CMS-10823 Appendix F

Appendix F: Dialysis Organization Corporate Representative
Interview Protocol
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection
of information unless it displays a valid OMB control number. The valid OMB control number for this
information collection is 0938-XXXX (Expires XX/XX/XXXX). This is a voluntary information collection.
The time required to complete this information collection is estimated to average 30 minutes per
response, including the time to review instructions, search existing data resources, gather the data
needed, and complete and review the information collection. If you have comments concerning the
accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500
Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland
21244-1850. Please do not send applications, claims, payments, medical records or any documents
containing sensitive information to the PRA Reports Clearance Office. Please note that any
correspondence not pertaining to the information collection burden approved under the associated
OMB control number listed on this form will not be reviewed, forwarded, or retained. If you have
questions or concerns regarding where to submit your documents, please contact Christopher King at
[email protected] or (410) 786-6972.

Introduction
Hello. My name is [interviewer name] from Insight Policy Research, and I want to thank you again for
agreeing to speak with me today about your involvement in activities related to dialysis care. I’m joined
today by [note taker name] from Insight, who will be taking notes for the interview.
We were hired by the Centers for Medicare & Medicaid Services, otherwise known as CMS, to conduct
an evaluation of the ESRD Quality Incentive Program (QIP). CMS is interested in learning how this
initiative may have affected dialysis patients’ health, outcomes, satisfaction, access to care, quality of
care, and healthcare spending. CMS has also asked us to learn about other topics that are less directly
related to the QIP.
This year we are focusing on the following topics related to ESRD care and will be asking you about them
today:


Quality of dialysis care



Health Equity and access to ESRD care



Factors associated with access to home dialysis



Factors associated with access to transplant

Informed Consent
Let me also take a minute to review the informed consent for the interview and how we’ll handle the
information you provide:


We will use the information you share with us for research purposes only.

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

All your responses will be kept confidential. No one except the Insight research team will have
access to the information you provide.



We will use your answers to produce summaries from our collective set of interviews.



We will not report information in any way that identifies you or the organization you are
affiliated with to anyone outside the research team, except with your permission or as required
by law. CMS will not see your name or your organization’s name connected to your individual
responses. That being said, there are only a few organizations out there, so be mindful that CMS
may be able to determine which organization is affiliated with certain remarks.



All information identifying you is stored securely and will be destroyed at the end of the study.



We’d also like to emphasize that your participation is completely voluntary:





Your participation or nonparticipation will not be reported to anyone.



You can stop the interview at any time for any reason, and you can decline to discuss any
topic we raise.

We expect that this call will take about 30-45 minutes.

If you would like this information in writing, let me know, and I will send you a copy to your email.
With your permission, we’d like to audio record the interview to ensure we capture and analyze your
remarks accurately. Only the research team will have access to the recording, and it will be destroyed at
the end of the project. Would it be okay to audio record the interview?
Do you have any questions before we begin?

Introduction of Interviewee(s)
[If there are several interviewees on the phone, call out each one individually and ask them the same
introductory question below.]
1. Before we start our discussion, would you please share with me your job title and your role at
[organization name]? How long have you been working in the ESRD field?
I’m going to ask you some questions about a variety of topics related to ESRD care, but since we are
talking to many different stakeholder organizations, some of the questions may not fall within your
purview of expertise. If that is the case, please let me know and I can move on to another set of
questions.

Dialysis Quality
My first set of questions has to do with the quality of care dialysis patients receive.
1. How do you evaluate the quality of care your facilities provide to your patients? (i.e., which survey
or metrics do you use to measure quality)?
2. How well aligned are the QIP measures with what you track and measure internally?

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3. Have you noticed misalignments of QIP measures with the quality measures of other governmentrelated efforts, such as Five Star or the alternative payment models like the Kidney Care Choices
model and the ESRD Treatment Choices model? If so, please describe those misalignments.
4. Are there any QIP measures that are particularly challenging for facilities to maintain or improve
their scores over time? If so, please explain.
5. Are there any QIP measures that you feel don’t fully represent with patients’ priorities for their
ESRD care? If so, which measures and how do they differ from patients’ priorities?

Access to Care
Next, I’m going shift gears a little and ask about patient access to ESRD care.
1. Does your organization collect data on health-related social needs (e.g., food insecurity, stable
housing, mobility impairment, transportation barriers)? If so, what does your organization do with
the information collected related to those needs?
2. Focusing on underserved populations treated by your facilities (such as low income, rural,
uninsured), what are some strategies to improve access to care that you have implemented or seen
implemented by facilities or providers?
a. What are some challenges, if any, that affected implementation of these strategies?
b. What resources or incentives facilitated the implementation of these strategies?
3. Has your organization adopted strategies to address health inequities? If so, please describe them.
a. [If yes to Q8] Did the QIP encourage the development and implementation of these strategies? If
so, how?
b. [If yes to Q8] Were did other non-QIP CMS initiatives or Models encourage the development and
implementation of these strategies to address health inequities? If so, which ones and how?
4. Can you please tell me about your organization’s strategies to improve access to home dialysis for
patients who are interested?
5. Are there ways in which the QIP is designed that helps or creates challenges to patients’ access of
home dialysis? If so, please describe.
6. Can you please tell me about your organization’s strategies to improve access to transplants or
transplant waitlist for patients who are interested?
7. Are there ways in which the QIP is designed that helps or creates challenges for patients’ access to
transplant? If so, please describe.

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Closing
Before we finish, is there anything you would like to share that I haven’t asked about or anything you
would like to elaborate on that you didn’t get a chance to discuss about the QIP?
Thank you for taking the time to speak with me today. Your input is helpful, and we look forward to
summarizing all the information we hear from stakeholders. If you have questions after the call or wish
to offer additional feedback, please feel free to reach out to me.

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