CMS-10826.Health Care Providers (Primary Care and Specialist)

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Interview Guides

Form Approved OMB No. XX
Exp. Date X/XX/202X


Open Payments
Interview Guide A
Health Care Providers (Primary Care and Specialist)


    I. Introduction (2 minutes)

Hello, my name is 	, and I will be conducting this interview today. Thank you for taking time out of your schedule to talk with me.

This interview is sponsored by the Centers for Medicare and Medicaid Services or CMS to help them learn more about one of their programs for health care providers.

We will take no more than 45 minutes and everything you say will be confidential. Findings from this interview will be summarized together with almost 50 other interviews in a final report and will not be presented in a way that will identify you. Having said that, this conversation will be audio recorded. I also have a colleague on the line with me who will be taking notes to ensure we’re capturing everything. We will not share our notes, the recording, your name, or any identifying information with CMS or anyone outside our research team.

I am not with CMS. I am an independent researcher who talks with people about all sorts of things (not just health, but many different topics for a variety of organizations). So, I have no stake in what we will discuss today. I just want to hear what you have to share in your own words—your thoughts, experiences, and opinions about the topics we’ll be discussing.

Your participation is voluntary and you can leave at any time. Do you have any questions before we begin?
    II. Warm-Up (5 minutes)

        1. Let’s begin by talking a bit about your work day. What are your major responsibilities on a typical day?

        2. Does your work involve any administrative responsibilities, such as filling out forms or registrations? What type of administrative work do you do?

        3. How do you work with or deal with pharmaceutical or medical device companies, or representatives from those companies?
    III. Attitudes about Health Care Transparency (5 minutes)

So now I’d like to talk with you about the idea of financial transparency in health care.

    4. What does the term, “financially transparent and accountable health care system,” mean to you, if anything?
[If their description is substantially different than the following, define the term, saying: Right, and for the purposes of our discussion today, CMS is defining “transparency” as making information about financial relationships between providers and certain pharmaceutical and medical device companies available to the public.]
    5. How important is a financially transparent and accountable health care system to you, if at all?
Probe, as needed:
        ◦ Importance to you as a health care provider

    6. What do you see as the benefits of financial transparency in health care, if any? Probe, as needed:
        ◦ Benefits to provider
        ◦ Benefits to the public

    7. What are the downsides of financial transparency in health care?

    IV. Attitudes about Open Payments (10 minutes)

Now I’d like to talk about a program of the Centers for Medicare and Medicaid Services or CMS that is called Open Payments.

    8. What have you heard about the Open Payments program, if anything?
I’ll put a description of the program on the screen for you.

[Show the following statement on screen and read aloud: Open Payments is a national program that makes information about payments individual health care providers receive from drug and other companies publicly available online. At OpenPaymentsData.CMS.gov, anyone can search for health care providers and see the payments they have received, what they were for, the companies that made the payments, and how these payments compare to national averages.]

And here is what people see when they search for a provider on Open Payments. This is for demonstration purposes only—not anyone’s real data.

[Briefly show a screen grab of the Open Payments database results page.]

    9. Now that I have told and shown you a bit about Open Payments, what are your overall thoughts about the program? [Redirect interviewee from commenting about other CMS programs (e.g., Medicare, Medicaid) so focus is on Open Payments.]

    10. As a health care provider, what else would you like to learn about Open Payments?

    11. How do you feel about patients and others having access to information about payments health care providers have received from companies?

    12. How do you think Open Payments could affect you or your practice?

    V. Checking Data in Open Payments (5 minutes)

CMS would like health care providers to register in Open Payments so that each spring they can check the data that companies report about them before it is published online in June, or dispute the data if needed.

    13. Have you ever heard or read a request from CMS or anyone else to check your data in Open Payments? Where did you hear or read it?

    14. How feasible is it for you to register and check your data each spring? Probes:
o Barriers: What would prevent you from doing it?

    15. What would be some of the things that would motivate you to register and check your data each spring?
Probe, as needed:
    • What could CMS do to encourage you to register and check your data?
    • If you got a reminder, where would you be most likely to notice it (e.g., email, certain journals you read, social media, direct mail)?

    16. How feasible would it be for the administrative staff in your practice or where you work to check your data each spring?
    VI. Provider Message/Fact Sheet Testing (10 minutes)

We are now going to look at a fact sheet about Open Payments. As you read this fact sheet, if you can, jot down what you like, what you don’t like, and what you find confusing.

Just a reminder: I didn’t write this fact sheet, so I won’t take any of your comments personally.

[Show fact sheet on screen.]

Can you see the screen that says “Open Payments” in bold at the top? Take a minute to read it and then we will talk.

    17. What are your overall reactions to this fact sheet?

    18. What is confusing, unclear, or hard to understand?

Now I would like to ask you about some specific words or phrases used in the fact sheet.

    19. In the first box on the fact sheet it says that one of the things a provider can do is: “If a patient asks, answer questions and provide more information about the payments to you.” How comfortable would you be telling patients about Open Payments and your data?

    20. What types of prepared materials might you want to share with them about Open Payments, if any?
    21. In the same box it also includes talking to your colleagues about Open Payments. How comfortable would you be doing that?

    22. There is some information (under Open Payments Data) that describes the number of Open Payments records, total amount of payments, etc. How helpful to you do you find that information, if at all?
    23. The second box on the page includes two columns. The first is Covered Recipients and the second is Reporting Entities. Are you comfortable with these terms as they are, or are there other words that you would use instead?

    24. The second box on the page includes a bullet under recipients called Advanced Practice Providers. What do you think this refers to?

    25. Finally, there are three websites mentioned on the page. The third paragraph mentions OpenPaymentsData.CMS.gov, the text box mentions portal.cms.gov, and the last sentence mentions cms.gov/openpayments. How do you think these sites differ?

    26. How confusing is it to have different sites mentioned on the same fact sheet, if at all?
    VII. Patient Call to Action Testing (5 minutes)
Now I am going to show you some language from a draft fact sheet for patients about Open Payments.

[Show on screen: You can use the information in Open Payments to:
        1. Talk with your provider about why they recommend certain medications or treatments for you or a loved one, including asking about generic and non-drug options.
        2. Start a discussion with your provider about their areas of professional interest and expertise based on the research or consulting they have done.
        3. Directly ask your provider some of these questions:

            ▪ Is this you?
            ▪ What type of work do you do with these companies?
            ▪ Have you prescribed me any drugs that are manufactured by companies you've taken payments from?
            ▪ What devices have you used in my care that are manufactured by companies you've taken payments from?]

    27. Looking at number 1, how would you react to a patient talking with you about why you recommend certain medications, including asking about generic or non- drug options?

    28. Looking at number 2, how would you react to a patient starting a discussion with you about your areas of professional interest or expertise based on the research and consulting payments to you that they see in Open Payments?
    29. Looking at number 3, how would you react to a patient directly asking you these questions? Probes: Are you comfortable with them directly asking you about the payments to you? Are you comfortable with them asking you if you have prescribed any medications or used any products from those companies in their care?

    30. Is there anything else you think patients should do with the information they find in Open Payments about payments to their health care providers?
    VIII. Wrap Up (2 minutes)

    31. Are there any issues or ideas related to Open Payments we haven’t talked about today that you think we should consider?
Thank you for your time and your opinions today. Your thoughts are going to shape how the government informs health care providers and the public about the information available in Open Payments. We will be sending you a check to say thank you for participating today. If you don’t receive it within a week, please contact us so we can make sure you get it. Thanks again