Attachment 4 - P4P_Eval - Part A_Attachment_1_HHA Survey Directions 052009

P4P_Eval - Part A_Attachment_1_HHA Survey Directions 052009.doc

Evaluation of the Home Health Pay for Performance Demonstration: Survey instrument

Attachment 4 - P4P_Eval - Part A_Attachment_1_HHA Survey Directions 052009

OMB: 0938-1064

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Home Health Pay for Performance (P4P) Demonstration Web Survey Outline


Dear P4P Demonstration Participant:

Thank you for taking a few minutes of your time to complete the secure, Web-based survey that is part of the evaluation of the CMS P4P Demonstration project.

The following is an outline of the questions that you will answer in the survey.

Q 1 – 3: Identification (some will be pre-filled for you)

Q 4 – 6: Staffing changes in CY2008

Q 7: QIO involvement

Q 8 – 11: Policies and Practices in CY2008

Q 12: Corporate initiatives (if applicable)

Q 13: Local/Regional influences on practice

Q 14 – 18: Perceptions of the effectiveness of the P4P Demonstration (Omit Q14-17 for “Control” participants)

Q 19: Opportunity for comments

You may want to have documents that are relevant to these topics available to you prior to beginning the survey. You will notice that answers for Q 4 – 7, and 12 – 18 have been pre-filled with a “no change” or “neutral” response to facilitate your completion of the survey.

If you choose to select one of the “Other (specify)” options for an item, please remember to both click on the “radio” button AND fill in a response in the box provided. If you forget to complete both elements for these items, you will be prompted to fill in the necessary information when you try to submit the survey.

The information you provide on the Web survey will be kept secure in the following ways:

  1. You can review (and print) your answers prior to submitting them.

  2. You are entering these data on a secure Web site at the University of Colorado, Denver.

  3. When you press the “submit data” button, the data will be automatically transmitted to a secure server at the Division of Health Care Policy and Research at the University of Colorado, Denver where the data analyses will be conducted. When the data are transmitted, none of your data will remain on the secure Web site at the University of Colorado, Denver.

  4. No individual home health agency will be identified in any report produced from these data.

  5. Once the evaluation of the P4P Demonstration is complete, the data will be purged from the secure server at the Division of Health Care Policy and Research at the University of Colorado, Denver.

When you are ready to begin the survey, type in the following URL and follow the directions on the screen. Your CCN is both your ID and your Password.

https://hschealth.uchsc.edu/hcpr/loginP4P.asp

Again, thank you for your time in helping CMS evaluate the effectiveness of this demonstration project.

Sincerely,

University of Colorado, Denver

CMS Evaluation contractor

File Typeapplication/msword
File TitleHome Health Pay for Performance (P4P) Demonstration Web Survey Outline
AuthorGene Nuccio
Last Modified ByGene Nuccio
File Modified2009-05-29
File Created2009-05-29

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