask Medicare health plan related questions. It will provide more specific information about visitor concerns. Throughout the process of developing and testing the survey questions included in this package, CMS will build upon the work of the researchers with expertise in

Website survey design to develop the best possible assessment questions to measure current and changing levels of user satisfaction.

5) Small business

There is no burden on small businesses. Users of the Websites would respond voluntarily to the survey tool.

6) Consequences of less frequent collections

The survey will be available for 15 days each year for three years. The message that invites users to answer the survey tool will say that the users should not complete the survey if they have completed one on that site in the past 30 days. Our hope is to observe the users opinions over time, as their information needs change, and as the sites themselves changes. If we were to ask users to fill out the forms less frequently, such as indicating that they should not fill out the form if they have ever filled out a form in the past, we would not be able to observe their opinions over time and after changes are made to the sites.

7) Special circumstances

There are no special circumstances with this information collection package. Information collection will not be conducted in a manner:

Requiring respondents to prepare a written response to a collection of information in fewer than 30 days after receipt of it.

Requiring respondents to submit more than an original and two copies of any document.

Requiring respondents to retain records, other than health, medical, government contract, grant-in-aid, or tax records for more than three years.

In connection with a statistical survey, that is not designed to produce valid and reliable results that can be generalized to the universe of study.

Requiring the use of a statistical classification that has not been reviewed and approved by OMB.

That includes a pledge of confidentiality that is not supported by authority established in statute or regulation, that is not supported by disclosure and data security policies that are consistent with the pledge, or which unnecessarily impedes sharing of data with other agencies for compatible confidential use; or

Requiring respondents to submit proprietary trade secrets, or other confidential information unless the agency can demonstrate that it has instituted procedures to protect the information’s confidentiality to the extent permitted by law.

8) Federal Register/Outside Consultation

The 60-day Federal Register notice for this collection published December 28, 2007. The 30-day Federal Register notice published on March 14, 2008.

9) Payments / gifts to respondents

There are no provisions for payments or gifts to respondents on either the Medicare.gov site or the CMS.hhs.gov site.

10) Confidentiality

Assurance of confidentiality for Internet users responding to the survey tool will be made on the basis of the Privacy Act of 1974, as amended (45 CFR 5b).

User confidentiality will be assured by adherence to Section 903(d) of the Public Health Service Act (42 USC 299 a-1[c]) as follows:

All information obtained through the survey will be reported in aggregate. No information will be published or released in other forms if the person who supplied the information or who is described in it is identifiable unless such person has consented (as determined under regulations of the Secretary) to its publication or release.

There will be no cookies set on any computer as part of this information collection effort.

11) Sensitive questions

We have avoided any questions that could be considered sensitive, such as questions about income, illegal activities, alcohol consumption, sexual orientation, or health risk behaviors. There is no requirement to answer questions. The survey tool will offer a refusal option, such as a “don’t know/don’t wish to answer” and the respondent may continue with the survey. Respondents will not be asked for their names or addresses.

12) Estimates of annualized burden

The purpose of the survey tool is to obtain feedback so the provider of these sites can determine how to revise the Websites.

Survey will take a number of steps to promote a high response rate to the Medicare.gov and CMS.hhs.gov Website evaluation. These steps include:

• Creating a pop-up invitation that mirrors the look and feel of each Website, thereby assuring respondents of the legitimacy of the invitation and avoiding confusion with commercial advertisements.

• Crafting an invitation with a compelling message, emphasizing the importance of participation and stressing the role of site visitors in determining the design and content of these sites.

• Making it easy to complete the survey by providing a simple click-through interface.

• Keeping the survey short (about five minutes) to minimize burden.

• Assuring the confidentiality of responses.

• Providing a link to a full description of the survey, its sponsorship, and purpose.

• Offering respondent support through a clickable e-mail address and a toll-free telephone number.

It is contractor experience that these steps will create stronger salience with respondents and will thereby promote a higher response rate than with standard intercepts.

We estimate 7,000 respondents per year will answer the survey. The survey will be available for 15 days for each of three years. We also estimate that the survey will take about 10 minutes to complete. Therefore, the total time of 1167 hours will be spent per year completing this survey. There will be an option when the survey appears on screen, which says “I do not wish to take this survey at this time.”

13) Estimates of capital cost

The annualized cost is negligible. The form will be placed on the existing Medicare.gov and CMS.hhs.gov Websites. The responses to the form will go into a database that can be analyzed by the contractor.

14) Estimates of annualized government cost

The cost of putting this form on the Websites and collecting the information are negligible, since the Websites are already operational.

15) Program changes/Burden changes

We increased the amount of time associated with the survey from 5 minutes per person to 10 minutes per person. The burden increased accordingly.

16) Publication and tabulation

The information will be tabulated and analyzed to inform future changes to the Websites. There are no publication dates.

17) OMB expiration date exemption

Exemption is not being sought.

18) Exceptions to certification statement

The proposed data collection does not involve any exceptions to the certification statement identified in line 19 of OMB form 83-I

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