Agency for Healthcare Research and Quality, 34016-34019 [E9-16567]
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34016
Federal Register / Vol. 74, No. 133 / Tuesday, July 14, 2009 / Notices
FEDERAL RESERVE SYSTEM
Sunshine Act; Notice of Meeting
TIME AND DATE: 11:30 a.m., Monday,
July 20, 2009.
PLACE: Marriner S. Eccles Federal
Reserve Board Building, 20th and C
Streets, NW., Washington, DC 20551.
STATUS: Closed.
MATTERS TO BE CONSIDERED:
1. Personnel actions (appointments,
promotions, assignments,
reassignments, and salary actions)
involving individual Federal Reserve
System employees.
2. Any items carried forward from a
previously announced meeting.
FOR MORE INFORMATION PLEASE CONTACT:
Michelle Smith, Director, or Dave
Skidmore, Assistant to the Board, Office
of Board Members at 202–452–2955.
SUPPLEMENTARY INFORMATION: You may
call 202–452–3206 beginning at
approximately 5 p.m. two business days
before the meeting for a recorded
announcement of bank and bank
holding company applications
scheduled for the meeting; or you may
contact the Board’s Web site at https://
www.federalreserve.gov for an electronic
announcement that not only lists
applications, but also indicates
procedural and other information about
the meeting.
Dated: July 10, 2009.
Robert deV. Frierson,
Deputy Secretary of the Board.
[FR Doc. E9–16843 Filed 7–10–09; 4:15 pm]
BILLING CODE 6210–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Agency for Healthcare Research and
Quality
Agency Information Collection
Activities: Proposed Collection;
Comment Request
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AGENCY: Agency for Healthcare Research
and Quality, HHS.
ACTION: Notice.
SUMMARY: This notice announces the
intention of the Agency for Healthcare
Research and Quality (AHRQ) to request
that the Office of Management and
Budget (OMB) approve the proposed
information collection project: ‘‘Medical
Expenditure Panel Survey (MEPS)
Household Component and the MEPS
Medical Provider Component through
2012.’’ In accordance with the
Paperwork Reduction Act of 1995,
Public Law 104–13 (44 U.S.C.
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Proposed Project
by providing another data point for
comparisons over time.
The MEPS–HC and MEPS–MPC are
two of three components of the MEPS:
b MEPS–HC is a sample of
households participating in the National
Health Interview Survey (NHIS) in the
prior calendar year and are interviewed
5 times over a 2 and 1/2 year period.
These 5 interviews yield two years of
information on use of and expenditures
for health care, sources of payment for
that health care, insurance status,
employment, health status and health
care quality.
b MEPS–MPC collects information
from medical and financial records
maintained by hospitals, physicians,
pharmacies, health care institutions,
and home health agencies named as
sources of care by household
respondents.
b Insurance Component (MEPS–IC):
The MEPS–IC collects information on
establishment characteristics, insurance
offerings and premiums from
employers. The MEPS–IC is conducted
by the Census Bureau for AHRQ and is
cleared separately.
This request is for the MEPS–HC and
MEPS–MPC only.
‘‘Medical Expenditure Panel Survey
(MEPS) Household Component and the
MEPS Medical Provider Component
through 2012’’
AHRQ seeks to renew the Medical
Expenditure Panel Survey Household
Component (MEPS–HC) and the MEPS
Medical Provider Component (MEPS–
MPC) through the year 2012. For over
thirty years, the results of the MEPS and
its predecessor surveys (the 1977
National Medical Care Expenditure
Survey, the 1980 National Medical Care
Utilization and Expenditure Survey and
the 1987 National Medical Expenditure
Survey) have been used by OMB, DHHS,
Congress and a wide number of health
services researchers to analyze health
care use, expenses and health policy.
AHRQ is authorized to conduct the
MEPS pursuant to 42 U.S.C. 299b–2.
Major changes continue to take place
in the health care delivery system. The
MEPS is needed to provide information
about the current state of the health care
system as well as to track changes over
time. The current MEPS design, unlike
the previous periodic surveys, permits
annual estimates of use of health care
and expenditures and sources of
payment for that health care. It also
permits tracking individual change in
employment, income, health insurance
and health status over two years. The
use of the National Health Interview
Survey (NHIS) as a sampling frame
expands the surveys’ analytic capacity
Method of Collection
The MEPS is designed to meet the
need for information to estimate health
expenses, insurance coverage, access,
use and quality. Households selected for
participation in the MEPS are
interviewed five times in person. These
rounds of interviewing are spaced about
5 months apart. The interview will take
place with a family respondent who will
report for him/herself and for other
family members.
