Evaluation of the National External Breast Prostheses Reimbursement Program

Interview guide - consumers

Page last updated: 05 November 2010

Introduction (5 mins)

Thank you all for meeting with me today. My name is # and I am from Urbis. We are a social research firm and specialise in conducting program evaluations for state and federal government.

We are carrying out an evaluation of the National External Breast Prostheses Reimbursement Program for the Department of Health and Ageing. Today I will be asking you about your knowledge of the program, your experience with the program, and what impact the program has had on your quality of life.

It is important that you know that I will be taping our discussion to help with writing our report – specifically so that I can go back at a later stage and accurately describe exactly what was said today. In saying this however, whatever you say will be kept strictly confidential – you will in no way be identified or named in our research. Your comments will be completely anonymous.

It is also important that you feel at ease in participating in today's discussion. I understand that this is a sensitive topic, and you may at times feel uncomfortable in disclosing information. Whilst I am keen to hear your views and experiences, you are in no way obliged to share sensitive or confidential information with us here today. Of course we would like to know what you feel may be working well or not so well, so that the program can be improved for women who use it in the future. Please remember that whilst I would like to hear from all of you, it would be appreciated if you could talk one at a time.

Do you have any questions about the evaluation before we start?

I'd be grateful if you could please turn off all mobile phones to avoid interruptions.

Questions

Information sources and claiming under the program (15 mins)

  1. Could you please briefly introduce yourself?
  2. Have you heard about the National External Breast Prostheses Reimbursement Program? (If all answer no go to 'Participants who have not claimed under the program')
  3. What were your initial thoughts about the program?
  4. How did you find out about the program? (Prompt: internet, Breast Care Nurse, GP, other medical practitioner, Medicare, DoHA, Department of Veterans’ Affairs, BCNA, NBOCC, NBCF, McGrath Foundation, Cancer Council, breast cancer support group, word of mouth, breast prosthesis supplier, migrant group, other)
  5. How would you rate the availability of information about the program? (e.g. how easy or difficult was it to find all the information you needed about the program? Did it come from one source, or did you have to search for more information about the reimbursement? Where did you search?
  6. Do you think that there are any ways in which the availability of information could have been improved? If so, how?
  7. In your view, what would be the best way to inform women about the program, particularly if they had their mastectomy some years ago and are not currently under the care of a health professional?
  8. Have you claimed for reimbursement for an external breast prosthesis through the program? (If all answer no go to 'Participants who have not claimed under the program') Top of page

Making the claim (30 mins)

  1. How did you find the process of claiming for your reimbursement? Was it:
      • Fair? (why/not?)
      • Efficient? (why/not?)
      • Easy to understand? (why/not?)
      • Easy to obtain and to complete the application forms? (why/not?)
  2. How did you make your claim for reimbursement? (prompt: downloaded form, completed at Medicare office, called/wrote to Medicare and they sent the form, completed the form provided by supplier) How well did this process work for you?
      • Did you need any assistance with understanding the language used in the information sheet or claim form?
  3. As part of making a claim through the program, did anyone also claim reimbursement from a private health fund? How well was this option communicated as part of the program? How well did this option fit with claiming through the program? If not, why was this?

  4. How easy or difficult did you find it to collect the necessary supporting information for the claim?

  5. Do you think that there are any ways in which the claim process could be improved? Do you think that there are there ways in which the process could be improved for women of a non-English speaking or Aboriginal or Torres Strait Islander background?

  6. Do you think the program is equally available to all women? Do you think that there are there any barriers to accessing the program? (probe for age group, social economic status, culturally and linguistically diverse backgrounds and Aboriginal and Torres Strait Islander backgrounds, time since mastectomy, geographical location)

Purchasing the prosthesis and receiving the reimbursement (15 mins)

  1. Was anyone’s claim rejected? (probe why)
  2. For those of you who have received the reimbursement, did the reimbursement for an external breast prosthesis under the program cover or mostly cover the cost?

  3. Do you have any feedback about paying for the breast prostheses up-front and then obtaining a reimbursement? Did paying up-front impact on you?

  4. Approximately how long did it take for you to receive the reimbursement payment into your bank account? Do you have any feedback about the timeliness of the program in making payments?

  5. What do you think about the frequency of reimbursement (every two-years) for claiming a replacement prosthesis?
Top of page

Impact of the program (20 mins)

  1. Overall, what impact, if any, has the program had on your life?

  2. Would you like to make any other comments?

Participants who have not heard about the program (25 mins)

Provide explanation about the program for those who haven't heard about it – in particular that it is a national program that allows women who have had a mastectomy as a result of breast cancer to claim for a reimbursement for the external breast prostheses through Medicare Australia.

  1. From what you now know about the program, do you think you would be interested in claiming for a reimbursement through the program? (Probe why/not)

  2. In your view, what would be the best way to inform women about the program, particularly if they had their mastectomy some years ago and are not currently under the care of a health care professional? (probe: internet, through breast care nurse, through breast cancer support organisation, through local breast cancer support group, through Medicare Australia, through GP, through the Department of Health and Ageing, through word of mouth, other etc)

  3. Are there any other comments you would like to make about this program?

Participants who have not claimed under the program (25 mins)

  1. For what reason/s did you choose not to claim for the reimbursement? (Prompt: have not heard about the program, claimed through private health cover or the Department of Veteran's Affairs, could not afford the up front payment of a prostheses, chose not to, felt it didn't meet my needs or wasn't appropriate for my condition, was advised by Medicare Australia that wouldn't be able to claim, other etc)

  2. From what you now know about the program, do you think you would claim for a reimbursement through the program? (Probe why/not)

  3. In your view, what would be the best way to inform women about the program particularly if they had their mastectomy some years ago and are not currently under the care of a breast nurse or other clinician?

  4. Are there any other comments you would like to make about this program?