CMS-10823 Appendix H

End-stage Renal Disease (ESRD) Quality Incentive Program (QIP): Study of Quality and Patient Experience (CMS-10823)

CMS-10823 ESRD_QIP_M&E AppH - Recruitment Materials

OMB: 0938-1450

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Appendix H: Recruitment Materials
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 to 60 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.
[These materials are intended to serve as a template for correspondence involving obtaining participant
interest in participating in the study, confirming participation, and interview appointment reminders.]

Facility Administrator, Social Worker, and Nephrologist Recruitment Email/Call
Dear [NAME],
My name is [NAME] from Insight Policy Research. We are conducting a study for the Centers for
Medicare and Medicaid Services (CMS) talking to key informants about their experiences providing and
receiving care under the Quality Incentive Program (QIP). CMS is interested in learning about how the
QIP has affected patients’ health outcomes, access to care (including home dialysis and transplant), and
quality of care. They are also interested in understanding how the quality of life for individuals with
ESRD has changed over time.
We are looking to schedule telephone interviews with [INSERT PARTICIPANT TYPE] like you to learn
about your perspectives on these topics. We expect the interview to take [INSERT TIME BASED ON
PARTICIPANT TYPE] and will include a $100 VISA gift card as a token for taking the time to speak with us.
If you are interested in participating, or if you have questions or concerns please respond to this email
or contact [RECRUITER NAME] at [PHONE] or [EMAIL].
Thank you for your time.
Sincerely,
[RECRUITER EMAIL SIGNATURE]

Insight ▪ ESRD QIP Recruitment Materials

1

Transplant Center Administrator Recruitment Email/Call
Dear [NAME],
My name is [NAME] from Insight Policy Research. We are conducting a study for the Centers for
Medicare and Medicaid Services (CMS) talking to key informants about their experiences providing and
receiving care under the Quality Incentive Program (QIP). CMS is interested in learning about how the
QIP has affected patients’ health outcomes, access to care (including home dialysis and transplant), and
quality of care. They are also interested in understanding how the quality of life for individuals with
ESRD has changed over time.
We are looking to schedule telephone interviews with transplant center administrators like you to learn
about your perspectives on these topics. We expect the interview to take 30 minutes and will include a
$50 VISA gift card as a token for taking the time to speak with us.
If you are interested in participating, or if you have questions or concerns please respond to this email
or contact [RECRUITER NAME] at [PHONE] or [EMAIL].
Thank you for your time.
Sincerely,
[RECRUITER EMAIL SIGNATURE]

Corporate Representatives and Patient Advocacy Organizations Recruitment
Email/Call
Dear [NAME],
My name is [NAME] from Insight Policy Research. We are conducting a study for the Centers for
Medicare and Medicaid Services (CMS) talking to key informants about their experiences providing and
receiving care under the Quality Incentive Program (QIP). CMS is interested in learning about how the
QIP has affected patients’ health outcomes, access to care (including home dialysis and transplant), and
quality of care. They are also interested in understanding how the quality of life for individuals with
ESRD has changed over time.
We are looking to schedule telephone interviews with stakeholders like you to learn about your
perspectives on these topics. We expect the interview to take 30 minutes.
If you are interested in participating, or if you have questions or concerns please respond to this email
or contact [RECRUITER NAME] at [PHONE] or [EMAIL].
Thank you for your time.
Sincerely,
[RECRUITER EMAIL SIGNATURE]

Insight ▪ ESRD QIP Recruitment Materials

2

Non-Patient Confirmation Email
Dear [NAME],
Thank you for your participation! This message is to confirm your interview scheduled for [DATE] at
[TIME] [TIME ZONE]. At the time of the interview, please use the call-in information below.
[MEETING LINK]
[MEETING PHONE NUMBER]
If you have any questions or need to reschedule, please contact [RECRUITER NAME] at [RECRUITER
PHONE NUMBER] or [RECRUITER EMAIL].
Thank you for your time.
Sincerely,
[RECRUITER EMAIL SIGNATURE]

Patient Recruitment Email/Call
Dear [NAME],
My name is [NAME] from Insight Policy Research. We are conducting a study for the Centers for
Medicare and Medicaid Services (CMS) talking to individuals with ESRD about their experiences
surrounding accessing and receiving care for ESRD, including dialysis treatment and other options such
as transplant. CMS is also interested in understanding how the quality of life for individuals with ESRD
has changed over time.
We are looking to schedule telephone interviews with individuals with ESRD who currently receive
dialysis to learn about your perspectives on these topics. We expect the interview to take one hour and
will include a $100 VISA gift card as a token for taking the time to speak with us.
If you are interested in participating, or if you have questions or concerns please respond to this email
or contact [RECRUITER NAME] at [PHONE] or [EMAIL].
Thank you for your time.
Sincerely,
[RECRUITER EMAIL SIGNATURE]

Insight ▪ ESRD QIP Recruitment Materials

3

Patient Confirmation Email
Dear [NAME],
Thank you for your participation! This message is to confirm your interview scheduled for [DATE] at
[TIME] [TIME ZONE]. At the time of the interview, please use the call-in information below.
[MEETING LINK]
[MEETING PHONE NUMBER]
If you have any questions or need to reschedule, please contact [RECRUITER NAME] at [RECRUITER
PHONE NUMBER] or [RECRUITER EMAIL].
Thank you for your time.
Sincerely,
[RECRUITER EMAIL SIGNATURE]

Reminder Email/Call (All participant Types)
Dear [NAME],
This email is a reminder of your interview scheduled with Insight Policy Research [DATE] at [TIME] [TIME
ZONE]. At the time of the interview, please use the call-in information below.
[MEETING LINK]
[MEETING PHONE NUMBER]
If you have any questions or need to reschedule, please contact [RECRUITER NAME] at [RECRUITER
PHONE NUMBER] or [RECRUITER EMAIL].
Thank you for your time.
Sincerely,
[RECRUITER EMAIL SIGNATURE]

Insight ▪ ESRD QIP Recruitment Materials

4


File Typeapplication/pdf
File TitleAppendix H: Recruitment Materials
SubjectPaperwork Reduction Act, End-stage Renal Disease, Dialysis Facilities, Interview Guides
AuthorCMS
File Modified2022-11-28
File Created2022-11-27

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