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Federal forms, ICRs, and supporting documents

Information Collection Request

Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey

ICR 201910-3206-004 · OMB 3206-0274 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 3206-XXXX Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey Form and Instruction Unchanged Available
Supporting Statement B 2019 12 16.docx Supporting Statement B Uploaded 2019-12-18 Available
CAHPS OMB Supporting Statement_rev_ccc.docx Supporting Statement A Uploaded 2019-11-20 Available
CAHPS_60 Day FRN.pdf Supplementary Document Uploaded 2019-08-28 Available
IC Document Collections
IC IDCollectionTypeStatusForm
237579 Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey Form and Instruction Unchanged
ICR Details
3206-0274 201910-3206-004
Active 201908-3206-001
OPM 3206-XXXX
Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey
Existing collection in use without an OMB Control Number   No
Regular
Approved with change 12/19/2019
Retrieve Notice of Action (NOA) 11/20/2019
This collection is approved based on the revised materials provided by the Agency. OPM must report this collection as a violation in the Information Collection Budget.
  Inventory as of this Action Requested Previously Approved
12/31/2022 36 Months From Approved
73,505 0 0
18,376 0 0
197,546 0 0
OPM uses the CAHPS results as part of the FEHB Plan Performance Assessment (PPA). The PPA enables a consistent, objective evaluation of carrier performance and also provides more transparency for enrollees. This assessment uses a discrete set of quantifiable measures to examine key aspects of performance in the areas of clinical quality, customer service and resource use. Eight CAHPS measures are part of this discrete set of quantifiable measures. Taken together with more traditional assessments of contract administration, these measures help ensure that enrollees receive high quality affordable healthcare and a positive customer experience. The PPA is linked to carrier profit and premium adjustment factors. FEHB contracts include language to incorporate the PPA as a determinant of the Service Charge or Performance Adjustment.
None
None
Not associated with rulemaking
  84 FR 35137 07/22/2019
84 FR 63905 11/19/2019
Yes
1
IC Title Form No. Form Name
Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey 3206-XXXX CAHPS Survey
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 73,505 0 0 73,505 0 0
Annual Time Burden (Hours) 18,376 0 0 18,376 0 0
Annual Cost Burden (Dollars) 197,546 0 0 197,546 0 0
Yes
Miscellaneous Actions
No
Previously used ICR now being submitted for OMB approval.
$245,235
Yes Part B of Supporting Statement
    No
    No
No
No
No
Uncollected
Charles Conyers 202 606-0125 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
11/20/2019