CMS-10482 Attachment C - Interview Topic Guides and Correspondence

Attachment C: Interview Topic Guides for Participating Eligible Professionals and
Administrators

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PQRS Participation Module
eRx Participation Module
PQRS Non-Participation Module
eRx Non-Participation Module

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Eligible Professional and Administrator Interview Topic Guide:
Participation Module
PQRS Participation Decision
1. How many years have you participated in PQRS?
2. Who decided to participate in PQRS?
Probe: You or your practice?
3. What are the top three incentives for participating in the program?
4. In what ways has participation in PQRS changed your delivery of health care to Medicare
beneficiaries?
Probe: Has participation changed documentation?
Has participation improved quality (e.g., more systematic screening; more attention to
chronic conditions)?
5. Do you think that PQRS participation changed care to your other patients (i.e., non-Medicare
patients)?
6. Does it take extra time for you to participate?
a. If yes:
i. Why?
ii. How much time do you estimate it adds to your workload on a weekly basis?
iii. How much time does it add to the workload of your other staff on a weekly basis?
b. If no, why not?
7. What factors influenced your choice of measures to submit?
8. Did you submit a measures group?
a. If yes, which ones and why?
9. Did you receive an incentive payment?
a. If yes:

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Eligible Professional and Administrator Interview Topic Guide:
Participation Module
i. Was the incentive payment what you expected?
ii. How did the incentive payment compare with the effort involved in participating in
the system?
b. If no, why did you not qualify for an incentive payment?
10. Does the plan to publicly report PQRS measures influence your decision to participate?
PQRS Measure Submission
This next section asks about the PQRS submission process.
11. Are you familiar with this process?
a. If yes, continue.
b. If no, ask who to contact at the practice and skip to PQRS Feedback Reports section.
12. How does your practice report the measures?
Probe: claims; GPRO (Group Practice Reporting Option) Web interface; Electronic Health
Record (EHR) Product; registry; data submission vendor.
13. What is the easiest part of the measure submission process?
14. What is the most difficult part of the measure submission process?
15. How would you improve the measure submission process?
16. How much staff time does it take to submit the measures?
a. What staff are involved in the submission process?
17. Who do you contact when you have questions about the submission process?
Probe: QualityNet Help Desk.
a. Are they helpful?
How could the available assistance be improved?

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Eligible Professional and Administrator Interview Topic Guide:
Participation Module

PQRS Feedback Reports
18. Have you seen a PQRS feedback report?
a. If yes:
i. How did you obtain it?
ii. What program year did you receive it for? How helpful was the feedback report?
iii. What happened to the information contained in the feedback report within the
organization?
iv. Did it have an impact on your delivery of health care?
v. How could the feedback report be more helpful to you?
b. If no, what were the barriers to receiving the report?
Conclusion
19. Do you have any other comments on the PQRS program?

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Eligible Professional and Administrator Interview Topic Guide:
eRx Participation Module

eRx Participation Decision
1. How many years have you participated in eRx?
2. Who decided to participate in eRx?
a. Probe: You or your practice?
3. What are the top three motivations for participating in the program?
4. How has participation in eRx changed your delivery of health care to Medicare beneficiaries?
Probe: Has participation increased prescribing efficiency and costs to provider?
Has participation improved quality (reduced dispensing of medication that contraindicated or
could cause adverse reaction)?
Has participation assisted patients in finding lower cost and therapeutically appropriate
alternatives?
Has participation identified drug diversion?
5. Do you think that eRx participation changed care to your other patients (i.e., non-Medicare
patients)?
6. Did the incentive offered by the eRx program encourage your practice to adopt electronic
prescribing or expand the capability of your existing electronic prescribing system?
7. Does it take extra time for you to participate?
a. If yes:
i.

Why?

ii.

How much time do you estimate it adds to your workload on a weekly basis?

iii.

How much time does it add to the workload of your other staff on a weekly basis?

b. If no, why not?

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Eligible Professional and Administrator Interview Topic Guide:
eRx Participation Module
8. Did you receive an incentive payment or a penalty?
a. If yes:
i.

Was the incentive payment or penalty what you expected?

ii.

How did the incentive payment or penalty compare with the effort involved in
participating in the system?

b.

If no, why did you not qualify for an incentive payment?
eRx Measure Submission

This next section asks about the eRx submission process.
9. Are you familiar with this process?
a. If yes, continue.
b. If no, ask who to contact at the practice and skip to the eRx Feedback Reports section.
10. How does your practice report the measures?
Probe: claims; GPRO (Group Practice Reporting Option) Web interface; Electronic Health
Record Product (EHR), registry; data submission vendor.
11. What was the easiest part of the measure submission process?
12. What was the most difficult part of the measure submission process?
13. How would you improve the measure submission process?
14. How much staff time does it take to submit the measures?
a. What staff are involved in the submission process?
15. Who do you contact when you have questions about the submission process?
Probe: QualityNet Help Desk.
a. Are they helpful?
b. How could the available assistance be improved?

