ID
Number: CMS-10615
OMB Control Number: 0938-1300
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The focus groups are part of the qualitative component of the evaluation and are designed to collect rich information from the perspective of HIP 2.0 enrollees on the demonstration, including their understanding of various aspects of HIP 2.0 as well as their experiences with enrollment, cost-sharing, POWER accounts, seeking and obtaining care under their HIP 2.0 health plan, and overall satisfaction with their plan. In addition, focus groups will collect information on the experiences of former HIP 2.0 beneficiaries who have been disenrolled and locked-out of the program. Focus group findings will complement other data collection and analysis efforts in the evaluation but they will be the only data source providing in-depth, qualitative information from the HIP 2.0 enrollee perspective.
The Urban Institute will request from the State of Indiana four randomly drawn lists of current and former HIP 2.0 enrollees from the state’s HIP 2.0 enrollment files. These four lists will serve as the sampling frame for the focus groups with up to 300 individuals per list--one list of HIP beneficiaries in Indianapolis, one list of disenrollees in Indianapolis, one list of beneficiaries in Gary, and one list of beneficiaries in a rural area to be determined close to Indianapolis or Gary. Apart from being currently or formerly enrolled in either HIP Plus or Basic, individuals will also meet the following criteria:
Adult enrollees (ages 18-64)
Home address is in a zip code within the selected geographic areas
Primary language is English
For enrollee groups, enrolled in HIP 2.0 (Basic or Plus) for at least four (4) months at the point in time when the lists are drawn
For disenrolled groups, disenrolled within the past four (4) months so HIP 2.0 is in their recent memory
For each sample person, we would request the following information from HIP 2.0 enrollment files be provided: name, contact information (street address, phone number and, if available email address), age, gender, race/ethnicity, and income level (ideally, as expressed as a percentage of the federal poverty level). This information will enable us to put together focus groups that are generally representative of the demographic and economic characteristics of the overall HIP 2.0 population. Our attached recruitment script reflects having this information available when we contact prospective focus group participants.
There will be up to 8 focus groups. Each focus group will include approximately 8-10 participants. In our experience, however, there are often several people who sign up for the focus group but do not show up. So to ensure we meet our target number of participants (8-10 participants) we will recruit a total of 12-13 participants for each of the four focus groups.
All focus groups will be conducted in English. Given the small number of focus groups, conducting them all in English will be the most efficient way to collect valid and reliable qualitative information from individuals who represent a relatively large subset of HIP 2.0 enrollees. Because a single focus group is susceptible to bias, it is better to have multiple focus groups with individuals sharing similar characteristics to allow better interpretation of the information collected.
Briljent will establish a secure FTP site for the state of Indiana to upload the two focus group lists. Urban Institute researchers will provide guidance to Briljent on the targeted demographic composition of focus groups based on information available in the state of Indiana’s quarterly reports submitted to CMS on HIP 2.0. For example, Briljent would be instructed to target recruitment so that the proportion of HIP Basic focus group participants under 50% of the federal poverty level approximately reflects the proportion in the HIP Basic population at that income level. An experienced Briljent recruiter will invite individuals from the list using a pre-written recruitment script (included in this package). They will recruit by phone and email if available until the targeted number of participants is obtained for each group.Briljent may also distribute flyers to be posted in health care settings with a phone number that interested individuals can call to see if they are are eligible to participate in a focus group.
Close to the day of the focus group, a trained Briljent recruiter will make follow-up calls and send follow-up reminders to individuals who agreed to participate in the focus groups, reminding them of the date, time and place, and confirming their participation. Throughout the process, Briljent will update the Urban Institute on recruitment numbers.
Briljent will secure focus group venue(s) in the selected locations where the focus groups will be held. The space will be easily accessible by public transportation if possible and have adequate privacy so a candid discussion can be conducted and recorded without background noise. The venue will include a table, enough chairs for the focus group participants, facilitator and note taker, and access to a restroom. Examples of possible meeting space include the Briljent Indianapolis office, a conference room at a Federally Qualified Health Center, local library or a community organization meeting hall. Briljent will also purchase and set up a light meal and drinks in the focus group venue(s) prior to each group.
