AHRQ Quality indicators Workgroup on Risk Adjustment Approaches to Administrative Data, 28345-28346 [06-4574]
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Federal Register / Vol. 71, No. 94 / Tuesday, May 16, 2006 / Notices
Topics to be discussed during this
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(including ‘‘indigenous’’ peoples of the
U.S. and the Pacific Islands),
Information Technology’s Role in
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Dated: May 8, 2006.
Mirtha R. Beadle,
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Office of Public Health and Science, Office
of the Secretary, Department of Health and
Human Services.
[FR Doc. E6–7438 Filed 5–15–06; 8:45 am]
BILLING CODE 4150–29–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Agency for Healthcare Research and
Quality
AHRQ Quality indicators Workgroup
on Risk Adjustment Approaches to
Administrative Data
Agency for Healthcare Research
and Quality (AHRQ), HHS.
ACTION: Notice of request for
nominations.
sroberts on PROD1PC70 with NOTICES
SUMMARY: The Agency for Healthcare
Research and Quality (AHRQ) is seeking
nominations for members of an AHRQconvened Workgroup on risk
adjustment specifically aimed at the
AHRQ Quality Indicators (QIS). This
Workgroup is being formed as part of a
structured approach for evaluating riskadjustment and the appropriateness of
hierarchical modeling methodology for
16:06 May 15, 2006
Jkt 208001
Please submit nominations on or
before June 15, 2006. Self-nominations
are welcome. Third-party nominations
must indicate that the individual has
been contacted and is willing to serve
on the workgroup. Notification of
selected candidates will be contacted by
AHRQ no later than June 29, 2006.
ADDRESSES: Nominations can be sent in
the form of a letter or e-mail, preferably
as an electronic file with an e-mail
attachment and should specifically
address the submission criteria as noted
below. electronic submissions are
strongly encouraged. Responses should
be submitted to:
DATES:
AGENCY:
VerDate Aug<31>2005
the AHRQ Quality Indicators at the area
and/or provider levels. The Workgroup
will evaluate appropriate technical and
methodological approaches currently
available, and will also discuss and
suggest strategies as to what risk
adjustment approach(s), if any, would
best fit AHRQ QI user needs. As part of
this effort and using the AHRQ QIs, the
Workgroup member will be addressing
several key issues for the development
of a risk adjustment methodology,
including but not limited to:
• Statistical and methodological
issues related to the development and
validation of risk adjusted models that
predict patient outcomes using
administrative data, and are suitable for
assessing quality at different levels
(individual hospital, State, region).
• Methods for comparing the
performance of hierarchical methods
with previously employed methods
based on administrative data to improve
predictive and discriminant ability, and
overall fit.
• Appropriate use of sub-sampling
techniques for model validation.
• Computation of confidence
intervals for assessing provider-specific
and State-level performance in
comparison to national summary
statistics (means or percentiles).
For additional information about the
AHRQ QIs, please visit the AHRQ Web
site at https://
www.qualityindicators.ahrq.gov.
Specifically, the AHRQ QIs Risk
Adjustment Workgroup will consist of
up to 9 individuals who are familiar
with different risk adjustment
methodologies including hierarchical
modeling approaches. The Workgroup
will have a series of conference calls to
discuss the technical and policy issues
surrounding risk adjustment for the
AHRQ QIs and will then assist AHRQ in
developing a report that will aim to
summarize the discussions and
suggestions of the workgroup, which
will be made available for public
comment.
PO 00000
Frm 00050
Fmt 4703
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28345
ATTN: Project Officer, AHRQ Quality
Indicators Project, Agency for
Healthcare Research and Quality,
Center for Delivery, Organization and
Markets, 540 Gaither Road, Room
5121, Rockville, MD 20850, E-mail:
projectofficer@qualityindicators.
ahrq.gov.
