CMS-10398 (#39) 39 Protocol for EI States

OMB Control Number 0938-1148

Expiration date: { mm/dd/2015 } CMS staff to fill this in.

Exchange Innovators Learning Collaborative

State Participants

2015 Individual Discussion Guide

(45 minutes)

INTRODUCTION

Hello, I’m [NAME] from Mathematica Policy Research. Thank you for taking the time to talk with me. As part of the MAC LC project, Mathematica is assessing the LC experience. Through this assessment we will provide feedback that may be used to help CMS learn about the features of effective LCs and to improve the LC experience for states in the future. We’re collecting feedback from participants from the states, as well as from LC facilitators and the CMS subject matter experts associated with each LC. We’re interested in talking with you about your experiences as a participant with the Exchange Innovators LC (also known as the ‘Early Innovators LC’).

This interview will cover all three years of the LC, from late 2011 through September 2014. We will not share interview notes with the LC facilitation teams, or other CMS staff, and we will not use direct quotes in any reports or briefing documents that result from the assessment activities. If it is okay with you, we’d like to record this interview for the purpose of completing our notes only. Do you have any objection to our taping of the discussion?

The discussion will last up to 45 minutes. We have a series of questions we would like to ask you, so to make sure we don’t take up too much of your time, we may re-direct the conversation at some points.

Do you have any questions before we begin?

A. Respondent Background and Role in the Exchange Innovators LC

Let’s do quick introductions.

1. Please tell us your name, organization, job title, and how long you have been with the organization.

2. When did you become involved in the Exchange Innovators LC? How long were you involved?

B. Goals and Objectives

Now, let’s talk about your goals and objectives for participating in the Exchange Innovators LC.

1. Thinking back to when you first decided to participate in the Exchange Innovators LC, what did you hope to gain from participating?

   1. For example, were you interested in the Exchange Innovators LC primarily to ask CMS questions about implementation challenges, to hear about other states’ approaches to policy and implementation, or to hear about ideas for improving your Exchange’s performance?

2. How were the goals and objectives of the LC communicated to you? How well did they align with your own motivation for participating?

   1. Do you think the goals and objectives of the LC shifted over time? How did that affect the value of the LC experience for your state?

C. State Experience of LC Activities

Now we have a few questions about your engagement and experience with the LC.

1. How would you describe your state’s level of participation in the webinars, discussions and meetings convened by the Exchange Innovators LC?

   1. About what proportion of the approximately fifty Exchange Innovators LC webinars and meetings that were held from December 2011 to September 2014 did your state attend (e.g. a third, half, three-quarters)?

      1. [If less than three-quarters:] What prevented or discouraged you from attending more meetings?

         1. [Prompt if needed:] Was it that meeting content was not relevant, for example, or were you not given enough notice?

   2. Did you present material about your state’s policies or decisions at an LC meeting?

      1. If not, did you ever want to present material or feel that you had insights to share? What prevented you from sharing your insights?

   3. Did you ask questions during discussions?

      1. How helpful were the responses you received?

      2. If you did not ask questions, what prevented you from asking questions?

   4. Did you ever contact another state, CMS, or the LC facilitators to follow up after an LC session? How helpful was that interaction?

2. During its first two years, the Exchange Innovators LC, focused on webinars and Q&A-based technical assistance, covering topics like the federal data services hub, plan choice decision support, and vendor selection. In early 2014, the LC shifted to focus primarily on a project titled the “Marketplace Improvement Learning Initiative,” which developed state-specific reports and recommendations on topics like outreach and marketing, eligibility and enrollment business processes, and the role of Marketplace designs and QHP selection criteria in competition. How did this shift affect your experience of the LC?

3. Were the reports and memos produced as part of the Marketplace Improvement Learning Initiative useful to you?

   1. If so, how?

   2. If not, why not? What would have made them more useful?

4. Have you used other documents – like Q&A summaries, slide decks and flow charts - produced or disseminated by the LC?

   1. How have you used the materials?

   2. How appropriate was the level of detail for material shared in the Exchange Innovators LC? Did it strike the right balance between being too basic and getting too detailed?

   3. What was your experience accessing materials via the ‘Collaborative Application Life-cycle management Tool’, or CALT?

5. What could have been done to enhance your level of engagement in the LC?

   1. Do you feel that you had sufficient notice about upcoming LC sessions so that appropriate staff from your state could be available to attend?

      1. Thinking about specific webinars, were you able to identify who should attend from the state, given the information provided in advance about the topics covered? [Interviewer note: Example of webinars include those on special enrollment periods, exemptions from the shared responsibility payment, appeals, or the federal data services hub]

   2. Do you feel like you had sufficient opportunity to suggest topics that should be covered in LC sessions or in written products, including those produced as part of the Marketplace Improvement Learning Initiative?

6. How would you describe the interaction between LC states and CMS subject matter experts? Was it sufficient and productive?

   1. What supports/hinders this interaction?

7. How would you describe the interaction between LC states? What worked or did not work to promote a peer-to-peer learning environment?

   1. Would you be interested in engaging with other states through an online forum or document sharing tool? What aspects of such a forum or tool would make your active participation more likely (for example, a forum facilitator, e-mailed updates when a participant posts something)?

D. Benefits for States

1. In what ways did you benefit from participation in the LC? How well did the LC meet your goals and objectives? Please give specific examples.

2. Since this LC wound down in September 2014, have you felt a need for alternative venues to discuss the kind of issues that the Exchange Innovators LC covered or a need for the kind of technical assistance that the LC provided? If so, how are you addressing those needs?

3. What specific role can LCs play, in contrast to other kinds of technical assistance offered to states? How best can LCs compliment and not duplicate the assistance provided by state-led organizations, think tanks or other non-profits, such as the National Association of Medicaid Directors or the Robert Wood Johnson Foundation?

4. Can you think of any ways the LC model could be modified so that your state reaps additional benefits?

5. Looking back at the LC overall, what features or aspects worked well and would be important to incorporate in future LCs?

E. Suggested Improvements

Now, let’s wrap up.

1. Other than what you’ve already mentioned, are there any ideas you would like to share with me for improving the effectiveness of future LCs?

2. Thank you for taking the time to talk with us today. Is there anything else you would like to add before we end the discussion?

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