An experienced, senior Urban Institute researcher will facilitate each of up to eight focus groups. A junior Urban Institute researcher will take written notes on an encrypted password protected laptop during the sessions. In addition, if focus group participants agree (see attached consent form), we will use a digital audio recorder to create an audio recording of each focus group. Urban Institute will not transcribe the audio files verbatim, but rather use the recordings as back-up, to confirm the notes for accuracy and to clarify any areas where written notes may be unclear. All audio recordings and focus group notes will be uploaded directly onto a dedicated, segregated, password-protected partition on the Urban Institute secure server, with access limited to only those project staff with a need to use these data.
Participants will each receive a $60 payment to a vendor such as Amazon or Target to defray expected costs such as transportation or childcare. Briljent will purchase the participant payments and give them to Urban Institute researchers conducting the focus groups. Urban Institute staff will collect signed receipts from each focus group participant receiving a payment.
Briljent will store the focus group recruitment lists on a password protected computer only accessible to trained Briljent staff involved in recruitment, and will destroy these lists once the focus groups are completed. Urban Institute researchers will implement a number of safeguards to ensure the confidentiality of all communications between researchers and focus group participants. They will obtain written informed consent from focus group participants after: explaining to them the purpose of our study; informing them that focus groups are confidential to the extent permitted by law, voluntary, and can be stopped at any time; requesting their permission to take notes and audio record the focus group; and soliciting and answering any questions they may have. A copy of the informed consent statement that participants will be asked to sign at the start of all focus groups is included with this package.
The project will adhere to fundamental principles of research ethics and take the following measures to ensure that the security of the data collected is protected and maintained:
Data identifiable to an individual will not be revealed to anyone outside of the research team, including to other study participants, the study’s funder, or to State of Indiana officials.
The identities of interviewees and focus group participants will not be identified to anyone outside of the study team, including to other study participants, the study’s funder, or to State of Indiana officials.
Access to data will be restricted to those research team members who require access for analysis purposes.
Project findings and reports prepared for dissemination will not contain information that could readily be used to identify an individual participant.
Urban Institute staff will save electronic audio recordings and focus group notes on a dedicated, segregated, password-protected partition on the Urban Institute secure server, which staff will access through PGP-encrypted computers. Access to these files will be restricted to researchers who have signed a staff pledge of confidentiality and have a need to access the data. All identifiers will be redacted in interview and focus group notes, and not mentioned in reports we write as part of this study. Recordings will be expunged once all focus group notes are cleaned and reviewed by research team members.
With regard to analysis, findings will be presented in aggregate form only in the form of memorandums, presentations and reports summarizing evaluation findings. Results will be presented within the context of findings from other portions of the evaluation. No data will be presented in such a way that individuals can be identified. No personal identifiers will be printed in the conduct of analysis. Any statistical summaries of focus group participant characteristics will be sufficiently aggregated to protect individuals from identification.
After completion of project work or in the event of the early termination of the project, all project data sets holding micro-data will be purged from the server partitions on the Urban Institute secure servers, secure workstation drives, backup media, and the hard drive holding the originally delivered data.
Each focus group will last approximately 90 minutes. We estimate each participant may spend up to 3 hours in total for participating in the recruitment call, receiving reminders, in commute to and from the focus group, and in the focus group itself. With up to 8 focus groups of up to 10 participants each, this results in 8 groups x 10 participants x 3 hours = 240 total burden hours involved with the focus groups.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Supporting Materials for Indiana HIP 2.0 Evaluation Focus Groups |
| Subject | Healthy Indiana Plan; HIP 2.0; Evaluation |
| Author | Centers for Medicare and Medicaid Services |
| File Modified | 0000-00-00 |
| File Created | 2021-01-20 |