After a preliminary mail contact
containing an advance letter,
households will be mailed MEPS record
keeping materials (a calendar) and a
DVD and brochure. After the advance
contact, households will be contacted
for the first of five in-person interviews.
The interviews are conducted as a
computer assisted personal interview
(CAPI). The CAPT instrument is
organized as a core instrument that will
repeat unchanged in each of the rounds.
Additional sections are asked only once
a year and provide greater depth.
Dependent interviewing methods in
which respondents are asked to confirm
or revise data provided in earlier
interviews will be used to update
information such as employment and
health insurance data after the round in
which such data are usually collected.
The main data collection modules for
the MEPS–HC are as follows:
Household Component Core
Instrument. The core instrument
3506(c)(2)(A)), AHRQ invites the public
to comment on this proposed
information collection.
This proposed information collection
was previously published in the Federal
Register on May 6th 2009 and allowed
60 days for public comment. No
comments were received. The purpose
of this notice is to allow an additional
30 days for public comment.
DATES: Comments on this notice must be
received by August 13, 2009.
ADDRESSES: Written comments should
be submitted to: AHRQ’s OMB Desk
Officer by fax at (202) 395–6974
(attention: AHRQ’s desk officer) or by email at OIRAsubmission@omb.eop.gov
(attention: AHRQ’s desk officer).
Copies of the proposed collection
plans, data collection instruments, and
specific details on the estimated burden
can be obtained from the AHRQ Reports
Clearance Officer.
FOR FURTHER INFORMATION CONTACT:
Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427–1477, or by
e-mail at doris.lefkowitz@ahrq.hhs.gov.
SUPPLEMENTARY INFORMATION:
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Federal Register / Vol. 74, No. 133 / Tuesday, July 14, 2009 / Notices
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collects data about persons in sample
households. Topical areas asked in each
round of interviewing include condition
enumeration, health status, health care
utilization including prescribed
medicines, expense and payment,
employment, and health insurance.
Other topical areas that are asked only
once a year include access to care,
priority conditions, income, assets,
satisfaction with health plans and
providers, children’s health, adult
preventive care. While many of the
questions are asked about the entire
reporting unit (RU), which is typically
a family, only one person normally
provides this information.
Adult Self-Administered
Questionnaire. A brief self-administered
questionnaire (SAQ), administered once
a year in rounds 2 and 4, will be used
to collect self-reported (rather than
through household proxy) information
on health status, health opinions and
satisfaction with health care for adults
18 and older.
Diabetes Care SAQ. A brief self
administered questionnaire on the
quality of diabetes care is administered
once a year in rounds 3 and 5 to persons
identified as having diabetes.
Permission forms for the MEPS–MPC.
As in previous panels of the MEPS, we
will ask respondents for permission to
obtain supplemental information from
their medical providers (hospitals,
physicians, health care institutions,
home health agencies and pharmacies).
MEPS–MPC Instruments
The main objective of the MEPS–MPC
is a collection of data from medical
providers that will serve as an
imputation source of medical
expenditure and source of payment data
reported by household respondents.
This data will supplement, replace and
verify information provided by
household respondents about the
charges, payments, and sources of
payment associated with specific health
care encounters. The questionnaires
used in the MEPS–MPC vary according
to type of provider. The data collection
instruments are as follows:
Home Care for Health Care Providers
Questionnaire. This questionnaire is
used to collect data from home health
care agencies which provide medical
care services to household respondents.
Information collected includes type of
personnel providing care, hours or visits
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provided per month, and the charges
and payments for services received.
Home Care Provider Questionnaire for
Non-Health Care Providers. This is used
to collect information about services
provided in the home by non-health
care workers to household respondents
because of a medical condition; for
example, cleaning or yard work,
transportation, shopping, or child care.
Office-based Providers Questionnaire.
This questionnaire is for the officebased physician sample, including
doctors of medicine (MDs) and
osteopathy (DOs), as well as providers
practicing under the direction or
supervision of an MD or DO (e.g.,
physician assistants and nurse
practitioners working in clinics).
Providers of care in private offices as
well as staff model HMOs are included.
Separately Billing Doctors
Questionnaire. Information from
physicians identified by hospitals as
providing care to sampled persons
during the course of inpatient,
outpatient department or emergency
room care, but who bill separately from
the hospital, is collected in this
questionnaire.
Hospitals Questionnaire. This
questionnaire is used to collect
information about hospital events,
including inpatient stays, outpatient
department, and emergency room visits.