Submission Criteria
To be considered for membership on
the AHRQ QI Workgroup, please send
the following information for each
nominee:
1. A brief nomination letter
highlighting experience/knowledge
relevant in the development and use of
risk adjustment methodology including
hierarchical modeling approaches and
familiarity with the AHRQ QIs and
health care administrative data. (See
selection criteria below.) Please include
full contact information of nominee:
name, title, organization, mailing
address, telephone and fax numbers,
and e-mail address.
2. Curriculum vita (with citations to
any pertinent publications).
Nominee Selection Criteria
Nominees should have technical
expertise in health care quality
measurement development, and a
familiarity with statistical methods in
the area of risk adjustment as well as
hierarchical modeling,.
More specifically, each candidate will
be evaluated using the following
criteria:
• Knowledge of recent riskadjustment and hierarchical modeling
approaches published in the literature;
• Peer-reviewed publications relevant
to the development and use of riskadjustment, hierarchical modeling;
performance measures and reporting;
• Expertise in statistical methods
relevant to the evaluation of alternative
approaches to risk-adjustment and
hierarchical modeling;
• Experience with development of
measures based on administrative data
and its uses;
• Expertise in hospital quality
improvement and patient safety;
• Familiarity with the AHRQ Quality
Indicators and their application; and,
• Availability to participate in
conference calls and provide written
comments starting from late June
through September 2006.
Time Commitment
In an effort to provide for expert input
and for recommendations on how to
improve on the existing risk adjustment
approach to administrative data, we are
initiating a review process that will
require participation in approximately
E:\FR\FM\16MYN1.SGM
16MYN1
28346
Federal Register / Vol. 71, No. 94 / Tuesday, May 16, 2006 / Notices
four to five conference calls with some
pre and post evaluation time
(approximately 13 hours). Results from
this process will influence the
development of risk-adjustment and
hierarchical modeling approaches for
the AHRQ Quality Indicators. Beginning
in late June through September, selected
nominees will be asked to participate in
the following activities:
Workgroup Activities
1. Provide evaluative comments on
current methodology for risk-adjustment
and hierarchical modeling (2.0 hours)
and participate in subsequent
Workgroup call (1.0 hour);
2. Participate in second Workgroup
conference call to discuss suggested
changes to the current modeling
methodology, including the adoption of
hierarchical methods (1.5 hour);
3. Provide evaluative comments on
AHRQ’s new draft or revised
methodology (1.5 hour);
4. Participate in third Workgroup call
to respond to each others’ comments
and questions or provide additional
clarifications regarding draft
methodology (1.5 hours);
5. Review draft summary document
(1.5 hour);
6. Participate in fourth Workgroup
call. Provide suggestions for summary
document for public comment (2.0
hours); and,
7. Participate in final Workgroup call.
Discuss and respond to public
comments (2.0 hours).
Please note that should additional
conference calls be necessary,
Workgroup members are expected to
make every effort to participate. The
Workgroup will conduct business by
telephone, e-mail, or other electronic
means as needed.
FOR FURTHER INFORMATION CONTACT:
Mamatha Pancholi, Center for Delivery,
Organization, and Markets, Agency for
Healthcare Research and Quality, 540
Gaither Road, Rockville, MD 20850;
Phone: (301) 427–1470; Fax: (301) 427–
1430; E-mail:
mamatha.pancholi@ahrq.hhs.gov
Marybeth Farquhar, Center for
Delivery, Organization, and Markets,
Agency for Healthcare Research and
Quality, 540 Gaither Road, Rockville,
MD 20850; Phone: (301) 427–1317; Fax:
(301) 427–1430; E-mail:
marybeth.farquhar@ahrq.hhs.gov.
sroberts on PROD1PC70 with NOTICES
SUPPLEMENTARY INFORMATION:
Background
The AHRQ Quality Indicators (AHRQ
QIs) are a unique set of measures of
health care quality that make use of
readily available hospital inpatient
VerDate Aug<31>2005
16:06 May 15, 2006
Jkt 208001
administrative data. The QIs have been
used for various purposes. Some of
these include tracking, hospital selfassessment, reporting of hospitalspecific quality or pay for performance.
