CMS-10632.Appendix G - Recruitment Scripts for Online Surveys, Focus Groups, and Interviews

EVALUATION OF COVERAGE TO CARE

Appendix G

Recruitment Scripts for Semi-Structured Interviews as Part of Case Study

PRA Disclosure Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number.  The valid OMB control number for this information collection is 0938-XXXX.  The time required to complete this information collection is estimated to average [Insert Time (hours or minutes)] (Expiration Date) per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection.  If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850. *****CMS Disclaimer*****Please do not send applications, claims, payments, medical records or any documents containing sensitive information to the PRA Reports Clearance Office. Please note that any correspondence not pertaining to the information collection burden approved under the associated OMB control number listed on this form will not be reviewed, forwarded, or retained.

OMB No.: 0938-XXXX

Expiration Date: MM/DD/YYYY

Dear [Name],

The Centers for Medicare & Medicaid Services (CMS) within the Department of Health and Human Services (DHHS) has contracted with the RAND Corporation to conduct an evaluation of Coverage to Care (C2C). The goals of the study are to:

1. Maximize the impact of C2C at the local, state, and national levels; and

2. Assess whether and how C2C improves consumer health literacy and care utilization.

The purpose of the study is to better understand the spread and uptake of C2C; what organizations did with C2C materials/messages; how consumers used C2C materials/messages; and to what extent is C2C associated with changes in outcomes such as health insurance literacy and care utilization. CMS is particularly interested in learning of C2C materials that have been translated into other languages are being used within communities and the impact they may be having.

We would like to invite you to participate in an interview to share information about how your organization has used C2C materials, any impact you have seen, and any recommendations you may have for how to improve or shape C2C in the future. As a thank you for your time, we will send you a gift card worth $XX [NOTE: this amount will be determined in conjunction with CMS and will depend on the case study location].

We are also hoping you will be willing to help us identify consumers who might be willing to participate in a focus group about C2C as assist us with recruitment. To help offset the time and costs to your organization of supporting this study, we can offer your organization a modest stipend.

While your participation is voluntary, we do hope you will decide to contribute to this important study as requested in the attached letter from Cara James, Director of the CMS Office of Minority Health.

How You Can Help

1. Participate in an interview. The interview will last about 45 minutes. In order for our study to be representative of the organizations in your community, we hope you will participate. We will be in [location] on [dates]. We will work with you to find a time that works for you while we are there, but we can also schedule a time to speak by phone if that is more convenient.

2. Identify consumers who would be willing to participate in the study. As part of this project, we are hoping to speak to 10-15 consumers in your community who have seen or used C2C materials, such as the “Roadmap to Better Care and a Healthier You”. Please help us to identify consumers who might be interested in providing us with their feedback. The focus group will take place on [dates] and they will receive $XX [NOTE: dollar amount will be finalized once case study is selected to ensure amount is reasonable based on cost of living but not coercive] for their participation. We will be happy to provide you with additional information about this.

What Will Happen to the Information I Provide?

Your responses will be combined with others and reported together. If quotations are used in any reports, they will not be connected to an individual or organization. At the end of the study, we will destroy any information that identifies you as a participant, and identifiable information about you (e.g., name, program name) will not be shared with anyone outside of the RAND project staff without your permission, except as required by law.

Contact

The Centers for Medicare & Medicaid Services has contracted with the RAND Corporation to conduct an evaluation of Coverage to Care (C2C). For more information about the study, contact Tom Conannon ([email protected]).

EVALUATION OF COVERAGE TO CARE

Appendix G

Recruitment Scripts for Consumer Focus Group as Part of Case Study

September 30, 2016

OMB No.: 0938-XXXX

Expiration Date: MM/DD/YYYY

Invitation will be translated into the language of the case study. Back translation will also be done for quality assurance.

Dear ****,

My name is [Name], I work at the RAND Corporation. I received your name from [XXX] as someone who may be willing to speak with us about Coverage to Care (C2C). You may have seen or received a booklet called “A Roadmap to Better Care and a Healthier You”. This booklet was created by the Centers for Medicare & Medicaid Services. As part of a continuous improvement process, we are interested in speaking with people like you who may be interested in sharing your thoughts with us.

We would like to learn more about:

• How you first learned about C2C;

• Whether and how you have used C2C materials;

• Whether C2C has helped you understand health insurance;

• Whether you have used C2C to learn more about health care.

The group discussion will take approximately an hour and we will give you a $XX gift card as a thank you [NOTE: dollar amount will be determined once site visit location is selected to ensure that the incentive is reasonable with respect to cost of living (e.g., transportation, child care), but not coercive]. Please let me know if you are interested in participating and if you are available during any of the following times:

[Insert list of potential date(s)/time(s) for focus group(s)]

Thank you for your time and consideration and we look forward to speaking with you.

Sincerely,

[RAND staff]

RAND Corporation