Evaluation of Patient Satisfaction and Experience of Care for Medicare Beneficiaries with ESRD: Impact of the ESRD Prospective Payment System (PPS) and ESRD Quality Incentive Program (QIP)

Forms and Documents

Document Name	Status
Attachment D - BeneSurveyCrosswalk - for OMB Item 10 (Revised July 19, 2013).xlsx Supplementary Document	2013-08-09
Supporting Statement Part B - ESRD SBRD (Revised July 18 2013).docx Supporting Statement B	2013-08-09
BeneSurveyCrosswalk - 080812.xlsx Supplementary Document	2012-09-24
ESRD_survey_draft_cover_letter_080212.pdf Supplementary Document	2012-09-24
Supporting Statement Part A - ESRD SBRD (Revised July 18 2013).docx Supporting Statement A	2013-08-09

IC Document Collections

IC ID	Document Title	Status
204531	Evaluation of Patient Satisfaction and Experience of Care for Medicare Beneficiaries with ESRD Instruction	New

ICR Details

OMB Control No: 0938-1206	ICR Reference No: 201210-0938-007
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Evaluation of Patient Satisfaction and Experience of Care for Medicare Beneficiaries with ESRD: Impact of the ESRD Prospective Payment System (PPS) and ESRD Quality Incentive Program (QIP)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 08/14/2013
	Date Received in OIRA: 10/18/2012
Terms of Clearance: Approved consistent with the following terms of clearance; following completion of the evaluation CMS will provide OMB with a description of the response rates achieved, and describe the results of their non-coverage bias analysis and nonresponse bias analysis.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2016	36 Months From Approved
Responses	2,540	0	0
Time Burden (Hours)	662	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) directed the Secretary of HHS to implement a payment system under which providers or renal dialysis facilities receive a single payment for renal dialysis services in lieu of any other payment. The end-stage renal disease (ESRD) prospective payment system (PPS or "bundled payment") combines composite rate dialysis services with separately billable services under a single payment adjusted to reflect patient differences in resource needs or case-mix. MIPPA also stipulated the development of quality incentives for the ESRD program, known as the ESRD Quality Incentive Program (QIP). The ESRD QIP reduces ESRD payments by up to 2.0 percent for dialysis providers and facilities that fail to meet or exceed a specified performance score. The Centers for Medicare and Medicaid Services (CMS) is planning a qualitative and quantitative evaluation of the impact of the recently implemented ESRD PPS/QIP on beneficiary satisfaction and experience of care. To support its review of the legislative impact on satisfaction and care, CMS will conduct two separate data collection efforts: one with ESRD beneficiaries and one with stakeholders in the renal care community. The quantitative data collection effort for this study will include 2,500 telephone interviews with 2,500 ESRD beneficiaries. CMS will assess beneficiary experiences using the current version of the In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH-CAHPS) Survey. The qualitative data collection effort for this study will include interviews of 40 key stakeholder professionals in the renal care community. The focus of these interviews will include an assessment of whether there are missing domains or topics in the current ICH-CAHPS Survey (to support future modifications to the survey instrument).

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Authorizing Statute(s): PL: Pub.L. 92 - 603 2991 Name of Law: Chronic Renal Disease Considered to Constitute Disability
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 27777	05/11/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 58558	09/21/2012
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Evaluation of Patient Satisfaction and Experience of Care for Medicare Beneficiaries with ESRD

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	2,540	0	0	2,540	0	0
Annual Time Burden (Hours)	662	0	0	662	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Subsequent to the publication of the 60-day Federal Register notice (77 FR 27777), the annual burden hours have decreased from 1,287 to 662. Early cognitive interview findings of the ESRD Beneficiary Survey submitted during the 60 day notice exhibited respondent complaints that the survey was too long and some participants had to hang up early because they were feeling sick. Medicare beneficiaries with end stage renal disease (ESRD) are very sick and unable to remain cognitively aware for 30 minutes. The ESRD Beneficiary Survey was significantly shortened so that the time necessary to interview a single participant was reduced from 30 to 15 minutes.

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Annual Cost to Federal Government: $265,856

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 10/18/2012

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