CMS-10477 Stakeholder interview scheduling script

Medicaid Incentives for Prevention of Chronic Diseases Evaluation

Attachment_7c_Scheduling_Script

Stakeholder Interview

OMB: 0938-1219

Document [pdf]
Download: pdf | pdf
Attachment 7.c. Scheduling Script
ID:____________________
Date: _________________
Time:_________________

Call notes:_______________________________
State:____________

Telephone Stakeholder Interview Scheduling Script
My name is . I work for RTI International, a non-profit research
organization. We are a conducting a study with the Centers for Medicare & Medicaid Services (CMS).
 State program leadership recently identified you as an important stakeholder and
recommended that we talk with you about our study.
We have been working closely with state leadership from  to identify stakeholders
who provide services and directly interact with Medicaid beneficiaries. Examples of stakeholders
include individuals such as yourself as well as [READ ALL BUT THEIR CATEGORY] peer coaches,
navigators, lifestyle coaches, health educators, certified diabetes educators, dieticians, program teachers,
participant motivators, outreach coordinators, and community liaisons.
The purpose of my call is to tell you about the study, answer any questions you may have, and, if you
are interested in participating, to schedule an interview with you.
The goal of the interview is to learn about your experiences providing services and directly interacting
with Medicaid beneficiaries in . By interviewing you and other stakeholders, we
hope to gain a better understanding of the beneficiary experience and how the program addresses quality
of care, accessibility, and beneficiary satisfaction.
If you choose to participate, your participation is voluntary and you can choose to end participation at
any time. Your answers will remain confidential and will be reported in summary form, so that nothing
you can say can identify you. Also, we are audio-recording the interviews in case we miss anything in
the notes. The audio recordings are kept secure and are only available to project staff.
If you are interested, we would ask to call you for an interview that will last about an hour.
Does this sound like something you would be interested in participating in?
[If NO] Thank you for your time.
[If YES] Great. We just need to determine whether you meet the eligibility requirements of our study.
1. Do you spend 50% of your time providing services and directly interacting with Medicaid
beneficiaries in ?
[If NO] Unfortunately, you are ineligible for the study. Thank you for your time.
[If YES] Great.
2. Have you been in your role one year or longer?
[If NO] Unfortunately, you are ineligible for the study. Thank you for your time.
[If YES] Great.
3. We are attempting to schedule an interview ” or
“VIA PHONE”>. 
[If NO] Is there an alternative  that you would like us
to  you at?

1

Record alternate location or phone number:________________
[If YES] Great.
4. What day and time would be convenient for you?
Time: __________
Day: ___________
5. [If needed] I’d like to send you a reminder or confirmation about the interview. Would you
rather receive that reminder via telephone or email?
Prefers telephone reminder
Prefers email reminder

Record telephone number: _____________
Record email address: _______________

2


File Typeapplication/pdf
File TitleMedicaid Incentive for Prevention of Chronic Disease demonstration PRA package Part A - Attachment 7c Scheduling Script
SubjectMedicaid, incentives, prevention of chronic disease, CMS demonstration evaluation, beneficiary satisfaction survey, focus group
AuthorCenters for Medicare & Medicaid Services
File Modified2013-05-06
File Created2013-02-11

© 2024 OMB.report | Privacy Policy