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Request for Approval under the “Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery” (OMB Control Number: 0704-0553)

TITLE OF INFORMATION COLLECTION: Customer Satisfaction Incentive Surveys

PURPOSE: TRICARE supplements the health care resources of the uniformed services with networks of civilian professionals to provide high-quality health care services while maintaining the capability to support military operations. The Defense Health Agency (DHA) has partnered with civilian regional contractors in the regions to provide these health care services and support to beneficiaries. These health care provider contracts, or Managed Care Support Contracts (MCSC) in turn, maintain networks of civilian health care providers to offer services through TRICARE. The MCSC augments the Military Health System (MHS) in operating an integrated healthcare delivery system combining resources of the military’s direct medical care system and the Contractor’s managed care support to provide health, medical, and administrative support services to TRICARE-eligible beneficiaries.

These Customer Satisfaction Surveys provide regional Administrative Contracting Officers (ACOs) with information on beneficiary-user satisfaction. The reports of findings from these surveys, coupled with performance criteria from other sources, will be used to determine the vendors’ incentives.

DESCRIPTION OF RESPONDENTS: Respondents are TRICARE beneficiaries who had an eligible encounter/claim applicable to the specific survey.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [ X ] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus Group [ ] Other: ______________________

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name:_ Dr. Kimberley Marshall-Aiyelawo, Chief, Patient Experience Measure, Analytics and Evaluation Division (AED), DHA

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [ X ] No

2. If Yes, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [ X ] No

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [ X ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [ X ] No

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
TRICARE Dental Care Satisfaction Survey respondents	1,608	5 min	134 hours
TRICARE Medicare Eligible Program (TMEP) Survey respondents	1,608	5 min	134 hours
TRICARE Pharmacy Beneficiary Survey (PBS) respondents	1,608	5 min	134 hours
TRICARE Beneficiary Satisfaction Survey respondents	3,216	5 min	268 hours
TRICARE Provider Satisfaction Survey respondents	408	5 min	34 hours
Totals	8,448	5 min	704 hours

PUBLIC COST: The estimated annual cost to the public is $22,162.

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [ X ] Yes [ ] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

A simple random sampling of unique beneficiaries who have had a claim processed within the respective MCSC contracted services within the previous period of care period will be drawn and will be contacted via phone and asked to participate.

TRICARE Dental Care Satisfaction Survey

The target response pool of 402 beneficiaries per quarter was developed to accurately estimate the proportion of the population this is satisfied to three percentage points on a 100-point scale with 95 percent confidence. It is assumed that approximately 90% of users will be satisfied with outpatient purchased care services and that the distribution of responses to the overall satisfaction item will be binomial (i.e. satisfied not satisfied).

TRICARE Medicare Eligible Program (TMEP) Survey

The target response pool of 402 beneficiaries per quarter was developed with an interest to achieve an estimate of "percent satisfied" to three percentage points on a 100-point scale with 95 percent confidence. It is assumed that approximately 90% of users will be satisfied with outpatient purchased care services and that the distribution of responses to the overall satisfaction item will be binomial (i.e. satisfied, not satisfied).

TRICARE Pharmacy Beneficiary Survey (PBS)

The target response pool of 402 beneficiaries per quarter was developed to estimate the proportion of the population that is satisfied to three percentage points on a 100-point scale with 95 percent confidence. It is assumed that approximately 90% of users will be satisfied with mail order pharmacy services and that the distribution of responses to the overall satisfaction item will be binomial (i.e. satisfied, not satisfied).

TRICARE Beneficiary Satisfaction Survey

The target response pool of 804 beneficiaries per TRICARE region (East and West) was developed to accurately estimate “percent satisfied” within 3 percentage points on a 100-point scale during a six-month period of care. Each month, 134 responses are collected per region to produce the six-month response pool of 804. It is assumed that approximately 90% of users will be satisfied with outpatient purchased care services and that the distribution of responses to the overall satisfaction item will be binomial (i.e. satisfied, not satisfied). This assumption is based on prior studies of beneficiary satisfaction with purchased care services.

TRICARE Provider Satisfaction Survey

On a monthly basis, samples for each survey and region will be drawn using a simple random sample from the appropriate TRICARE database and delivered securely to the survey vendor. The list will be de-duped. The random samples are constructed such that there is a sufficient amount in each sample to yield 408 completed responses per year, reported in groups of 102 participant responses for each of the two TRICARE Regions every six months. The total sample size (including all TRICARE Regions) received annually is approximately 4,000. The survey vendor must attempt to reach each and every potential respondent in the sample.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[ ] Web-based or other forms of Social Media

[ X ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [ X ] Yes [ ] No

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