Consumer Focus Group Materials

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Open Payments Focus Group Moderator Guide A
Form Approved
OMB No. XX 
Exp. Date X/XX/202X


Open Payments
Focus Group Moderator Guide A
Health Care Consumers

    I. Introduction (10 minutes)

Hello and thank you for agreeing to participate in this focus group. My name is ________, and I will guide the group discussion. 

This focus group is sponsored by a government health agency called the Centers for Medicare & Medicaid Services to help them learn more about how people choose and work with health care providers. To be clear, I am not with the government. I am an independent researcher who talks with people about all sorts of things (not just health care, but many different topics for a variety of organizations). So, I have no stake in how you respond to the questions that 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. 

This discussion will be audio recorded and there also are notetakers on the line to ensure I don’t miss anything. Our notes and recordings will be destroyed after the project is finished.

Findings from this discussion—and about 20 other discussions like this—will be summarized together in a final report and will not be presented in a way that will identify you.  

Let’s quickly go over a few guidelines for our discussion.
    A. Guidelines
    • This group will last no more than an hour and a half.
    • I have a discussion guide in front of me to help me make sure we cover all of our important topics for today. At some point, I may need to cut off a conversation and move on to a different topic entirely. If I do that, please know that I am not trying to be rude. I am just trying to make sure we touch on each topic in the time we have together. 
    • There are no right or wrong answers—the goal is to hear a variety of viewpoints, not to reach consensus.
    • Please speak loudly and speak one at a time. Everyone will get a chance to speak if they want to. There may be times when everyone will be asked to respond to a question.
    • Feel free to talk to each other, disagree/agree, ask questions or for clarification—just observe common courtesy.
    • Try to state your first name each time you want to say something so that we can keep track of who is speaking.
    • Our research team will keep all of your comments secure and anonymous. Under no circumstances will the government receive your name or any other information that could identify you. They will receive a report that summarizes the themes we hear across all focus groups we are doing on this topic. Altogether we will be talking with about 120 people, so please feel free to speak your mind.

    B. Introductions
Let’s have each of you introduce yourself by saying your first name, and if you were a doctor or other type of health care provider, what type you would be. I'll go first, my name is ______ and I would be a dermatologist so I could help people feel confident about their skin, and find skin cancers. 
    II. Warm-Up/Finding a Health Care Provider/Awareness of Open Payments (10 minutes)

Let’s begin by talking a bit about how you find your health care providers. When I say “health care provider,” I mean any professional who takes care of your health or a loved one’s health, such as a primary care doctor, a nurse practitioner, a specialist like a surgeon, etc.

        1. How do you find a healthcare provider? Probes: 
    • Internet, specific online resources 
    • Family and friends
    • Primary care vs. specialist

Now you will see on the screen the first of three quick polls we are going to do today. 

[Moderator conducts online poll 1:
Have you heard of the Open Payments program or website?
1  
Yes
2  
No
3
Not sure

If poll results are entirely 2 (“No”) and 3 (“Not sure”), skip to section III.]
Now I’d like to ask you about that program that some of you have heard of called “Open Payments.” 

        2. What have you heard about Open Payments, if anything? Probe, as needed: What do you think is the purpose of Open Payments? 
    III. Attitudes Toward Health Care Transparency (15 minutes)

Okay, we will come back to Open Payments in a minute, and I promise I will tell you all about it, but before I do, I have a few other questions.

        3. What does the term “financially transparent and accountable health care system” mean to you, if anything?

        4. Let’s think of “health care transparency” as making information available to you about financial relationships between health care providers and certain pharmaceutical and medical device companies—how important is that to you, if at all? Probe, as needed: What makes it important to you?

        5. How common do you think it is for health care providers to receive payments from companies that make medications or medical devices? Payments might be things like food, travel, or consulting fees.

        6. What would be your reaction be if you learned that your doctor was receiving consulting fees from a drug or medical device company? What about research funds?

        7. What would be your reaction be if you learned that your doctor was receiving funds from a drug or medical device company for food, travel, or entertainment? 
    IV. Attitudes Toward Open Payments, Questions, Barriers (20 minutes) 

A few minutes ago, I asked what you had heard about the Open Payments program, if anything. Now I’d like to describe that program 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 received, what they were for, the companies that made the payments, and comparisons to national averages.

Let’s take a quick poll. How interested in trying the Open Payments website are you?
[Moderator conducts online poll 2:
How interested in trying the Open Payments website are you?
1  
Very interested
2  
Somewhat interested
3
Not too interested
4
Not interested at all
5
Not sure
]
        8. I’d like to begin by asking you a broad question. What are your initial thoughts about the idea of the Open Payments program?

        9. What questions do you have about Open Payments? 
Now I am going to quickly show you a video of how it works. This video is about a minute and a half long.  Can you see the screen that says “OpenPaymentsData.cms.gov” at the top? Okay, let’s begin. [Moderator shows demonstration portion of Open Payments video (https://www.youtube.com/watch?v=4__S807H3gI), from 4:40 – 6:03.]

Now that you have seen more about Open Payments, let’s take that quick poll again. How interested in trying the Open Payments website are you? 
[Moderator conducts online poll 3:
How interested in trying the Open Payments website are you?
1  
Very interested
2  
Somewhat interested
3
Not too interested
4
Not interested at all
5
Not sure
]
        10. For those who were interested, what makes you interested in trying the Open Payments website?

        11. For those who weren’t that interested, what makes you not interested?

        12. What information in the Open Payments database seems like it might be useful to you, if any?

        13. When might you use the Open Payments database? Probes, if needed: Before choosing doctor, after receiving a prescription or treatment plan 

        14. What would keep you from using the Open Payments database?
    V. Information Use (20 minutes)

Let’s look at the Open Payments database more closely. Please take a minute to look at this search results screen and then we will talk about it. This is not real information about a doctor, just an example. [Show prepared Open Payments database “John Smith” example. Wait a minute or two.] 

        15. What was most interesting to you on this screen?

        16. What do you think the numbers you see mean? 

        17. Imagine for a moment that Dr. Smith is a provider you are thinking about going to. What would you do with the information you see here in Open Payments, if anything? 

        18. Now imagine for a moment that Dr. Smith is a provider you or a loved one has been going to for many years. What would you do with the information you see here in Open Payments, if anything? 

        19. Let’s look at a few things people might do with the information they see about their providers on Open Payments. 

[Show screen with one bullet at a time, asking questions after each.] Would this be something you would do? Why or why not? 
    • Talk with your provider about why they recommend certain medications or treatments for you or a loved one, including asking about generic options.
    • Start a discussion with your provider about their areas of professional interest and expertise based on the research or consulting they have done.
    • 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?
    • Consider financial relationships when searching for a new provider.]

        20. What else might you do with the information you saw on Open Payments? 

        21. What might you see on Open Payments that would make you think about NOT going to a health care provider, if anything? 
    VI. Motivators for Using Open Payments (10 minutes)

        22. What could the government do to encourage people like you to give the Open Payments database a try? 

        23. How could the government encourage people like you to use the information in Open Payments in productive ways that support the relationship between a patient and a health care provider? 
    VII. Wrap Up (5 minutes)

        24. 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 the public about the information available in Open Payments. We will be sending you $100 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.

Open Payments Database Example