CMS-10710. [Medicare Research GenIC#14-TRIPTK] Coversheet_JourneyAI Survey_Beneficiaries & Caregivers

Status: Original and derived artifacts are available for this document.

Download: docx | pdf | html

Request for Approval under the “Generic Clearance for Improving Customer Experience: OMB Circular A-11, Section 280 Implementation” 
(OMB Control Number: 0938-1382)

TITLE OF INFORMATION COLLECTION: GenIC #14 -TRIPTK- Journey AI Surveys – Beneficiaries & Caregivers


PURPOSE OF COLLECTION:  
What are you hoping to learn / improve? How do you plan to use what you learn? Are there artifacts (user personas, journey maps, digital roadmaps, summary of customer insights to inform service improvements, performance dashboards) the data from this collection will feed?

We’ll use this survey to understand how beneficiaries and caregivers experience Medicare: the key moments, needs, and decisions that shape discovery, coverage choices, and plan management.


TYPE OF ACTIVITY: (Check one)

[ X ] Customer Research (Interview, Focus Groups, Surveys)	
[   ] Customer Feedback Survey 
[   ] Usability Testing of Products or Services 

ACTIVITY DETAILS

    1. If this is a survey, will the results of this survey be reported to Touchpoints as part of quarterly reporting obligations specified in OMB Circular A-11 Section 280?
[ X ] Yes
[  ] No
[  ] Not a survey

    2. How will you collect the information? (Check all that apply)
[ X ] Web-based or other forms of Social Media 
[  ] Telephone	
[  ] In-person 
[  ] Mail 
[  ] Other, Explain

    3. Who will you collect the information from?
Explain who will be interviewed and why the group is appropriate for the Federal program / service to connect with. Please provide a description of how you plan to identify your potential group of respondents and if only a sample will be solicited for feedback, how you will select them(e.g., anyone who provided an email address to a call center rep, a representative sample of Veterans who received outpatient services in May 2019, do you have a list of customers to reach out to (e.g., a CRM database that has the contact information, intercept interviews at a particular field office?) 

This survey is accessed through a link provided by an external research vendor. Users self-select by clicking the link to take the survey. The survey link is available to users who qualify via provided screening criteria. The survey is automated and begins once a user clicks the link to begin. The audience we are targeting is a representative mix of beneficiaries and caregivers with varying locations, ages/Medicare stages, languages, socio-economic statuses, health insurance coverage types, health conditions, caregiver influences, and medicare.gov portal usage levels.


    4. How will you ask a respondent to provide this information? 
(e.g., after an application is submitted online, the final screen will present the opportunity to provide feedback by presenting a link to a feedback form / an actual feedback form)

Users will provide this information voluntarily through an online survey. They will first be prompted to answer a short screener to deem eligibility to participate in the research. If they pass the screener successfully, they will enter the survey automatically, and the data is collected using Qualtrics software. Data is automatically saved as it is entered.

    5. What will the activity look like?
Describe the information collection activity – e.g. what happens when a person agrees to participate? Will facilitators or interviewers be used? What’s the format of the interview/focus group? If a survey, describe the overall survey layout/length/other details? If User Testing, what actions will you observe / how will you have respondents interact with a product you need feedback on? 

The survey will be conducted online, using Qualtrics software. It is unmoderated and designed to take each participant approximately 15-20 minutes to complete. Each question will be shown on a single screen, with a “next” button to get to the next question. The survey data will be automatically saved as it is entered. No PII is collected for this effort.

    6. Please provide your question list.
Paste here the questions or prompts presented to participants in your activity. If you have an interview / facilitator guide, that can be attached to the submission and referenced here. 

Please make sure that all instruments, instructions, and scripts are submitted with the request.


    7. When will the activity happen?
Describe the time frame or number of events that will occur (e.g., We will conduct focus groups on May 13,14,15, We plan to conduct customer intercept interviews over the course of the Summer at the field offices identified in response to #2 based on scheduling logistics concluding by Sept. 10th, or “This survey will remain on our website in alignment with the timing of the overall clearance.”)

This survey will run in early December. We plan to field for approximately 1-2 weeks until research quotas are met.


    8. Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants?  
[ X ] Yes [ ] No  
If Yes, describe:

For JourneyAI surveys, incentives are standard practice to ensure that respondents take the time to write the thorough open-ended responses that our AI needs to surface themes in the data. Recruitment is conducted via our vendor, who works with various panel-providers to source the right respondents and then dispenses the incentive once the survey is completed. Incentive is estimated to be about $15.00 per respondent.
In the case that we encounter fraud (e.g. respondents copy/pasting answers, entering a bunch of meaningless characters, etc.,) we clean them out of the dataset and they are not given compensation.


BURDEN HOURS 

Category of Respondent 
No. of Respondents
Participation Time
Burden
Hours
Individual Beneficiaries
700
15-20 minutes
233
Caregivers
400
15-20 minutes
133
Totals
1,100

366

CERTIFICATION:

I certify the following to be true: 
    1. The collections are voluntary;
    2. The collections are low-burden for respondents (based on considerations of total burden hours or burden-hours per respondent) and are low-cost for both the respondents and the Federal Government;
    3. The collections are non-controversial;
    4. Any collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the near future;
    5. Personally identifiable information (PII) is collected only to the extent necessary and is not retained;
    6. Information gathered is intended to be used for general service improvement and program management purposes
    7. The agency will follow the procedures specified in OMB Circular A-11 Section 280 for the required quarterly reporting to OMB of trust data and experience driver data from surveys. 
    8. Outside of the quarterly reporting mentioned in the bullet immediately above, if the agency intends to release journey maps, user personas, reports, or other data-related summaries stemming from this collection, the agency must include appropriate caveats around those summaries, noting that conclusions should not be generalized beyond the sample, considering the sample size and response rates. The agency must submit the data summary itself (e.g., the report) and the caveat language mentioned above to OMB before it releases them outside the agency. OMB will engage in a passback process with the agency.  

Name and email address of person who developed this survey/focus group/interview: 

CMS POC

Name: Jon Booth

Email address: [email protected]

TRIPTK (Contractor) POC
      
Name: Alex Anderson

Email address: [email protected]

All instruments used to collect information must include:
OMB Control No. 0938-1382
Expiration Date: 12/31/2026