CMS-10549.GenIC#7 - Mini Supporting Statement

Application to Use Burden/Hours from Generic PRA Clearance:

Generic Clearance for Questionnaire Testing and Methodological Research for the Medicare Current Beneficiary Survey (MCBS) (CMS-10549)

Generic Information Collection (GenIC #7):

MCBS COVID-19 Rapid Response Supplement Testing

Office of Enterprise Data and Analytics (OEDA)

Centers for Medicare & Medicaid Services (CMS)

Under the CMS Generic Clearance (OMB No. 0938-1275, expiration 05/31/2021) for the Medicare Current Beneficiary Survey (MCBS), CMS requests approval to conduct a field test of the MCBS COVID-19 Rapid Response Supplement.

The current generic clearance includes seven types of potential research and testing activities; a field test is one of the activities specified in the clearance. In addition, the generic clearance specifies that it seeks to accomplish the following goals, of which goals two and four are supported with this request:

1. Improve data quality and accuracy by evaluating and revising existing questionnaire items;

2. Address emerging policy and program issues by testing new questionnaire items;

3. Reduce respondent burden by improving questionnaire items, response categories, and questionnaire flow;

4. Reduce survey costs and implement efficiencies by improving questionnaire items and interview flow, as well as considering new methods and modes of data collection;

5. Increase response rates by improving respondent materials and improving questionnaire content and flow to reduce survey length.

Justification

The MCBS is an ongoing survey of a representative sample of Medicare beneficiaries, both aged and disabled. The MCBS currently conducts interviews of over 15,000 Medicare beneficiaries across the US, conducting three interviews per year over a four-year period; the MCBS is conducted under clearance 0938-0568, expiration 08/31/2022.

With the emergence of the COVID-19 pandemic in the U.S., CMS is uniquely positioned to quickly collect vital information on how the pandemic is impacting the Medicare population by utilizing the MCBS. MCBS beneficiaries, by definition, are most at risk for underlying conditions that may lead to more severe COVID-19 complications. CMS requests OMB approval to test a MCBS COVID-19 Rapid Response Supplement to be administered by telephone in June 2020. All MCBS respondents who completed 2019 interviews and whose data will be included in the 2019 MCBS Survey File will be eligible for the supplement. By using MCBS participants, we can reduce the burden of the questionnaire by only needing to ask questions directly related to the impact of the pandemic.

There are several purposes of this test.

• First, due to the emergence of this health emergency, the MCBS is especially well-suited to provide CMS critical data on measures of Medicare beneficiary knowledge about telehealth, social distancing and other important health behaviors, along with updated information about COVID-19 testing and the results of those tests. Since MCBS has a sample size sufficient for estimation, it provides a ready source to obtain high quality data.

• Second, CMS wants to test this series of questions in preparation for a MCBS Supplement that will again be administered to all MCBS respondents in the Fall of 2020 and possibly Winter 2021, depending on the course of the pandemic. Testing the questions and methodology under this generic clearance will provide meaningful information for the MCBS Supplement. If the June test under this generic clearance proves successful, CMS plans to request approval from OMB in July 2020 to administer a fall and winter supplement under a new emergency clearance.

• And third, this test extends research to date on CMS’ ability to conduct MCBS data collection over the phone. MCBS is traditionally conducted as an in-person interview although telephone interviewing is permitted. Since late March 2020, MCBS interviews have pivoted to telephone collection only in order to comply with restrictions related to the pandemic. While this test supplement is considerably shorter than the traditional MCBS interview, it nonetheless will allow further testing of the effectiveness of telephone administration with this important population.

Testing Plan

Experiment Design

CMS’ contractor, NORC at the University of Chicago, will conduct an out-of-cycle rapid response survey by telephone with MCBS respondents who completed a MCBS interview from August 2019 through December 2019 and are currently living in the community setting. Respondents who are living in long term care facilities will not be included in the sample.

The MCBS COVID – 19 Rapid Response Supplement will be launched in June 2020 with a 4-5 week data collection period. Regular MCBS Summer 2020 Round 87 data collection will also continue as scheduled and be conducted by phone between May 6, 2020 and August 31, 2020.

We will develop a communication strategy to explain the two data collections to respondents. First, respondents will be sent an advance letter (Attachment A) notifying them of the addition of the Rapid Response Supplement. Because these are existing MCBS respondents, we have phone numbers for all respondents that were obtained through prior contacts. We also have alternative back up contact information which will facilitate contacting respondents who may have changed their phone numbers since their last interview. As a note, these respondents are used to interviewers calling them to set MCBS appointments and therefore, we anticipate a high success rate of contact.

Second, the Supplement will be conducted using our MCBS field interviewers. These interviewers have established rapport with respondents and are well-trained and experienced at conducting telephone outreach. Field Interviewers will recruit respondents in various ways depending on the status of the respondent’s participation in the regular MCBS Summer 2020 Round 87 data collection:

• For respondents who have already completed the Summer 2020 Round 87 interview, field interviewers will call the respondent back and invite them to complete the COVID-19 Rapid Response Supplement over the phone.

• For respondents who have not yet completed the Summer 2020 Round 87 interview, field interviewers will invite respondents to complete the COVID-19 Rapid Response Supplement over the phone when calling them to make an appointment for completing the R87 interview.

When making outreach, field interviewers will explain the purpose of the study using the contacting script (Attachment B).

Field interviewers will telephone respondents from their home and will administer a supplemental questionnaire (Attachment C), separate from the current MCBS Community questionnaire (again, the MCBS Community questionnaire is fielded under 0938-0568). They will use the same interview equipment used to conduct the MCBS (laptops and tablets). The questionnaire will include a request for consent before moving on to the Supplement questions. The questionnaire content will be specific to the impact of COVID-19 on the respondent’s life, such as access to care during the pandemic, symptoms and consequences of COVID-19, and the impact of the pandemic on their behavior and well-being. The contacting script and questionnaire have been cognitively tested by administering it to less than 10 respondents and were determined to perform successfully. The cognitive testing also provided confidence in our estimate of the time it will take to administer the Supplement. The MCBS COVID – 19 Rapid Response Supplement field test has also been approved by NORC’s Institutional Review Board.

Burden

In the current generic clearance, it was assumed that field tests would be conducted as part of production and therefore not incurring additional burden. However, in order to field test the MCBS COVID-19 Rapid Response Supplement in a timely manner, we must program it independently from the MCBS production questionnaire and administer it as a separate supplement.

We are assuming a 75% response rate. This is based on the response rate observed during the most recent round of telephone data collection conducted from March 24, 2020 through April 9, 2020 for Winter 2020 Round 86.

Projects	Number of Participants	Number of Responses/ Participant	Average hours per response	Response Burden
MCBS COVID-19 Rapid Response Supplement	10,949	1	0.25	2,737

After collection of the MCBS COVID-19 Rapid Response Supplement, NORC will merge the data from the supplemental survey with data on the respondents conducted during prior interviews, such as demographics and health status information. CMS will use these data to conduct preliminary analysis of the impact of COVID-19 on the Medicare population. In addition, CMS will assess the rapid response protocol, and if it was successful, apply for an emergency clearance to conduct additional COVID-19 Rapid Response Supplements simultaneous to Fall 2020 and Winter 2021 MCBS data collection.

If you have any questions or would like to discuss this request, please do not hesitate to contact the CMS MCBS Project Director, Debra Reed-Gillette.

Attachments:

1. Advance Letter

2. Contacting Script

3. Questionnaire

1