Hospital data are collected not only
from the billing department, but from
medical records and administrative
records departments as well. Medical
records departments are contacted to
determine the names of all the doctors
who treated the patient during a stay or
visit. In many cases, the hospital
administrative office also has to be
contacted to determine whether the
doctors identified by medical records
billed separately from the hospital itself.
Institutions Questionnaire. This
questionnaire is used to collect data
from health care institutions providing
care to sampled persons and includes
nursing homes, assisted living facilities,
rehabilitation facilities, as well as any
other health care facilities providing
health care to a sampled person.
Pharmacies Questionnaire. This
questionnaire requests the prescription
name, NDC code, date prescription was
filled, payments by source, prescription
strength, form and quantity, and person
for whom the prescription was filled.
Most pharmacies have the requested
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34017
information available in electronic
format and respond by providing a
computer generated printout of the
patient’s prescription information. If the
computerized form is unavailable, the
pharmacy can report their data to a
telephone interviewer.
Estimated Annual Respondent Burden
Exhibit I shows the estimated
annualized burden hours for the
respondents time to participate in the
MEPS–HC and MEPS–MPC. The MEPS–
HC Core Interview will be completed by
15,000 ‘‘family level’’ respondents, also
referred to as RU respondents. Since the
MEPS–HC consists of 5 rounds of
interviewing covering a full two years of
data, the annual average number of
responses per respondent is 2.5
responses per year. The MEPS–HC core
requires an average response time of 1
and 2 hours to administer. The Adult
SAQ will be completed once a year by
each person in the RU that is 18 years
old and older, an estimated 21,000
persons. The Adult SAQ requires an
average of 7 minutes to complete. The
Diabetes care SAQ will be completed
once a year by each person in the RU
identified as having diabetes, an
estimated 1,800 persons and takes about
3 minutes to complete. Permission
forms for the MEPS–MPC will be
completed once for each medical
provider seen by any RU member. Each
of the 15,000 RUs in the MEPS–HC will
complete an average of 5.2 forms, which
require about 3 minutes each to
complete. The total annual burden
hours for the MEPS–HC is estimated to
be 62,690 hours.
The MEPS–MPC uses 7 different
questionnaires; 6 for medical providers
and 1 for pharmacies. Each
questionnaire is relatively short and
requires 3 to 5 minutes to complete.
The total annual burden hours for the
MEPS–MPC is estimated to be 20,077
hours. The total annual burden hours
for the MEPS–HC and MPC is estimated
to be 82,767 hours.
Exhibit 2 shows the estimated annual
cost burden associated with the
respondents’ time to participate in this
information collection. The annual cost
burden for the MEPS–HC is estimated to
be $1,226,216; the annual cost burden
for the MEPS–MPC is estimated to be
$285,965.
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Federal Register / Vol. 74, No. 133 / Tuesday, July 14, 2009 / Notices
EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS
Number of
respondents
Form name
Number of
responses per
respondent
Hours per
response
Total burden
hours
MEPS–HC
MEPS–HC Core Interview ...............................................................................
Adult SAQ ........................................................................................................
Diabetes care SAQ ..........................................................................................
Permission forms for the MEPS–MPC ............................................................
15,000
21,000
1,800
15,000
2.5
1
1
5.2
1.5
7/60
3/60
3/60
56,250
2,450
90
3,900
Subtotal for the MEPS–HC .......................................................................
52,800
na
na
62,690
Home care for health care providers questionnaire ........................................
Home care for non-health care providers questionnaire .................................
Office-based providers questionnaire ..............................................................
Separately billing doctors questionnaire ..........................................................
Hospitals questionnaire ...................................................................................
Institutions (non-hospital) questionnaire ..........................................................
Pharmacies questionnaire ...............................................................................
441
23
13,665
12,450
5,402
72
7,760
6.5
6.6
5.8
2
6.5
1.5
23.3
5/60
5/60
5/60
3/60
5/60
5/60
3/60
239
13
6,605
1,245
2,926
9
9,040
Subtotal for the MEPS–MPC ....................................................................
39,813
na
na
20,077
Grand Total .......................................................................................
92,613
na
na
82,767
MEPS–MPC
EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN
Number of
respondents
Form name
Average
hourly
wage rate*
Total burden
hours
Total cost
burden
MEPS–IIC
MEPS–HC Core Interview ...............................................................................
Adult SAQ ........................................................................................................
Diabetes care SAQ ..........................................................................................
Permission forms for the MEPS–MPC ............................................................
