Supporting Statement B

B. COLLECTION OF INFORMATION EMPLOYING STATISTICAL METHODS

Rather than employ statistical sampling of MA plans for the mail survey, CMS intends to conduct a survey of the entire population of plans operating C/DM programs in 2008. About 472 MA plan contracts were operating in June 2007 and would be eligible for the survey; therefore, CMS has chosen to survey the entire population of MA plans.

1. Respondent Universe and Sampling Methods

The universe of MA plans for the mail survey is about 600 MA contracts that will be operating in May 2008. The mail survey will be administered to about 475 of these. Of the 600 contracts or plans, 130 will be excluded from the evaluation because they are demonstrations, pilots, Medical Savings Accounts, and Cost or Health Prepayment Plans which either do not include financial risk as MA plans normally do or are unlikely to have C/DM programs. Contact information for MA plans will come from CMS’s contract and plan contact databases maintained in the Health Plan Management System. We plan to survey all eligible MA plans and so will not sample from this population.

2. Procedures for the Collection of Information

The survey will be conducted with all MA plans under contract with CMS in 2008. An initial call will be placed to determine whether plans operate C/DM programs and identify the most knowledgeable person about the program(s). The survey will be sent to each plan along with a cover letter explaining the purpose of the survey. Respondents will be asked to fill out the questionnaire and return it by e-mail, fax, or in the pre-paid envelope within one month. Two weeks after sending out the survey, the research team will send a fax, mail, or electronic reminder about the survey to all respondents. The research team will conduct follow-up phone calls to respondents who have not yet returned the survey after one month.

3. Methods to Maximize Response Rates and Deal with Nonresponse

Response rates in the mail survey of MA plans will be maximized in a number of ways. Just before the survey begins, CMS will, during its weekly conference call, inform plans of the coming survey and the importance of participation. We will mail introductory letters on CMS stationery and follow with telephone calls to determine whether selected plans operate C/DM programs and are therefore eligible for the survey. During these calls, we will also identify the person most knowledgeable about these programs; we will then mail the survey to this designated survey respondent. The cover letter, which will be personally addressed and on CMS letterhead, will include contact information and the signature of the CMS project officer, as well as the toll-free number of the MPR survey director. The letter will describe the evaluation and the purpose of the mail survey, and will provide instructions and a date for responding. It will indicate that the survey is voluntary and give the estimated time for completion.

Follow-up telephone calls by trained interviewers (during which plans can complete the survey) extend our strategy. We will send one questionnaire by mail and place a follow-up call if the plan has not responded in two weeks. The questionnaire is relatively short and has only a few open-ended response categories. There are clear instructions on the first page. We considered making the survey available on the web but concluded that the response rate might be lower for this modality; we believe that a mail survey will be convenient for respondents because they may need to check administrative records as they complete the questionnaire.

The response rate for the mail survey will be calculated as the number of MA plans that complete the questionnaire (either by mail or by telephone) divided by the total number of MA plans that were mailed surveys (all unique MA plans). Because we know the universe of approved, unique MA plans or contracts, the denominator of the response rate does not include ineligible plans or plans whose eligibility is unknown. Response rate calculations are based on standards established by the American Association for Public Opinion Research.

Based on previous surveys with similar populations, we anticipate achieving a minimum response rate of 80 percent on the survey. For non-respondents, we will construct a profile based on characteristics of the plans drawn from the HPMS and data collected through the pre-survey screening outreach.

4. Tests of Procedures or Methods to Be Undertaken

A total of nine MA plans were selected to pretest the survey instrument. The plans were selected to represent a mix that varies by whether C/DM was offered. The pretest identified some items that were burdensome or difficult to respond to, and these items were removed or revised accordingly. An average response time estimate from the pretests was 55 minutes, which is used in our response burden estimate in Section A.12 above.

5. People Consulted on Statistical Aspects, and People Collecting or Analyzing Data

The following people have contributed to the design of the mail survey: Dr. Lisa Green, project director at L&M Policy Research (240-476-6663); Ms. Myra Tanamor of L&M (202) 230-9029; Ms. Julia Doherty of L&M (202) 291-2518; Ms. Jennifer Schore, an MPR senior researcher (609-275-2380); and Mr. Todd Ensor, an MPR senior survey researcher (609-275-2326). Ms. Noemi Rudolph (410-786-6662), Project Officer at CMS, Office of Research, Demonstrations, and Information, is supervising the study for the government.