Mini Part A for Second IC_061711

Application to Use Burden/Hours from Generic PRA Clearance for

Consumer Research on Public Reporting of Hospital Quality Measures

Information Collection #2
June 13, 2011

Division of Consumer Assessment & Plan Performance (DCAPP)
Centers for Medicare & Medicaid Services (CMS)

1

A. Background
One of the primary missions of the Centers for Medicare & Medicaid Services (CMS) is to
improve the quality and efficiency of care in the Fee-for-Service (FFS) program, by publicly
reporting of quality of care information on the Hospital Compare website. This vehicle also
serves to provide healthcare professionals, Medicare beneficiaries, other consumers with the
type of data needed to make informed decisions about which hospitals to use for their care or
the care of their patients. Not only do physicians make decisions about where to refer their
patients for hospital care, but they also answer questions from patients about consumer
information, such as is posted on Hospital Compare. Insuring that physicians understand the
data as intended, interpret them correctly, and make and offer patients accurate inferences
about their significance and implications helps the Agency to fulfill its mission.
As noted in the Supporting Statement to our generic, or “umbrella,” request for information
collection, CMS proposes to conduct two types of activities related to Consumer Research on
Public Reporting of Hospital Quality Measures:
1. Formative research to explore how to best organize quality, safety, and efficiency
information on the Hospital Compare website, using focus groups with consumers
(patients and informal caregivers)
2. Iterative rounds of research to elicit specific feedback on ways of displaying new
measures to be added to Hospital Compare
a. Round 1: intensive individual interviews probing understanding of mock
displays and eliciting feedback about them from
i. consumers (patients and their informal family caregivers)
ii. health care providers (physicians who refer patients to hospitals or
inform them about hospital quality).
b. Round 2: intensive individual interviews probing understanding of revised
displays (based on input from round 1) and eliciting feedback about them
from
i. consumers (patients and their informal family caregivers)
ii. health care providers
This current Information Collection Request (ICR) addresses the first round of the second
activity outlined above, as it relates to physician respondents (section 2.a.ii, highlighted in
boldface above). A second request, submitted along with this one, focuses on consumer
respondents (2.a.i.). ICRs for the other activities outlined above will be submitted at a later
date.

B. Description of Information Collection
The current Information Collection serves to provide individual feedback from internists,
primary care physicians, and surgeons to 3 new types of measures: Hospital Acquired
Condition rates, Healthcare Associated Infections (Central Line-Associated Blood Stream
1

Infections), and two measures of timely transfer of Emergency Department patients to
admitted status. The research team will conduct individual interviews with 6 physicians,
ideally balance between these three types. The stimulus materials include explanatory text
and displays of measure data, rates and benchmarks.
Moderators will look for misinterpretations, unintended reactions or confusion, and what
changes to the display or language might improve them. The goal of gathering such
individual feedback about the mock-ups will be to determine how to best integrate the new
information into the existing website using the display devices similar to those used for
extant measures, but presenting the information clearly and in such a way that physicians and
their patients could draw accurate and useful inferences from the data. Recommendations
will be made to internal clients responsible for reporting of quality metrics to the public and
to those responsible for maintaining the Hospital Compare website.
We will work with established, reliable market research firms to enlist the necessary
participants, providing them tailored screeners for the recruitment process. We have attached
a recruitment screener that includes a detailed script along with specific criteria to use when
contacting potential participants. The script includes screening questions designed to target
the specific audience required for this research, including such criteria as gender, age, race
and ethnicity, and level of education. Our screening tool also takes into account certain
exclusion criteria, screening out, for example, individuals who work in government or the
insurance industry, or whose primary role is teaching, research or quality improvement, to
avoid response bias.
For this information collection request, the following data collection tools are attached:
1) A recruitment screening form to be used by the research facilities to match the
participant pool to the recruitment goals of the research team (Attachment A);
2) A semi-structured guide for interviews with physicians (Attachments B);
3) Mock ups (Attachment C); and
4) Consent form (Attachment D)
C. Deviations from Generic Request

OMB currently approves incentive of up to $75/hour for professionals. CMS wishes to
recruit physicians representative of those clinically active in their communities, rather than
those who are primarily involved with teaching, research, or administration. It also wishes to
avoid recruiting physicians actively participating guiding quality improvement projects. In
CMS’s and its contractor’s prior experience with physicians, biases have been introduced
into the subject pool at the standard incentive rate. CMS requests to provide subjects $200
for their participation. Lower remuneration may alter the subject pool in ways that could bias
the results.

2

D. Burden Hour Deduction
This is a new collection of information. From the total of 186.64 burden hours in the original
generic request, 1 hour is requested for screening of physicians using the physician screener.
An additional 18 hours are requested for interviews with 6 physicians. Hence, the deduction
from the original requested burden hours is 19 hours.
E. Timeline
The current IC request is for use in June/July 2011, so that recommendations may be made to
internal clients by the end of July 2011 for website language and display design.
The following attachments are provided for this information collection:
Attachment A – Screening forms
Attachment B – Intensive Individual interview guide
Attachment C – Testing Materials/Mockups
Attachment D – Consent form

3