15,000
21,000
1,800
15,000
56,250
2,450
90
3,900
$19.56
19.56
19.56
19.56
$1,100,250
47,922
1,760
76,284
Subtotal for the MEPS–HC .......................................................................
52,800
62,690
na
1,226,216
Home care for health care providers questionnaire ........................................
Home care for non-health care providers questionnaire .................................
Office-based providers questionnaire ..............................................................
Separately billing doctors questionnaire ..........................................................
Hospitals questionnaire ...................................................................................
Institutions (non-hospital) questionnaire ..........................................................
Pharmacies questionnaire ...............................................................................
441
23
13,665
12,450
5,402
72
7,760
239
13
6,605
1,245
2,926
9
9,040
14.24
19.56
14.24
14.24
14.24
14.24
14.24
3,403
254
94,055
17,729
41,666
128
128,730
Subtotal for the MEPS–MPC ....................................................................
39,813
20,077
na
285,965
Grand Total .......................................................................................
92,613
82,767
na
1,512,181
MEPS–MPC
* Based upon the mean of the average wages for Healthcare Support Workers, All Other (319099) and All Occupations (00–0000), Occupational Employment Statistics, May 2007 National Occupational Employment and Wage Estimates United States, U.S. Department of Labor, Bureau of Labor Statistics. https://www.bls.gov/oes/current/oes_nat.htm#b29–0000.
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Estimated Annual Costs to the Federal
Government
Exhibit 3 shows the total and
annualized cost of this information
collection. The cost associated with the
design and data collection of the MEPS–
HC and MEPS–MPC is estimated to be
$47.6 million in each of the next three
fiscal years.
EXHIBIT 3—ESTIMATED TOTAL AND ANNUALIZED COST
Total cost
(millions)
Cost component
Sampling Activities .......................................................................................................................................
Interviewer Recruitment and Training .........................................................................................................
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$2.79
8.52
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Annualized cost
(millions)
$0.93
2.84
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Federal Register / Vol. 74, No. 133 / Tuesday, July 14, 2009 / Notices
EXHIBIT 3—ESTIMATED TOTAL AND ANNUALIZED COST—Continued
Total cost
(millions)
Cost component
Annualized cost
(millions)
Data Collection Activities .............................................................................................................................
Data Processing ..........................................................................................................................................
Production of Public Use Data Files ...........................................................................................................
Project Management ....................................................................................................................................
86.7
21.39
19.53
3.93
28.9
7.13
6.51
1.31
Total ......................................................................................................................................................
142.8
47.6
Request for Comments
In accordance with the above-cited
Paperwork Reduction Act legislation,
comments on AHRQ’s information
collection are requested with regard to
any of the following: (a) Whether the
proposed collection of information is
necessary for the proper performance of
AHRQ health care research and health
care information dissemination
functions, including whether the
information will have practical utility;
(b) the accuracy of AHRQ’s estimate of
burden (including hours and costs) of
the proposed collection(s) of
information; (c) ways to enhance the
quality, utility, and clarity of the
information to be collected; and (d)
ways to minimize the burden of the
collection of information upon the
respondents, including the use of
automated collection techniques or
other forms of information technology.
Comments submitted in response to
this notice will be summarized and
included in the Agency’s subsequent
request for OMB approval of the
proposed information collection. All
comments will become a matter of
public record.
Dated: July 1, 2009.
Carolyn M. Clancy,
Director.
[FR Doc. E9–16567 Filed 7–13–09; 8:45 am]
information collection under the
project: ‘‘Evaluation of AHRQ’s Effective
Health Care Program.’’ In accordance
with the Paperwork Reduction Act of
1995, Public Law 104–13 (44 U.S.C.
3506(c)(2)(A)), AHRQ invites the public
to comment on this proposed
information collection.
This proposed information collection
was previously published in the Federal
Register on April 24th, 2009 and
allowed 60 days for public comment. No
comments were received. The purpose
of this notice is to allow an additional
30 days for public comment.
DATES: Comments on this notice must be
received by August 13, 2009.
ADDRESSES: Written comments should
be submitted to: AHRQs OMB Desk
Officer by fax at (202) 395–6974
(attention: AHRQ’s desk officer) or by email at OIRA_submission@omb.eop.gov
(attention: AHRQ’s desk officer).
Copies of the proposed collection
plans, data collection instruments, and
specific details on the estimated burden
can be obtained from the AHRQ Reports
Clearance Officer.
FOR FURTHER INFORMATION CONTACT:
Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427–1477, or by
e-mail at doris.lefkowitz@ahrq.hhs.gov.
