Response to comments (60-day)

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Response to Comment: The In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems Survey Mode Experiment (CMS-10105)
    1. A comment was received from an existing third-party survey vendor on the ICH CAHPS Survey. Below is a summary of their recommendations and CMS’s responses:
Comment: The commenter recommended that a web mode should also include both mail and telephone follow-up, rather than just mail follow-up like was tested in the 2022 mode experiment. They also provided suggested timing to make sure that all three modes could be included within the data collection period. 
Response: The 2027 mode experiment will test mail-only, telephone-only, mail with telephone follow-up, and web with mail and telephone follow-up. The timeline for this web-based mode will be similar to what the commenter recommends in their question submission. As suggested by the commenter, the total length of time in the field will not be reduced. 
Comment: The commenter suggested CMS include a survey URL and personal access code (WebID) on the Prenotification Letter. 
Response: The prenotification letter for ICH CAHPS is required as the sampling frame for the survey comes directly from a CMS database. As such, the prenotification letter must be the same for all sample patients and provide information about the forthcoming survey, including that a vendor will be contacting them soon. The prenotification tested in the mode experiment will be very similar to the prenotification letter that is used in national implementation. If the web-based mode is implemented nationally, because each dialysis facility will determine which mode(s) their authorized survey vendor will administer, not all sample patients will have a web-based mode option and therefore will not be provided with this website information. For these reasons, a survey URL and personal access code will be included in all other correspondence with sample patients (emails, web invite by mail, mail survey cover letter) in the web-based mode, but will not be included in the prenotification letter. 
Comment: The commenter suggested CMS adding a QR code to all survey materials sent to the sample patients.  
Response: The mode experiment will test a QR code that will be included in all correspondence with the sample patients in the web-based mode, other than the prenotification letter for the same reasons as noted above. 
Once the mode experiment has concluded and data have been analyzed, CMS will determine whether a web-based mode will be adopted for the national implementation of the ICH CAHPS Survey, and whether any changes should be made to the protocols tested.

    2. A comment was submitted by Mayo Clinic. Below is a summary of their recommendations and CMS’s responses:
Comment: The commenter suggested the following wording changes to two of the home dialysis only questions. 
To best reflect the partnership between the dialysis clinic staff and the patient's equipment and supply vendors, we recommend the wording of questions 23 and 24 be changed as follows:
• Q23: In the last 3 months, if you had problems with your home dialysis equipment and needed support from your dialysis center staff, how often were the staff able to help you?
• Q24: In the last 3 months, if you had problems receiving your home dialysis supplies and needed support from your dialysis center staff, how often were the staff able to help you?
Response: For these questions, we want to know that if a patient had a problem, and contacted their dialysis center staff, whether the staff were able to help solve the problem. The suggested edits change the interpretation of these questions and remove our ability to understand whether the patient’s problems were solved. To address their comment, we will add another Not Applicable (NA) option to Questions 23, 24, and 25. These will now each have two NA options: 
23. In the last 3 months, when you had problems with your home dialysis equipment, how often did dialysis center staff help you solve them?
☐          Never
☐           Sometimes
☐           Usually
☐           Always
☐           I did not have any problems with my dialysis equipment
☐           I had a problem with my dialysis equipment but did not need dialysis center staff help  *NEW*
 24. In the last 3 months, when you had problems receiving supplies for your home dialysis, how often did dialysis center staff help you solve them?
☐           Never
☐           Sometimes
☐           Usually
☐           Always
☐           I did not have any problems receiving dialysis supplies
☐           I had a problem receiving dialysis supplies but did not need dialysis center staff help *NEW*
 25. Think about any other problems you had with your home dialysis, not including problems with your equipment or receiving supplies. In the last 3 months, when you had any other problems with your home dialysis, how often did dialysis center staff help you solve them?
☐           Never
☐           Sometimes
☐           Usually
☐           Always
☐           I did not have any other problems 
☐           I had other problems but did not need dialysis center staff help *NEW*