The AHRQ QIs are provider- and arealevel quality indicators and currently
consist of four modules: the Prevention
Quality Indicators (PQI), the Inpatient
Quality Indicators, the Patient Safety
Indicators (PSI), and the Pediatric
Quality Indicators (PedQIs). In response
to feedback from the AHRQ QI user
community, AHRQ is committed to
developing risk adjustment approaches
in an effort to provide an overall view
of quality that is complete, useful and
easily understandable to consumers and
others with the health care field.
Dated: May 8, 2006.
Carolyn M. Clancy,
Director.
[FR Doc. 06–4574 Filed 5–15–06; 8:45am]
BILLING CODE 4160–90–M
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
Proposed Criteria for Removing
Chemicals From Future Editions of
CDC’s National Report on Human
Exposure to Environmental Chemicals
Centers for Disease Control and
Prevention (CDC), Health and Human
Services (HHS).
ACTION: Notice.
AGENCY:
SUMMARY: On Monday, October 7, 2002,
CDC published final criteria for
consideration of chemicals or categories
of chemicals for possible inclusion in
future releases of CDC’s ‘‘National
Report on Human Exposure to
Environmental Chemicals (the
‘‘Report’’) and also solicited chemicals
for possible inclusion in future editions
of the ‘‘Report’’ (See Federal Register,
67 FR 62477). The final selection
criteria have remained the same since
the issuance of the 2002 notice. They
are as follows: (1) Independent scientific
data which suggest that the potential for
exposure of the U.S. population to a
particular chemical is changing (i.e.,
increasing or decreasing) or persisting;
(2) seriousness of health effects known
or suspected to result from exposure to
the chemical (for example, cancer, birth
defects, or other serious health effects);
(3) proportion of the U.S. population
likely to be exposed to levels of
chemicals of known or potential health
significance; (4) need to assess the
efficacy of public health actions to
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reduce exposure to a chemical in the
U.S. population or a large component of
the U.S. population (for example, among
children, women of childbearing age,
the elderly); (5) existence of an
analytical method that can measure the
chemical or its metabolite in blood or
urine with adequate accuracy, precision,
sensitivity, and speed; and (6)
incremental analytical cost (in dollars
and personnel) to perform the analyses
(preference is given to chemicals that
can be added readily to existing
analytical methods).
On Tuesday, September 30, 2003,
CDC published a record of the
nominated chemicals of interest that
were scored by a panel of experts in
accordance with the published selection
criteria. (See Federal Register, 68 FR
56296.) All of this information is
available on CDC’s Web site at https://
www.cdc.gov/exposurereport/
chemical_nominations.htm. Past and
future nominations do not result in
obligatory laboratory analysis or
inclusion of nominated chemicals in the
‘‘Report,’’ but rather serve to better
inform CDC about which chemicals are
of concern to the public.
CDC now requests public comment on
proposed criteria for removing
chemicals from future editions of the
‘‘Report.’’ These removal criteria (given
below) will become part of a combined
process of nominating chemicals for
inclusion in or removal from the
‘‘Report.’’ This process will include (a)
nominations from the public of
chemicals to include or remove from the
‘‘Report,’’(b) an external scoring of
nominations in accord with the
published nomination and removal
criteria, and (c) assistance from the
Board of Scientific Counselors of CDC’s
National Center for Environmental
Health/Agency for Toxic Substances
and Disease Registry in reviewing plans
for including or removing chemicals
and identifying alternatives for
monitoring specific at-risk population
subgroups. This combined process for
nomination and removal would occur
periodically (e.g., every six years). The
criteria for selecting and removing
chemicals apply only to those chemicals
published in the ‘‘Report,’’ not those
merely nominated.