SUPPLEMENTARY INFORMATION:
Proposed Project
BILLING CODE 4160–90–M
’’Evaluation of AHRQ’s Effective Health
Care Program’’
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
AHRQ proposes to perform an
evaluation of the Effective Health Care
(EHC) programs’ governance structure,
methods for engaging stakeholders and
approaches to setting national research
priorities. Pursuant to Section 1013 of
the Medicare Prescription Drug,
Improvement, and Modernization Act of
2003, Public Law 108–173, the EHC
program was established by AHRQ to
conduct research, demonstrations, and
evaluations designed to improve the
quality, effectiveness, and efficiency of
Medicare, Medicaid, and the State
Children’s Health Insurance Program.
The EHC program was designed to
provide effectiveness and comparative
effectiveness evidence of medical
Agency for Healthcare Research and
Quality
mstockstill on DSKH9S0YB1PROD with NOTICES
Agency Information Collection
Activities: Proposed Collection;
Comment Request
AGENCY: Agency for Healthcare Research
and Quality, HHS.
ACTION: Notice.
SUMMARY: This notice announces the
intention of the Agency for Healthcare
Research and Quality (AHRQ) to request
that the Office of Management and
Budget (OMB) approve the proposed
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17:50 Jul 13, 2009
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treatments, therapeutics, devices and
drugs to assist policymakers, health care
providers, clinicians, consumers, and
other stakeholders in making informed
decisions. The EHC program has offered
a platform for combining explicit
reviews of scientific evidence on the
clinical effectiveness of pharmaceuticals
and other health care interventions, as
well as the translation and
dissemination of scientific findings into
meaningfui messages for a wide variety
of audiences. It serves as an interface
between the clinical research entities
and health policy making entities. This
program also provides a critical step in
AHRQ’s mission to support informed
decision making. In addition to its
program staff, the EHC program relies
on four centers to generate and
disseminate evidence: The Evidencebased Practice Centers (EPCs), the
Developing Evidence to Inform
Decisions about Effectiveness (DEcIDE)
Network Centers, the John M. Eisenberg
Clinical Decisions and Communications
Science Center, and the Centers for
Education & Research on Therapeutics
(CERTs). Since the process of
developing and disseminating this
evidence is a complex undertaking,
AHRQ has contracted with IMPAQ
International, LLC and Abt Associates,
Inc. (henceforth referred to as the
‘‘IMPAQ team’’) to perform this
evaluation.
Information will be collected to
identify strengths and weaknesses in the
current EHC program’s governance
structure, methods for engaging
stakeholders, and approaches to setting
priorities for the research conducted by
the EHC program. The second phase of
the evaluation will be to contrast the
EHC program with international
programs of similar purpose. To
implement this evaluation, the IMPAQ
team will conduct the following
information collections:
(1) Key informant interviews about
the governance structure of the EHC
program;
(2) An online survey of EHC center
staff and EHC program users and
stakeholders;
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]]>Agencies
[Federal Register Volume 74, Number 133 (Tuesday, July 14, 2009)]
[Notices]
[Pages 34016-34019]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-16567]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Agency for Healthcare Research and Quality, HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: This notice announces the intention of the Agency for
Healthcare Research and Quality (AHRQ) to request that the Office of
Management and Budget (OMB) approve the proposed information collection
project: ``Medical Expenditure Panel Survey (MEPS) Household Component
and the MEPS Medical Provider Component through 2012.'' In accordance
with the Paperwork Reduction Act of 1995, Public Law 104-13 (44 U.S.C.
3506(c)(2)(A)), AHRQ invites the public to comment on this proposed
information collection.
This proposed information collection was previously published in
the Federal Register on May 6th 2009 and allowed 60 days for public
comment. No comments were received. The purpose of this notice is to
allow an additional 30 days for public comment.
DATES: Comments on this notice must be received by August 13, 2009.
ADDRESSES: Written comments should be submitted to: AHRQ's OMB Desk
Officer by fax at (202) 395-6974 (attention: AHRQ's desk officer) or by
e-mail at OIRAsubmission@omb.eop.gov (attention: AHRQ's desk officer).
Copies of the proposed collection plans, data collection
instruments, and specific details on the estimated burden can be
obtained from the AHRQ Reports Clearance Officer.
FOR FURTHER INFORMATION CONTACT: Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427-1477, or by e-mail at
doris.lefkowitz@ahrq.hhs.gov.
