Attachment8

Attachment8.pdf

Medicare Health Outcomes Survey (HOS) and Supporting Regulations at 42 CFR 422.152

Attachment8

OMB: 0938-0701

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Attachment 8: Burden Estimate Calculations
Attrition Calculator of a MA Plan with a Sample Size of 1,200

Baseline
Follow-up

Sample Response Number of
Size
Rate
Respondents
1,200
70%
840
840
80%
672

Note: The maximum potential sample size for an individual plan is 1,200.

Time Calculator
Duration of Minutes in Fraction of
Survey (min) an Hour an Hour
10
60 0.166667
20
60 0.333333

Hour and Cost Burden Calculator
Number
of Plans
695
58
Total number

Baseline Followup
840
672
840
0

Total
Responses
1,050,840
48,720
1,099,560

Estimated
Burden Annual Cost
Hours
Per Plan
350,280 $ 27,216.00
16,240 $ 15,120.00
366,520
Cost per complete
$
18.00

Notes:
1) Figures bolded, italicized and in maroon are updated to reflect 2009 numbers.
2) In 2009 there were 695 MCOs and 58 PACE organizations. The assumption is that all these plans
have an enrollment of 1,200 members.


File Typeapplication/pdf
AuthorCMS
File Modified2010-05-25
File Created2010-05-25

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