Cognitive Testing of a Questionnaire for a Dual-mode Survey of Medicare Beneficiaries

As part of its mission to improve the quality of care provided to its beneficiaries, the Centers for Medicare and Medicaid Services (CMS) is carefully developing a survey designed to permit the beneficiaries to report on their own health status and care. One might think that the extensive administrative records maintained by CMS would be sufficient, but the claims data have limited utility. They do not measure people’s behavior, their perceptions of their own health status, or reasons why they do or do not seek care. There are no claims data for the beneficiaries who are in managed care plans; managed care plans are based on a fixed amount per enrollee regardless of utilization, therefore no individual claims are filed. Finally, there are no claims for services that are received outside the Medicare system or for services that are not covered by Medicare. Since the CMS is making a transition to a data-driven approach, the data are needed to help CMS’s 53 state Peer Review Organizations (PROs) monitor the quality of care received and to target beneficiary populations under the Health Care Quality Improvement Program. To meet this need CMS is developing the Medicar