Supporting Statement for the Paperwork Reduction Act of 1995
QIC Demonstration Evaluation Contractor
(QDEC): Analyze Medicare Appeals to Conduct
Formal Discussions and Reopening’s with DME
Suppliers and Part A Providers
June 1, 2020
Centers for Medicare & Medicaid Services
Center for Medicare (CM)
Medicare Enrollment and Appeals Group (MEAG) Division of Appeals Operations (DAO)
7500 Security Boulevard
Baltimore, MD 21244
Table of Contents
Part B. Collections of Information Employing Statistical Methods 1
1. Respondent Universe and Sampling Methods 3
2. Procedures for the Collection of Information 4
3. Methods to Maximize Response Rates and Deal with No Response 5
4. Test of Procedures or Methods to Be Undertaken 6
5. Individuals Consulted on Statistical Aspects and Individuals Collecting and/or Analyzing Data 6
Supporting Statement – Part B
The following is a description of data collection procedures.
Proposed data collection activities include a monthly web-based survey to assess experiences and satisfaction with the Demonstration (formal telephone discussions), and annual telephone key informant interviews to gather in-depth information about successes, challenges, and suggestions related to the Demonstration.
The respondent universe for the proposed web-based survey and key informant interview data collection includes all individuals affiliated with DME suppliers and Part A providers that participate or decline to participate in a formal telephone discussion with the Demonstration Qualified Independent Contractor (QIC) in a given month. The DME QIC is contracted to provide a maximum of 63,000 formal telephone discussions per year, from January 1, 2019 through March 31, 2022. The Part A East QIC will conduct telephone discussions on 12,200 claims with the option for an additional 6,000 claims. The Part A East QIC will also complete reopening is on 18,700 claims with the option for an additional 9,000 claims.
The web-based survey will employ a random sampling technique to obtain a representative understanding of DME supplier and Part A provider experience and satisfaction. A minimum of 382 complete responses are needed to achieve statistical power at the 95% confidence interval level, with a 5% margin of error. We will invite a total of 2,544 DME suppliers and 2,544 Part A providers annually to participate in the web-based survey, assuming a minimum 15% response rate, to ensure we collect the minimum number of completes needed. Sampling will occur on a monthly basis. A random sample of no more than 212 DME suppliers and no more than 212 Part A providers will be drawn each month from the pool of DME suppliers and Part A providers who participated in a formal telephone discussion in the prior month (totaling 2,544 DME suppliers and 2,544 Part A providers per year). Invitees will be sent up to two reminder notices before their unique survey link will be deactivated. We expect some DME suppliers and Part A providers will participate in more than one formal telephone discussion, and on average, most DME suppliers and Part A providers will be randomly selected twice per year. Because respondents will be instructed to answer the survey based on their experiences and satisfaction with one specific formal telephone discussion (specified on the invitation email), each set of responses obtained will be considered unique cases, even if an individual responds to the survey more than once.
Key informant interviews will employ a simple stratified random sampling plan to select a total of 100 DME supplier and 100 Part A provider respondents each year:
Fifty DME suppliers and 50 Part A providers will be randomly selected from the pool of web-based survey respondents who indicated dissatisfaction with the formal telephone discussion.
Fifty different DME suppliers and 50 Part A providers will be randomly selected from the entire remaining universe of DME suppliers and Part A providers who took part in a telephone discussion one month earlier.
Exhibit B-1 shows these stratifications. If sampled DME suppliers and Part A providers refuse to participate, another random selection will be done to refresh the sample. The sample will be refreshed until 100 interviews are conducted with each respondent type. Although it is not standard or methodologically appropriate to calculate a minimum sample size required for qualitative data collection, we believe including 100 DME suppliers and 100 Part A providers in our data collecting activities selected through a random process will allow us to reach saturation in supplier and provider views and perspectives about the Demonstration.