The proposed removal criteria are as
follows: A chemical may be removed
from the ‘‘Report’’: (1) If a new
replacement chemical (i.e., a metabolite)
is more representative of exposure than
the chemical currently being measured
or; (2) if after three survey periods (or
not less than six years), detection rates
for all chemicals within a
methodological and chemically-related
group* are less than 5 percent for all
E:\FR\FM\16MYN1.SGM
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]]>Agencies
[Federal Register Volume 71, Number 94 (Tuesday, May 16, 2006)]
[Notices]
[Pages 28345-28346]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 06-4574]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality
AHRQ Quality indicators Workgroup on Risk Adjustment Approaches
to Administrative Data
AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS.
ACTION: Notice of request for nominations.
-----------------------------------------------------------------------
SUMMARY: The Agency for Healthcare Research and Quality (AHRQ) is
seeking nominations for members of an AHRQ-convened Workgroup on risk
adjustment specifically aimed at the AHRQ Quality Indicators (QIS).
This Workgroup is being formed as part of a structured approach for
evaluating risk-adjustment and the appropriateness of hierarchical
modeling methodology for the AHRQ Quality Indicators at the area and/or
provider levels. The Workgroup will evaluate appropriate technical and
methodological approaches currently available, and will also discuss
and suggest strategies as to what risk adjustment approach(s), if any,
would best fit AHRQ QI user needs. As part of this effort and using the
AHRQ QIs, the Workgroup member will be addressing several key issues
for the development of a risk adjustment methodology, including but not
limited to:
Statistical and methodological issues related to the
development and validation of risk adjusted models that predict patient
outcomes using administrative data, and are suitable for assessing
quality at different levels (individual hospital, State, region).
Methods for comparing the performance of hierarchical
methods with previously employed methods based on administrative data
to improve predictive and discriminant ability, and overall fit.
Appropriate use of sub-sampling techniques for model
validation.
Computation of confidence intervals for assessing
provider-specific and State-level performance in comparison to national
summary statistics (means or percentiles).
For additional information about the AHRQ QIs, please visit the
AHRQ Web site at https://www.qualityindicators.ahrq.gov.
Specifically, the AHRQ QIs Risk Adjustment Workgroup will consist
of up to 9 individuals who are familiar with different risk adjustment
methodologies including hierarchical modeling approaches. The Workgroup
will have a series of conference calls to discuss the technical and
policy issues surrounding risk adjustment for the AHRQ QIs and will
then assist AHRQ in developing a report that will aim to summarize the
discussions and suggestions of the workgroup, which will be made
available for public comment.
DATES: Please submit nominations on or before June 15, 2006. Self-
nominations are welcome. Third-party nominations must indicate that the
individual has been contacted and is willing to serve on the workgroup.
Notification of selected candidates will be contacted by AHRQ no later
than June 29, 2006.
ADDRESSES: Nominations can be sent in the form of a letter or e-mail,
preferably as an electronic file with an e-mail attachment and should
specifically address the submission criteria as noted below. electronic
submissions are strongly encouraged. Responses should be submitted to:
ATTN: Project Officer, AHRQ Quality Indicators Project, Agency for
Healthcare Research and Quality, Center for Delivery, Organization and
Markets, 540 Gaither Road, Room 5121, Rockville, MD 20850, E-mail:
projectofficer@qualityindicators.ahrq.gov.
Submission Criteria
To be considered for membership on the AHRQ QI Workgroup, please
send the following information for each nominee:
1. A brief nomination letter highlighting experience/knowledge
relevant in the development and use of risk adjustment methodology
including hierarchical modeling approaches and familiarity with the
AHRQ QIs and health care administrative data. (See selection criteria
below.) Please include full contact information of nominee: name,
title, organization, mailing address, telephone and fax numbers, and e-
mail address.
