CMS-10615 Debriefing Script - Disenrolelee Lockout Survey

OMB Control Number: 0938-TBD

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Healthy Indiana Plan (HIP) 2.0
Disenrollee and Lockout Survey Testing Debriefing Script

Survey Background

Part of the federal evaluation of the Healthy Indiana Plan (HIP) 2.0 Demonstration will be based on information collected using three beneficiary survey instruments. The three target populations for the instruments include: (1) current HIP 2.0 beneficiaries; (2) newly enrolled HIP 2.0 beneficiaries; and (3) HIP 2.0 disenrollees and beneficiaries who have been “locked out.” All instruments contain survey questions from existing beneficiary questionnaires, survey questions adapted from existing beneficiary questionnaires, and newly developed survey questions. The newly developed survey questions are especially important for testing, and focus on specific policies of interest to CMS. The beneficiary feedback captured by these instruments will help inform CMS decision making on health care policies.

The HIP 2.0 disenrollees and beneficiaries who have been ‘locked out’ include three subpopulations – disenrollees, HIP Basic enrolled but formerly HIP Plus enrolled beneficiaries, individuals who have been locked out of HIP 2.0. These subpopulations are identified by their poverty level. The consequences of failing to make a monthly contribution to their POWER account vary. Those failing to make a monthly contribution above 100% FPL are locked out of HIP 2.0 and those failing to make a monthly contribution at or below 100% FPL are moved from HIP Plus to HIP Basic.

This survey testing script serves as a guide for the interviewer debriefing on the HIP 2.0 Disenrollee and Lockout Beneficiary Survey.

Pretest Introduction [Interviewer reads]

On behalf of the Centers for Medicare & Medicaid Services and Social and Scientific Systems, Inc., thank you for agreeing to participate in this study of the Healthy Indiana Plan 2.0 (HIP 2.0). Your comments and opinions are very important to us.

The purpose of this interview is not to collect data, but to test a questionnaire. The questionnaire we are testing will be provided to Hoosiers as a paper questionnaire and an online (Web) questionnaire. Some of the questions we will review today may be difficult to understand, hard to answer, or can be understood in different ways. I am more interested in what you were thinking when you answered these questions than your actual answers. I would like to know your experience with deciding how to answer certain questions. We expect that some of questions will not be perfect, and that is what you will be helping us identify today. Do you have any questions about what I just told you?

After you complete the questionnaire, I will go through it with you and sometimes ask what you think about a question or what a particular word means to you. We will not go through every question. Please feel free to give me any other comments you might have at the end of the interview.

Your comments will be kept private. Please answer the questions as freely as you can. You may refuse to answer any question that you do not wish to answer. This interview should take no more than 45 minutes of your time.

Do you have any questions?

OK, let’s begin. Please feel free to use your questionnaire to help you answer my questions.

General Interviewer Probes

[Interviewer Instructions: The following questions are probes that interviewers should utilize during the interview to help facilitate a meaningful conversation with respondents.]

• Could you please tell me more about that?

• Was that hard or easy to answer?

• How did you decide on that answer?

• How confident are you in your answer?

• Were any of the answer options unclear or confusing?

• I noticed that you hesitated – please tell me what you were thinking.

• Were there any questions that were asked that you did not seem to belong in this questionnaire?

Overarching/General Beneficiary Survey Interview Questions

INTERVIEWER: How easy or difficult was it to for you to understand the purpose of the survey?

INTERVIEWER: Based on your experience with the survey, how likely would you be to complete the actual paper mail in survey if you were selected to participate? Why/Why not?

INTERVIEWER: When thinking about the survey questions, were the time references difficult to follow?

PROBE: Was it hard to recall and think about “After you were no longer enrolled in HIP 2.0?”

PROBE: Was it hard to recall and think about “While you were in HIP 2.0?”

Survey Section: About Your HIP 2.0 Enrollment

Question #: 1

INTERVIEWER: What does the term “enrolled” mean to you? How did you interpret it?

INTERVIEWER: Have you heard of the term “lockout?”

PROBE: IF YES  Please tell me about your understanding of the term “lockout.”

PROBE: IF YES  Do you interpret being “lockedout” as the same or differed from being disenrolled from HIP?

INTERVIEWER: What did you select as your answer for Question 1?