Exhibit B-1: Simple Random Sampling Strata for Annual Key Informant Interviews
Key Informant Interview Group |
No. of DME Suppliers |
No. of Part A Providers |
Dissatisfied Group |
50 |
50 |
General Group |
50 |
50 |
Total |
100 |
100 |
Instruments and respondent recruitment materials for the survey are found under Attachment A: Web-Based Survey Instrument and Recruitment Materials, Appendix A through D. Instruments and respondent recruitment materials for the key informant interviews are found under Attachment B: Key Informant Interview Instrument and Recruitment Materials, Appendix A through D.
Web-Based Survey:
Each month, the list of DME suppliers and Part A providers who participated in a formal telephone discussion will be obtained from internal Agency records. This list will include the name and contact information of the person who participated. A sample of no more than 212 DME suppliers per month (2,544 per year) and no more than 212 Part A providers per month (2,544 per year) will be selected from the list using Stata software. Each selected DME supplier and Part A provider will be sent an invitation (Attachment A) to complete the short web-based survey. The web-based survey will be programmed with a unique date of the formal telephone discussion in question, for the respondent’s reference as they complete the survey. The web based survey will be managed through the Voxco software platform. Voxco tracks responses and generates reminder e-mails, which will be sent to non-responders during the first business week after the initial survey invite is sent, and again during the second business week after the initial survey invite is sent. No statistical methodology, estimations, or specialized procedures are necessary.
Key Informant Interviews:
On an annual basis, 100 DME suppliers and 100 Part A providers will be randomly selected to be invited to participate in a telephone-based key informant interview. As described in Section 1, 50 DME suppliers and 50 Part A providers will be randomly selected from the pool of web-based survey respondents who indicated dissatisfaction with the formal telephone discussion; and 50 different DME suppliers and 50 Part A providers will be randomly selected from the entire remaining universe of DME suppliers and Part A providers. Selected DME suppliers and Part A providers will receive an invitation letter via email (Attachment B) which will explain the goals of the interview and that a member of the research team will be in touch to schedule the interview. One week after the letter is sent, the research team will reach out by phone and/or email to confirm participation and identify a mutually-agreeable time.
At the agreed-upon date and time of the interview, the research staff will call the key informant and conduct a 30-minute discussion of the DME suppliers’ and Part A providers’ experiences, satisfaction, and recommendations for improving demonstration formal telephone discussions. At the beginning of the call, the interviewer will obtain verbal consent to audio record the interview. If the respondent refuses, only typed notes will be taken. The interview will begin with a brief description of the research, followed by the in-depth discussion. Audio-recorded interviews will be reviewed by the research team during the note-cleaning phase. No statistical methodology, estimations, or specialized procedures are necessary.
The following procedures will be used to maximize participation and to achieve the desired high response rate.
Web-Based Survey: We will receive contact information for the entire sampling frame on a monthly basis from the QIC, as described earlier. We will use two strategies to maximize our chances of obtaining a response rate of at least 15%. First, we will monitor and attempt to correct bounced back email addresses, using prior months’ contact information to try to identify a valid email address that might have been incorrectly entered in the current month’s roster. Second, because reminders have been shown to increase response rates, we will also monitor which sample members respond and do not respond to the initial email invite, and send up to two follow-up reminder each week to those who haven’t yet responded to a given month’s survey.
No other contact with non-respondents will be made.
Key Informant Interviews: Selected interviewees will be informed about the benefit of their participation to the demonstration, and to future programs like the formal telephone discussions which are designed to improve the accuracy of DME suppliers’ and Part A providers’ payments. The goal of the key informant interviews is not to generalize or be representative of all perspectives; rather, the key informant interviews are intended to gather in-depth information from participants to understand what worked well, and what could be improved. Collecting this level of information from a representative sample is not feasible for this project.
The web-based survey was pilot tested with nine suppliers randomly selected prior to OMB approval. The web-based survey will include fields for respondents to indicate problematic or unclear questions, and make recommendations for refining the instrument. Key informant interview guides have been reviewed internally by the Agency demonstration staff to ensure validity and relevance to the project.
Web-based survey and key informant interview data collection require a straightforward simple random selection procedure. IMPAQ International, LLC, will collect and analyze web-based survey and key information interview data on behalf of CMS.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Stephan McKenzie |
| File Modified | 0000-00-00 |
| File Created | 2021-01-13 |