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Eligible Professional and Administrator Interview Topic Guide:
eRx Participation Module

eRx Feedback Reports
16. Have you seen an eRx feedback report?
a. If yes:
i.

How did you obtain it?

ii.

What program year(s) did you receive it for?

iii.

How helpful was the feedback report?

iv.

What happened to the information contained in the feedback report within the
organization?

v.

Did it have an impact on your delivery of health care?

b. How could the feedback report be more helpful to you? If no, what were the barriers to
receiving the report?
Conclusion
17. Do you have any other comments about the eRx program?

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Eligible Professional and Administrator Interview Topic Guide:
PQRS Non-Participation Module
PQRS Non-Participation Module
1. Who at your practice decided not to participate in PQRS in 2013?
1a. Did your practice ever participate in PQRS?
1b. If yes, what factors influenced the decision to leave the program?
2. What are the top three barriers for not participating in the program?
Probe: Do the measures apply to your practice’s specialty? If so, what type of measures
would apply to your practice?
Probe: Does the practice not see enough Medicare patients to justify the effort?
3. What would motivate you to participate in PQRS?
Probe: Would a higher incentive/payment adjustment motivate you to participate in
PQRS?
Probe: Would fewer changes in the measures, incentives, and submission options from
year to year motivate you to participate?
Probe: Would more technical assistance motivate you? If so, what kind of assistance do
you need?
4. How would you describe the level of quality of care delivered to your patient?
5. What quality improvement initiatives are underway at your practice to improve the delivery
of health care?
Probe: Are you involved in other private, State and other Federal initiatives? If yes, what
has your experience been?
6. Who do you turn to for assistance in quality initiatives related to quality of care and
performance measurement?
7. Is there anything else that you would share about your impressions of PQRS and your
practice’s decision not to participate?

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Eligible Professional and Administrator Interview Topic Guide:
eRx Non-Participation Module
eRx Non-Participation Module
1. Who at your practice decided not to participate in eRx in 2013?
1a. Did your practice ever participate in eRx?
1b. If yes, what factors influenced the decision to leave the program?
2. What are the top three barriers for not participating in the program?
Probe: Did you receive an exemption from Medicare from participating (e.g., the practice
does not see enough Medicare patients, the practice is located in rural areas)?
Probe: Do you see enough Medicare patients to justify the effort?
Probe: Is the cost of installing an electronic prescribing system capable of meeting the
CMS requirements a barrier?
3. What would motivate you to participate in eRx?
Probe: Would a higher incentive/penalty motivate you to participate in eRx?
Probe: Would fewer changes in the measures, incentives, and submission options from
year to year motivate you to participate?
Probe: Would more technical assistance motivate you? If so, what kind of assistance do
you need?
4. How would you describe the level of quality prescribing medication delivered to your
patient?
5. What quality improvement initiatives are underway at your practice to reduce adverse drug
interactions and coordinate medication prescribed by multiple providers?
Probe: Are you involved in other private, State and other Federal initiatives? If yes, what
has your experience been?
6. Whom do you turn to for assistance in quality initiatives related to quality of care and
medication prescribing?
7. Is there anything else that you would share about your impressions of eRx and your
practice’s decision not to participate?

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E-Mail for Combined Interview Topic Guides with Eligible
Professionals and Administrators
Date

Dear Dr./Mr./Ms. [LAST NAME]:
Thank you for volunteering for a 30-minute phone interview in addition to completing the brief
survey evaluating the Physician Quality Reporting System (PQRS) and Electronic Prescribing (eRx)
Incentive Program.
CMS’ goal in including interviews as part of the Evaluation of PQRS and eRx programs is to learn
more about how well PQRS and eRx meet the aims of better care, healthy people, and affordable care, set
forth by the National Quality Strategy (NQS). Regardless of your PQRS and eRx program participation
status, your input is important to us!
We will contact you or your scheduler to set up a half-hour time that works with your schedule. If
you complete the interview, you will receive an additional $100 gift card.
If you have any questions about the interview or concerns about the privacy of the information you
provide, please contact Econometrica at 1-888-207-0728 from 9:00 a.m. to 5:00 p.m. (CST) or send an
email to [email protected].
Thank you for your participation in this important study and we look forward to interviewing you.
Sincerely,

Thomas R. Jackson
Project Director
Evaluation of PQRS and eRx