SUPPLEMENTARY INFORMATION:
Proposed Project
``Medical Expenditure Panel Survey (MEPS) Household Component and the
MEPS Medical Provider Component through 2012''
AHRQ seeks to renew the Medical Expenditure Panel Survey Household
Component (MEPS-HC) and the MEPS Medical Provider Component (MEPS-MPC)
through the year 2012. For over thirty years, the results of the MEPS
and its predecessor surveys (the 1977 National Medical Care Expenditure
Survey, the 1980 National Medical Care Utilization and Expenditure
Survey and the 1987 National Medical Expenditure Survey) have been used
by OMB, DHHS, Congress and a wide number of health services researchers
to analyze health care use, expenses and health policy. AHRQ is
authorized to conduct the MEPS pursuant to 42 U.S.C. 299b-2.
Major changes continue to take place in the health care delivery
system. The MEPS is needed to provide information about the current
state of the health care system as well as to track changes over time.
The current MEPS design, unlike the previous periodic surveys, permits
annual estimates of use of health care and expenditures and sources of
payment for that health care. It also permits tracking individual
change in employment, income, health insurance and health status over
two years. The use of the National Health Interview Survey (NHIS) as a
sampling frame expands the surveys' analytic capacity by providing
another data point for comparisons over time.
The MEPS-HC and MEPS-MPC are two of three components of the MEPS:
[squ] MEPS-HC is a sample of households participating in the
National Health Interview Survey (NHIS) in the prior calendar year and
are interviewed 5 times over a 2 and 1/2 year period. These 5
interviews yield two years of information on use of and expenditures
for health care, sources of payment for that health care, insurance
status, employment, health status and health care quality.
[squ] MEPS-MPC collects information from medical and financial
records maintained by hospitals, physicians, pharmacies, health care
institutions, and home health agencies named as sources of care by
household respondents.
[squ] Insurance Component (MEPS-IC): The MEPS-IC collects
information on establishment characteristics, insurance offerings and
premiums from employers. The MEPS-IC is conducted by the Census Bureau
for AHRQ and is cleared separately.
This request is for the MEPS-HC and MEPS-MPC only.
Method of Collection
The MEPS is designed to meet the need for information to estimate
health expenses, insurance coverage, access, use and quality.
Households selected for participation in the MEPS are interviewed five
times in person. These rounds of interviewing are spaced about 5 months
apart. The interview will take place with a family respondent who will
report for him/herself and for other family members.
After a preliminary mail contact containing an advance letter,
households will be mailed MEPS record keeping materials (a calendar)
and a DVD and brochure. After the advance contact, households will be
contacted for the first of five in-person interviews. The interviews
are conducted as a computer assisted personal interview (CAPI). The
CAPT instrument is organized as a core instrument that will repeat
unchanged in each of the rounds. Additional sections are asked only
once a year and provide greater depth. Dependent interviewing methods
in which respondents are asked to confirm or revise data provided in
earlier interviews will be used to update information such as
employment and health insurance data after the round in which such data
are usually collected. The main data collection modules for the MEPS-HC
are as follows:
Household Component Core Instrument. The core instrument
[[Page 34017]]
collects data about persons in sample households. Topical areas asked
in each round of interviewing include condition enumeration, health
status, health care utilization including prescribed medicines, expense
and payment, employment, and health insurance. Other topical areas that
are asked only once a year include access to care, priority conditions,
income, assets, satisfaction with health plans and providers,
children's health, adult preventive care. While many of the questions
are asked about the entire reporting unit (RU), which is typically a
family, only one person normally provides this information.
Adult Self-Administered Questionnaire. A brief self-administered
questionnaire (SAQ), administered once a year in rounds 2 and 4, will
be used to collect self-reported (rather than through household proxy)
information on health status, health opinions and satisfaction with
health care for adults 18 and older.
Diabetes Care SAQ. A brief self administered questionnaire on the
quality of diabetes care is administered once a year in rounds 3 and 5
to persons identified as having diabetes.
Permission forms for the MEPS-MPC. As in previous panels of the
MEPS, we will ask respondents for permission to obtain supplemental
information from their medical providers (hospitals, physicians, health
care institutions, home health agencies and pharmacies).
MEPS-MPC Instruments
The main objective of the MEPS-MPC is a collection of data from
medical providers that will serve as an imputation source of medical
expenditure and source of payment data reported by household
respondents. This data will supplement, replace and verify information
provided by household respondents about the charges, payments, and
sources of payment associated with specific health care encounters. The
questionnaires used in the MEPS-MPC vary according to type of provider.
