Testing of Web Survey Design and Administration for CMS Experience of Care Surveys (CMS-10694)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10694 Gen-IC #2 : HCAHPS Mode Experiment	Form and Instruction	New	Available
Form CMS-10694 GenIC #3 MA and PDP CAHPS Web Survey of Health and Drug Plans	Form and Instruction	New	Available
Form CMS-10694 GenIC 1 Gen-IC #1 Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Hospice Survey Mode Experiment	Form and Instruction	New	Available
Comment and Response Summary.docx	Supplementary Document	Uploaded 2019-04-15	Available
20190104_CMS-10694_Supp Statement B_Clean.docx	Supporting Statement B	Uploaded 2019-04-15	Available
30 Day_CMS-10694_Revised Supp Statement A_ CLEAN v2.docx	Supporting Statement A	Uploaded 2019-11-05	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
247130	Gen-IC #2 : HCAHPS Mode Experiment	Form and Instruction	New
246172	GenIC #3 MA and PDP CAHPS Web Survey of Health and Drug Plans	Form and Instruction	New
245297	Gen-IC #1 Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Hospice Survey Mode Experiment	Form and Instruction	New

ICR Details

OMB Control No: 0938-1370	ICR Reference No: 201904-0938-010
Status: Active	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No: CMS-10694
Title: Testing of Web Survey Design and Administration for CMS Experience of Care Surveys (CMS-10694)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 11/05/2019
	Date Received in OIRA: 04/18/2019
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2022	36 Months From Approved
Responses	75,250	0	0
Time Burden (Hours)	17,000	0	0
Cost Burden (Dollars)	928,200	0	0

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Abstract: Response rates for population surveys have been steadily declining, raising concerns among researchers and policy makers about the future of survey research as it exists currently. Seeking to counteract this trend, remain at the cutting edge of survey research, and work within the constraints of ever-shrinking budgets, an increasing number of federal surveys have been exploring the use of web components in their data collection efforts. This generic clearance request is for web methodological research, “Testing of Web Survey Design and Administration for CMS Experience of Care Surveys.” This generic clearance request encompasses an array of research activities to add web administration protocols to a series of surveys conducted by the Centers for Medicare & Medicaid Services (CMS). This request seeks burden hours to allow CMS and its contractors to conduct cognitive in-depth interviews, focus groups, pilot tests, and usability studies to support a variety of methodological studies around web modes of data collection. The administration of web-based surveys should be more economical than employing strictly traditional modes (mail-only, phone-only, and mixed-mode that includes mail with phone follow-up of non-respondents), but there are challenges that must be addressed to ensure valid, reliable data are collected. All of these challenges will be explored in this package across a variety of settings. The CMS vision for this research is to ensure that we can continue to collect quality data using more innovative, efficient, and analytically powerful modes of data collection. This research is aimed at a broad audience of those affected by CMS programs such as Emergency Department Experience of Care (EDPEC), Fee-for-Service (FFS) Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospital CAHPS (HCAHPS), Medicare Advantage and Prescription Drug (MA & PDP) CAHPS, Home Health (HH) CAHPS, Hospice CAHPS, In-Center Hemodialysis (ICH) CAHPS, the Health Outcomes Survey (HOS), and the Medicare Advantage and Part D Plan Disenrollment Reasons surveys. This effort will move CMS towards more innovative approaches for data collection with the hope of reducing burden and costs of data collection while improving response rates.

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Authorizing Statute(s): PL: Pub.L. 109 - 171 Section 5001(a) Name of Law: Reporting Hospital Quality Data for Annual Payment Update
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 731	01/31/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 15617	04/16/2019
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 0

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	75,250	0	0	75,250	0	0
Annual Time Burden (Hours)	17,000	0	0	17,000	0	0
Annual Cost Burden (Dollars)	928,200	0	0	928,200	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new collection, so there are no changes or adjustments.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 04/18/2019

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