[Interviewer Instructions: If respondent indicates an “A” answer option skip to PAGE 5 for beginning the interview and start with the HIP Basic Enrolled, Formerly HIP Plus Enrolled questions. All other responses, proceed with interview protocol]

Survey Section: About Your HIP 2.0 Enrollment

Question #: 6

INTERVIEWER: At what point did you consider yourself no longer enrolled in HIP?

PROBE: Do they consider being “lockedout” as being no longer enrolled in HIP?

Question #: 7

INTERVIEWER: How did you interpret the term “cost?”

Question #: 8

INTERVIEWER: Were the examples listed in the preventive care answer option make sense?

INTERVIEWER: Are there any other preventive care examples you think we should include?

INTERVIEWER: What do you usually think of as preventive care? Could you give us some examples?

INTERVIEWER: How did you define “doctor” / Who do you think of when reading “doctor?”

INTERVIEWER: Is there anything else you think should be included on this list?

Question #: 9 and 10

INTERVIEWER: When answering question 9 and 10 did you think of ‘not paying for transportation’ and ‘not getting transportation’ are one thing or two individual concepts?

INTERVIEWER: Was this question easy or hard to answer?

INTERVIEWER: How confident are you in your answer?

Question #: 11

INTERVIEWER: What does “monthly or annual contribution” mean to you?

INTERVIEWER: How did you interpret “paperwork?”

Question #: 12

INTERVIEWER: What does “reenroll” mean to you?

Question #: 13

INTERVIEWER: Did you feel that this question had a negative, positive, or neutral tone?

PROBE: Were any of the answer options unclear or confusing?

PROBE: Any missing answer options?

Survey Section: POWER accounts and monthly or annual contributions

INTERVIEWER: Please think about the questions in the POWER account section overall and how you answered them.

INTERVIEWER: What length of time were you thinking of when answering the questions in the POWER account section?

INTERVIEWER: This survey section (POWER accounts) mentions “monthly or annual contributions.” Did you understand what a “monthly or annual contribution” was?

Question #: 16

INTERVIEWER: Was the use of the word “part” confusing in answer option C?

Question #: 20

INTERVIEWER: Tell me in your own words how you would rephrase answer option B and C.

Question #: 21

INTERVIEWER: How did you interpret “use your POWER account”?

PROBE: What actions were you thinking of as using your POWER account?

Question #: 24

INTERVIEWER: Was this question easy or hard to answer? Why?

Question #: 26 and 27

INTERVIEWER: How easy or hard was it to distinguish all or some of your preventive services?

INTERVIEWER: When you answered this question did you think about all of your health care visits? Only some?

If SOME  INTERVIEWER: Which ones?

Survey Section: Access

Question #: 29 and 30

INTERVIEWER: What length of time did you think about when answering these questions?

PROBE: What time frame were they thinking about when answering these questions?

Survey Section: HIP Basic enrolled, formerly HIP Plus enrolled

INTERVIEWER: Please think about the questions in the HIP Basic enrolled, formerly HIP Plus enrolled section overall and how you answered them.

INTERVIEWER: Thinking about the questions in this section, was it hard to think about your HIP Basic and HIP Plus coverage experiences separately?

INTERVIEWER: Did you feel that you were able to answer the questions about each of your experiences in HIP Basic and HIP Plus?

PROBE: Did they tend to think of their experience in HIP 2.0 as one thing versus HIP Plus than HIP Basic?

Question #: 39

INTERVIEWER: Tell us in your own words answer option B and C

Question #: 40 and 41

INTERVIEWER: How did you interpret the term “cost?”

INTERVIEWER: Were the examples listed in the preventive care answer option make sense?

INTERVIEWER: Are there any other preventive care examples you think we should include?

INTERVIEWER: What do you usually think of as preventive care? Could you give us some examples?

INTERVIEWER: How did you define “doctor” / Who do you think of when reading “doctor?”

INTERVIEWER: Is there anything else you think should be included on this list?

Question #: 42 and 43

INTERVIEWER: When reading this question did you think of ‘not paying for transportation’ and ‘not getting transportation’ are one thing or two individual concepts?

INTERVIEWER: Was this question easy or hard to answer?

INTERVIEWER: How confident are you in your answer?

Survey Section: Demographics/About You

Question #: 50

INTERVIEWER: Are there any answer options you think should be included for this question?

Question #: 55

INTERVIEWER: Was this question easy or hard to answer? Why?

DEBRIEFING SCRIPT – DISENROLLEES & LOCKOUTS 6