The data collection instruments are as follows:
Home Care for Health Care Providers Questionnaire. This
questionnaire is used to collect data from home health care agencies
which provide medical care services to household respondents.
Information collected includes type of personnel providing care, hours
or visits provided per month, and the charges and payments for services
received.
Home Care Provider Questionnaire for Non-Health Care Providers.
This is used to collect information about services provided in the home
by non-health care workers to household respondents because of a
medical condition; for example, cleaning or yard work, transportation,
shopping, or child care.
Office-based Providers Questionnaire. This questionnaire is for the
office-based physician sample, including doctors of medicine (MDs) and
osteopathy (DOs), as well as providers practicing under the direction
or supervision of an MD or DO (e.g., physician assistants and nurse
practitioners working in clinics). Providers of care in private offices
as well as staff model HMOs are included.
Separately Billing Doctors Questionnaire. Information from
physicians identified by hospitals as providing care to sampled persons
during the course of inpatient, outpatient department or emergency room
care, but who bill separately from the hospital, is collected in this
questionnaire.
Hospitals Questionnaire. This questionnaire is used to collect
information about hospital events, including inpatient stays,
outpatient department, and emergency room visits. Hospital data are
collected not only from the billing department, but from medical
records and administrative records departments as well. Medical records
departments are contacted to determine the names of all the doctors who
treated the patient during a stay or visit. In many cases, the hospital
administrative office also has to be contacted to determine whether the
doctors identified by medical records billed separately from the
hospital itself.
Institutions Questionnaire. This questionnaire is used to collect
data from health care institutions providing care to sampled persons
and includes nursing homes, assisted living facilities, rehabilitation
facilities, as well as any other health care facilities providing
health care to a sampled person.
Pharmacies Questionnaire. This questionnaire requests the
prescription name, NDC code, date prescription was filled, payments by
source, prescription strength, form and quantity, and person for whom
the prescription was filled. Most pharmacies have the requested
information available in electronic format and respond by providing a
computer generated printout of the patient's prescription information.
If the computerized form is unavailable, the pharmacy can report their
data to a telephone interviewer.
Estimated Annual Respondent Burden
Exhibit I shows the estimated annualized burden hours for the
respondents time to participate in the MEPS-HC and MEPS-MPC. The MEPS-
HC Core Interview will be completed by 15,000 ``family level''
respondents, also referred to as RU respondents. Since the MEPS-HC
consists of 5 rounds of interviewing covering a full two years of data,
the annual average number of responses per respondent is 2.5 responses
per year. The MEPS-HC core requires an average response time of 1 and 2
hours to administer. The Adult SAQ will be completed once a year by
each person in the RU that is 18 years old and older, an estimated
21,000 persons. The Adult SAQ requires an average of 7 minutes to
complete. The Diabetes care SAQ will be completed once a year by each
person in the RU identified as having diabetes, an estimated 1,800
persons and takes about 3 minutes to complete. Permission forms for the
MEPS-MPC will be completed once for each medical provider seen by any
RU member. Each of the 15,000 RUs in the MEPS-HC will complete an
average of 5.2 forms, which require about 3 minutes each to complete.
The total annual burden hours for the MEPS-HC is estimated to be 62,690
hours.
The MEPS-MPC uses 7 different questionnaires; 6 for medical
providers and 1 for pharmacies. Each questionnaire is relatively short
and requires 3 to 5 minutes to complete.
The total annual burden hours for the MEPS-MPC is estimated to be
20,077 hours. The total annual burden hours for the MEPS-HC and MPC is
estimated to be 82,767 hours.
Exhibit 2 shows the estimated annual cost burden associated with
the respondents' time to participate in this information collection.
The annual cost burden for the MEPS-HC is estimated to be $1,226,216;
the annual cost burden for the MEPS-MPC is estimated to be $285,965.
[[Page 34018]]
Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
Number of
Form name Number of responses per Hours per Total burden
respondents respondent response hours
----------------------------------------------------------------------------------------------------------------
MEPS-HC
----------------------------------------------------------------------------------------------------------------
MEPS-HC Core Interview.......................... 15,000 2.5 1.5 56,250
Adult SAQ....................................... 21,000 1 7/60 2,450
Diabetes care SAQ............................... 1,800 1 3/60 90
Permission forms for the MEPS-MPC............... 15,000 5.2 3/60 3,900
---------------------------------------------------------------
Subtotal for the MEPS-HC.................... 52,800 na na 62,690
----------------------------------------------------------------------------------------------------------------
MEPS-MPC
----------------------------------------------------------------------------------------------------------------
Home care for health care providers 441 6.5 5/60 239
questionnaire..................................
