Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form OMB 3206-0274 Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey	Form and Instruction	New	Available
Form OMB 3206-0274 Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey	Form and Instruction	New	Repair queued
Form 3206-XXXX CAHPS Survey	Form and Instruction	Removed	Available
Form 3206-XXXX Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey	Form and Instruction	Removed	Repair queued
CAHPS Supporting Statement A 2022.docx	Supporting Statement A	Uploaded 2022-06-13	Repair queued
Statement B 4-29-22.docx	Supporting Statement B	Uploaded 2022-06-13	Repair queued
30 Day Notice 3206 0274.pdf	Supplementary Document	Uploaded 2022-06-13	Repair queued
60 Day Notice 3206 2074.pdf	Supplementary Document	Uploaded 2022-06-13	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
254218	Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey	Form and Instruction	New	Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey
254218	Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey	Form and Instruction	New
237579	Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey	Form and Instruction	Removed	CAHPS Survey
237579	Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey	Form and Instruction	Removed

ICR Details

OMB Control No: 3206-0274	ICR Reference No: 202206-3206-001
Status: Active	Previous ICR Reference No: 201910-3206-004
Agency/Subagency: OPM	Agency Tracking No: 3206-0274
Title: Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 10/19/2022
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/17/2022
Terms of Clearance: This collection is approved based on the revised materials provided by the agency.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2025	36 Months From Approved	12/31/2022
Responses	73,505	0	73,505
Time Burden (Hours)	18,376	0	18,376
Cost Burden (Dollars)	197,728	0	197,546

---

Abstract: OPM uses the CAHPS results as part of the FEHB Plan Performance Assessment (PPA). The PPA enables a consistent, objective evaluation of carrier performance and also provides more transparency for enrollees. This assessment uses a discrete set of quantifiable measures to examine key aspects of performance in the areas of clinical quality, customer service and resource use. Eight CAHPS measures are part of this discrete set of quantifiable measures. Taken together with more traditional assessments of contract administration, these measures help ensure that enrollees receive high quality affordable healthcare and a positive customer experience. The PPA is linked to carrier profit and premium adjustment factors. FEHB contracts include language to incorporate the PPA as a determinant of the Service Charge or Performance Adjustment.

---

Authorizing Statute(s): None

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 10834	02/25/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 35576	06/10/2022
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey	OMB 3206-0274	Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey
Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey	3206-XXXX	CAHPS Survey

---

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	73,505	73,505	0	73,505	-73,505	0
Annual Time Burden (Hours)	18,376	18,376	0	18,376	-18,376	0
Annual Cost Burden (Dollars)	197,728	197,546	0	197,728	-197,546	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: Reinstated Burden figures with updated form.

---

Annual Cost to Federal Government: $245,235

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? No

---

Common Form ICR:  No

---

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: 06/17/2022

---