2. Curriculum vita (with citations to any pertinent publications).
Nominee Selection Criteria
Nominees should have technical expertise in health care quality
measurement development, and a familiarity with statistical methods in
the area of risk adjustment as well as hierarchical modeling,.
More specifically, each candidate will be evaluated using the
following criteria:
Knowledge of recent risk-adjustment and hierarchical
modeling approaches published in the literature;
Peer-reviewed publications relevant to the development and
use of risk-adjustment, hierarchical modeling; performance measures and
reporting;
Expertise in statistical methods relevant to the
evaluation of alternative approaches to risk-adjustment and
hierarchical modeling;
Experience with development of measures based on
administrative data and its uses;
Expertise in hospital quality improvement and patient
safety;
Familiarity with the AHRQ Quality Indicators and their
application; and,
Availability to participate in conference calls and
provide written comments starting from late June through September
2006.
Time Commitment
In an effort to provide for expert input and for recommendations on
how to improve on the existing risk adjustment approach to
administrative data, we are initiating a review process that will
require participation in approximately
[[Page 28346]]
four to five conference calls with some pre and post evaluation time
(approximately 13 hours). Results from this process will influence the
development of risk-adjustment and hierarchical modeling approaches for
the AHRQ Quality Indicators. Beginning in late June through September,
selected nominees will be asked to participate in the following
activities:
Workgroup Activities
1. Provide evaluative comments on current methodology for risk-
adjustment and hierarchical modeling (2.0 hours) and participate in
subsequent Workgroup call (1.0 hour);
2. Participate in second Workgroup conference call to discuss
suggested changes to the current modeling methodology, including the
adoption of hierarchical methods (1.5 hour);
3. Provide evaluative comments on AHRQ's new draft or revised
methodology (1.5 hour);
4. Participate in third Workgroup call to respond to each others'
comments and questions or provide additional clarifications regarding
draft methodology (1.5 hours);
5. Review draft summary document (1.5 hour);
6. Participate in fourth Workgroup call. Provide suggestions for
summary document for public comment (2.0 hours); and,
7. Participate in final Workgroup call. Discuss and respond to
public comments (2.0 hours).
Please note that should additional conference calls be necessary,
Workgroup members are expected to make every effort to participate. The
Workgroup will conduct business by telephone, e-mail, or other
electronic means as needed.
FOR FURTHER INFORMATION CONTACT: Mamatha Pancholi, Center for Delivery,
Organization, and Markets, Agency for Healthcare Research and Quality,
540 Gaither Road, Rockville, MD 20850; Phone: (301) 427-1470; Fax:
(301) 427-1430; E-mail: mamatha.pancholi@ahrq.hhs.gov
Marybeth Farquhar, Center for Delivery, Organization, and Markets,
Agency for Healthcare Research and Quality, 540 Gaither Road,
Rockville, MD 20850; Phone: (301) 427-1317; Fax: (301) 427-1430; E-
mail: marybeth.farquhar@ahrq.hhs.gov.
SUPPLEMENTARY INFORMATION:
Background
The AHRQ Quality Indicators (AHRQ QIs) are a unique set of measures
of health care quality that make use of readily available hospital
inpatient administrative data. The QIs have been used for various
purposes. Some of these include tracking, hospital self-assessment,
reporting of hospital-specific quality or pay for performance. The AHRQ
QIs are provider- and area-level quality indicators and currently
consist of four modules: the Prevention Quality Indicators (PQI), the
Inpatient Quality Indicators, the Patient Safety Indicators (PSI), and
the Pediatric Quality Indicators (PedQIs). In response to feedback from
the AHRQ QI user community, AHRQ is committed to developing risk
adjustment approaches in an effort to provide an overall view of
quality that is complete, useful and easily understandable to consumers
and others with the health care field.
Dated: May 8, 2006.
Carolyn M. Clancy,
Director.
[FR Doc. 06-4574 Filed 5-15-06; 8:45am]
BILLING CODE 4160-90-M