Home care for non-health care providers 23 6.6 5/60 13
questionnaire..................................
Office-based providers questionnaire............ 13,665 5.8 5/60 6,605
Separately billing doctors questionnaire........ 12,450 2 3/60 1,245
Hospitals questionnaire......................... 5,402 6.5 5/60 2,926
Institutions (non-hospital) questionnaire....... 72 1.5 5/60 9
Pharmacies questionnaire........................ 7,760 23.3 3/60 9,040
---------------------------------------------------------------
Subtotal for the MEPS-MPC................... 39,813 na na 20,077
---------------------------------------------------------------
Grand Total............................. 92,613 na na 82,767
----------------------------------------------------------------------------------------------------------------
Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
Average
Form name Number of Total burden hourly wage Total cost
respondents hours rate* burden
----------------------------------------------------------------------------------------------------------------
MEPS-IIC
----------------------------------------------------------------------------------------------------------------
MEPS-HC Core Interview.......................... 15,000 56,250 $19.56 $1,100,250
Adult SAQ....................................... 21,000 2,450 19.56 47,922
Diabetes care SAQ............................... 1,800 90 19.56 1,760
Permission forms for the MEPS-MPC............... 15,000 3,900 19.56 76,284
---------------------------------------------------------------
Subtotal for the MEPS-HC.................... 52,800 62,690 na 1,226,216
----------------------------------------------------------------------------------------------------------------
MEPS-MPC
----------------------------------------------------------------------------------------------------------------
Home care for health care providers 441 239 14.24 3,403
questionnaire..................................
Home care for non-health care providers 23 13 19.56 254
questionnaire..................................
Office-based providers questionnaire............ 13,665 6,605 14.24 94,055
Separately billing doctors questionnaire........ 12,450 1,245 14.24 17,729
Hospitals questionnaire......................... 5,402 2,926 14.24 41,666
Institutions (non-hospital) questionnaire....... 72 9 14.24 128
Pharmacies questionnaire........................ 7,760 9,040 14.24 128,730
---------------------------------------------------------------
Subtotal for the MEPS-MPC................... 39,813 20,077 na 285,965
---------------------------------------------------------------
Grand Total............................. 92,613 82,767 na 1,512,181
----------------------------------------------------------------------------------------------------------------
* Based upon the mean of the average wages for Healthcare Support Workers, All Other (319099) and All
Occupations (00-0000), Occupational Employment Statistics, May 2007 National Occupational Employment and Wage
Estimates United States, U.S. Department of Labor, Bureau of Labor Statistics. https://www.bls.gov/oes/current/oes_nat.htm#b29-0000.
Estimated Annual Costs to the Federal Government
Exhibit 3 shows the total and annualized cost of this information
collection. The cost associated with the design and data collection of
the MEPS-HC and MEPS-MPC is estimated to be $47.6 million in each of
the next three fiscal years.
Exhibit 3--Estimated Total and Annualized Cost
------------------------------------------------------------------------
Total cost Annualized cost
Cost component (millions) (millions)
------------------------------------------------------------------------
Sampling Activities............... $2.79 $0.93
Interviewer Recruitment and 8.52 2.84
Training.........................
[[Page 34019]]
Data Collection Activities........ 86.7 28.9
Data Processing................... 21.39 7.13
Production of Public Use Data 19.53 6.51
Files............................
Project Management................ 3.93 1.31
-------------------------------------
Total......................... 142.8 47.6
------------------------------------------------------------------------
Request for Comments
In accordance with the above-cited Paperwork Reduction Act
legislation, comments on AHRQ's information collection are requested
with regard to any of the following: (a) Whether the proposed
collection of information is necessary for the proper performance of
AHRQ health care research and health care information dissemination
functions, including whether the information will have practical
utility; (b) the accuracy of AHRQ's estimate of burden (including hours
and costs) of the proposed collection(s) of information; (c) ways to
enhance the quality, utility, and clarity of the information to be
collected; and (d) ways to minimize the burden of the collection of
information upon the respondents, including the use of automated
collection techniques or other forms of information technology.
Comments submitted in response to this notice will be summarized
and included in the Agency's subsequent request for OMB approval of the
proposed information collection. All comments will become a matter of
public record.
Dated: July 1, 2009.
Carolyn M. Clancy,
Director.
[FR Doc. E9-16567 Filed 7-13-09; 8:45 am]
BILLING CODE 4160-90-M
