CROSSWALK - Changes to Advance Letter, Supporting Statements A and B, Survey Instrument, and Frequently Asked Questions

CROSSWALK

(Changes to Advance Letter, Supporting Statements A and B, Survey Instrument,

and Frequently Asked Questions)

With the addition of the web-based survey and in order to bring the survey into alignment with the Plain Language Act (PLA), changes/revisions were made to the survey materials. The tables below summarize the revisions made to the Advance Letter, Explanation for Inclusion of Survey Questions, Supporting Statements A and B, and the Survey Instrument.

Advance Letter

The Advance Letter was revised to reflect the additional mode of data collection and to reword the statement explaining the purpose of the survey. The table below summarizes these revisions to the letter.

Category	Section	Change/Reason	Effect to Reporting Burden
Revised Data Collection Plan	Advance Letter	The words Case ID were changed to CTM Complaint ID.	None
Revised Data Collection Plan	Advance Letter	Language was added to the Advance letter to highlight CMS’s commitment to ensure beneficiary quality of care. For example - “One of the ways we ensure quality care is to ask about the service you are currently receiving from your Medicare health plan and/or Prescription Drug Plan.”	None
Revised Data Collection Plan	Advance Letter	Language was added to the Advance Letter to describe the web-based survey and how beneficiaries can access the survey online. For example - “To collect this information, IMPAQ has developed a secure web-based survey, entitled the CMS 2012 Complaints Resolution Survey. Please go to: medicare-comp-survey.cms.gov to complete the brief 10 minute survey by [DATE-next two weeks]. You will be asked to provide your CTM Complaint ID (located in the top right corner of this letter) to access the web-based survey. Survey instructions are included on the website.”	None
Revised Data Collection Plan	Advance Letter	Language for the explanation of the purpose of the survey and confidentiality was revised	None
Revised Data Collection Plan	Advance Letter	The Advance Letter was translated into Spanish in order to expand the survey to bilingual and Spanish-speaking only beneficiaries.	None

Supporting Statements A and B

Additions were made to Supporting Statement A in order to accommodate the addition of the web-based data collection mode. The table below summarizes these additions to Supporting Statements A and B.

Category	Section	Change/Reason	Effect to Reporting Burden
Addition to Data Collection Plan	Supporting Statement A	Language was added to describe the addition of a third mode of data collection (web-based survey) to be administered in both English and Spanish.	None
Addition to Data Collection Plan	Supporting Statement A	Language was added describing how beneficiaries will change languages and how they can access FAQs and resource pages within the web-based survey.	None
Addition to Data Collection Plan	Supporting Statement A	Footnote citations were added as support for references within the document.	None
Addition to Data Collection Plan	Supporting Statement A	Language was added to indicate that both the English and Spanish versions of the online survey meet Plain Language Act standards.	None
Addition to Data Collection Plan	Supporting Statement A	The numbers of beneficiaries to be included in the pilot test and main data collection effort were updated to reflect the expanded universe for the web-based survey.	None
Response to Public Comments	Supporting Statement A & Supporting Statement B	Additional explanation was added to the sampling plan (supporting statement B) and background (supporting statement A) regarding the selected data collection period. The timeframe for data collection is expanded to the entire year from the original timeframe of the months with the highest volume.	None

Survey Instrument

CMS has reformulated some questions to the survey instrument without affecting the data collection burden. As mentioned above in section 3, all survey materials were revised to align with the standards set forth in the Plain Language Act of 2010. The table below summarizes the actions CMS has taken to address comments on the survey instrument. Again, there was no change in the reporting burden.

