CMS-10764 - Supporting Statement - Part B

CMS-10764 - Supporting Statement - Part B.docx

Evaluation of Risk Adjustment Data Validation (RADV) Appeals and Health Insurance Exchange Outreach Training Sessions (CMS-10764)

OMB: 0938-1400

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Supporting Statement – Part B


B. COLLECTION OF INFORMATION EMPLOYING STATISTICAL METHODS

B.1. Respondent Universe, Sample Selection and Expected Response Rates


B.1.1 Respondent Universe

The data collection is a census survey and therefore does not employ statistical methods.


B.1.2. Sample Selection

The data collection is a census survey and therefore does not include sampling methods.


B.1.3. Expected Response Rates

A response rate of approximately 70 percent is expected for this data collection effort. In addition to strategic data collection methods and online technology, the expected response rate is based on the fact that prospective respondents have a vested interest in the training events and related outreach efforts.


B.2. Procedures for the Collection of Information

The questionnaire includes primarily closed-ended questions (e.g., Likert scale, rating scale, rank order, or multiple response items), with a minimal number of “other (specify)” items, and open-ended questions. The survey will take approximately 15 minutes to complete.


ARDX will program and test the web-based survey instrument using online survey software. Following OMB Clearance, the survey will be published (with the OMB clearance number and burden statement) and administered following each training event.


B.3. Methods to Maximize Response Rates

Respondents will receive the evaluation instrument immediately following each event with a follow-up reminder the following day, which should result in an increased response rate. The online survey will remain available for three business days following each event, allowing flexibility while minimizing survey recall effect. Further, the survey invites respondent to contact CMS with any questions about the research study.


B.4. Pre-testing of Procedures and Methods

The evaluation team conducted an internal pre-test of the survey instrument to ensure that all research questions were addressed, questions were not ambiguous, and response choices were mutually exclusive and exhaustive. The pre-test was also used to estimate respondent burden in terms of the amount of time required to complete the survey.


In addition to the design pretest, the online instrument was tested for technical factors such as programming accuracy and browser compatibility. A checklist was developed to verify each step of the programming process, and the instrument was subjected to a first-and second-level review process prior to distribution to pretest respondents. The checklist included item-by-item checks for:


  • Accuracy of skip patterns and logic checks for all appropriate scenarios

  • Accuracy of programming of radio buttons for single-response items or check boxes for multiple response items

  • Adequate field length for open-ended questions

  • Connectivity

  • Functionality of survey links

  • 508 compliance

  • Correct export order and variable names


Only minor revisions (e.g., expansion of response choices) were required as a result of the pretest.


B.5. Individuals or Contractors Responsible for Statistical Aspects of the Design


The agency responsible for receiving and approving contract deliverables is:

Center for Program Integrity

Centers for Medicare & Medicaid Services

7500 Security Boulevard

Windsor Mill, MD 21244

Person Responsible: Kathleen Anderson, (410) 786-8946

[email protected]



The organization responsible for administering the surveys of Risk Adjustment Data Validation (RADV) Appeals and Health Insurance Exchange Outreach training participants is:


ARDX (A. Reddix & Associates)

5800 Lake Wright Drive, Suite 301

Norfolk, VA 23502


Persons Responsible: Mr. Matt Lemma, (757) 410-7704, [email protected]

Dr. Lateefah Hughes (757) 375-7291, [email protected]

Ms. Dorothea Claytor (757) 227-4034, [email protected]


The organization responsible for data analysis is:


ARDX (A. Reddix & Associates)

5800 Lake Wright Drive, Suite 301

Norfolk, VA 23502


Person Responsible: Ms. Sadie Bennett (757) 321-4123, [email protected]





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