CMS-10437 GenIC#2 - Supp. State. 2015 Online Provider Survey

Application to Use Burden/Hours from Generic PRA Clearance:

Generic Social Marketing & Consumer Testing Research

(CMS-10437, OMB 0938-1247)

Generic Information Collection (GenIC) #2: 2015 Online Provider Survey

Office of Communications (OC)

Centers for Medicare & Medicaid Services (CMS)

A. Background

The Office of Communication Division of Research will be conducting an online survey of providers for The Centers for Medicare and Medicaid Services (CMS). Survey respondents will be primary care physicians, specialists, and practice managers in primary care offices. The survey will measure provider perceptions and experience with CMS programs and initiatives including new technology such as Electronic Health Records, new health delivery initiatives such as ACOs, and sources and channels of communication with providers such as websites and social media. This study aims to update CMS knowledge of its provider audience, by assessing awareness, knowledge, participation in CMS programs and initiatives and awareness and use of existing outreach and communications. Improved knowledge will help CMS to improve the way it communicates with providers. Results of the survey will be shared with CMS stakeholders and used to improve communications with providers.

B. Description of Information Collection

The data will be professionally collected using an online questionnaire.

The interviews are expected to take an average of 20 minutes.

Respondents will be offered a $75 cash incentive for completing the interview. This level of participant incentive is in keeping with that specified in the original Supporting Statement for this collection, i.e., in accordance to OMB Circular A-21, section C, and subsection 3 “Reasonable Costs”.

Items will be drawn from the generic item pool and formatted for internet presentation. The survey will include: ATG7, AWG2, BG3, BP1, DG1, DG11, DMG1, DMG4A, DP2, ISG1,ISG2, , ISG3, ISG4A , ISG5, ISG6, K1, KG2, KG8, PG9, SB4, SG2, SP1, SP2, SP3.

C. Deviations from Generic Request

None

D. Burden Hour Deduction

1,200 participants x .3 hrs = 360 hours

E. Timeline

May – July, 2015

The following attachment is provided for this information collection:

Study Initiation Request Form (2015 Provider Assessment)