Category	Section	Change/Reason	Effect to Reporting Burden
Questionnaire Revision	Survey Instrument - General	The survey questions were revised to reflect alignment with the PLA standards.	None
Formatting for Web Programming	Survey instrument – Q1 – Q9	If Q1 – Q9 is not answered fully (e.g. a response on all 5 lines), beneficiary will receive a pop up notification letting them know that they must complete all questions before they can continue with the survey. After clicking “OK”, beneficiaries will see that the missing part of the question is in red. This will occur throughout the survey whenever a question skipped or only partially answered by the beneficiary.	None
Questionnaire Revision	Survey Instrument - Q1	”According to our records” was replaced with “Our records show”	None
Questionnaire Revision	Survey Instrument - Q2	Q2 was reworded to “How satisfied were you with the following parts of the complaint process?” A statement was added instructing beneficiaries to mark a response for all five (5) lines.	None
Questionnaire Revision	Survey Instrument - Q2	The list of the complaint process statements was reordered.	None
Questionnaire Revision	Survey Instrument - Q3	Q3 was reworded to “At any time during the complaint process, did you experience any of the following?” A statement was added instructing beneficiaries to mark a response for all four (4) lines.	None
Questionnaire Revision	Survey Instrument – Q3	In the list of experience statements, the word “coverage” was changed to “benefits”	None
Questionnaire Revision	Survey Instrument – Q3	The list of the experience statements was reordered.	None
Questionnaire Revision	Survey Instrument - Q5	Question 5 was revised to remove the phrase “Whether you agree or disagree with the final outcome”.	None
Questionnaire Revision	Survey Instrument - Q6	Question 6 was reworded to “How many attempts did you make to try and resolve this particular complaint?”	None
Questionnaire Revision	Survey Instrument - Q8	Question 8 was revised to remove the phrase “(the Medicare beneficiary)”.	None
Questionnaire Revision	Survey Instrument - Q9	This question was reworded to “Tell us who filled out this survey”	None
Questionnaire Revision	Survey Instrument - Q9	The response set was changed to “I am a Medicare beneficiary” “I am filling out the survey on behalf of a Medicare beneficiary”	None
Formatting for Web Programming	Survey Instrument – Thank you	A “thank you” message was revised to “Thank you! Your survey responses have been recorded. The information you provided will help improve the way Medicare plans handle complaints in the future. By providing feedback about your complaint experience, you are helping CMS and your health plan and/or prescription drug plan serve you better.”	None

Frequently Asked Questions

In addition to the revisions made to the survey questions, the Frequently Asked Questions (FAQs) were also revised and updated. In many cases, the language in the answers was simplified to align with the standards set forth in the Plain Language Act of 2010. The table below summarizes the changes made to the FAQs.

Category	Section	Change/Reason	Effect to Reporting Burden
FAQ Revision	FAQ – General	The order of FAQs has been reorganized.	None
FAQ Revision	FAQ - General	The FAQ language has been revised to reflect alignment with the PLA standards.	None
FAQ Revision	FAQ – Purpose of the Survey	The explanation of the purpose of the survey was revised and simplified. The revised language is “The goal of the survey is to understand your opinions about the way your health plan resolves beneficiary complaints. Your survey responses will help improve how complaints are handled.”	None
FAQ Revision	FAQ – Survey Sponsorship	The FAQ “Who are you” has been replaced with “Who is sponsoring the survey?	None
FAQ Revision	FAQ – Survey Sponsorship	The language for the survey sponsorship FAQ has been revised to “The Centers for Medicare & Medicaid Services (CMS) sponsors this survey and has contracted with IMPAQ International, LLC to conduct this survey for us.”	None
FAQ Revision	FAQ – Survey Length	The FAQ “How long will this take?” has been revised to “How long will it take me to complete the survey?”	None
FAQ Revision	FAQ – Survey Length	The language for the survey length FAQ has been revised to “The survey takes 5 to 10 minutes to complete. If you need to pause, you can come back and complete it later.”	None
FAQ Revision	FAQ - Interest	The FAQ “I’m not interested” has been revised to “Why should I be interested in taking the survey?”	None
FAQ Revision	FAQ - Interest	The language for the interest FAQ has been revised to “Your responses will be used to improve the way complaints are handled and how your health plan provides services to you. We depend on your responses to help CMS and your health plan and/or prescription drug plan serve you better.”	None
FAQ Revision	FAQ - Participation	The language for the participation FAQ has been revised to “Your participation is voluntary and doesn’t affect your services or benefits in any way.”	None
FAQ Revision	FAQ – Information Collection	The FAQ “What information do you intend to collect?” has been revised to “What kind of information does this survey collect?”	None
FAQ Revision	FAQ – Information Collection	The language for the information collection FAQ has been revised to “We’ll combine your responses with those of other Medicare beneficiaries and analyze them to evaluate how your plan is handling complaints.”	None
FAQ Revision	FAQ - Confidentiality	The language for the confidentiality FAQ has been revised to “Your responses will be held in complete confidence and used only for the purposes of this study.	None
FAQ Revision	FAQ - General	The following FAQs were removed due to their duplication of other FAQs or because the answer was addressed in the Advance Letter and survey introduction. How did you get my name? Someone filed a complaint on my behalf I didn’t file a complaint My complaint is not closed I don’t have time	None