Agency for Healthcare Research and Quality Agency Information Collection Activities: Proposed Collection; Comment Request, 52238-52241 [E9-24305]
Download as PDF
<![CDATA[
52238
Federal Register / Vol. 74, No. 195 / Friday, October 9, 2009 / Notices
Reports Clearance Office on (410) 786–
1326.
In commenting on the proposed
information collections please reference
the document identifier or OMB control
number. To be assured consideration,
comments and recommendations must
be submitted in one of the following
ways by December 8, 2009:
1. Electronically. You may submit
your comments electronically to
https://www.regulations.gov. Follow the
instructions for ‘‘Comment or
Submission’’ or ‘‘More Search Options’’
to find the information collection
document(s) accepting comments.
2. By regular mail. You may mail
written comments to the following
address: CMS, Office of Strategic
Operations and Regulatory Affairs,
Division of Regulations Development,
Attention: Document Identifier/OMB
Control Number, Room C4–26–05, 7500
Security Boulevard, Baltimore,
Maryland 21244–1850.
Dated: October 1, 2009.
Michelle Shortt,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
[FR Doc. E9–24236 Filed 10–8–09; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier CMS–10287]
mstockstill on DSKH9S0YB1PROD with NOTICES
Agency Information Collection
Activities: Submission for OMB
Review; Comment Request
AGENCY: Centers for Medicare &
Medicaid Services, HHS.
In compliance with the requirement
of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the
Centers for Medicare & Medicaid
Services (CMS), Department of Health
and Human Services, is publishing the
following summary of proposed
collections for public comment.
Interested persons are invited to send
comments regarding this burden
estimate or any other aspect of this
collection of information, including any
of the following subjects: (1) The
necessity and utility of the proposed
information collection for the proper
performance of the Agency’s function;
(2) the accuracy of the estimated
burden; (3) ways to enhance the quality,
utility, and clarity of the information to
be collected; and (4) the use of
automated collection techniques or
VerDate Nov<24>2008
16:05 Oct 08, 2009
Jkt 220001
other forms of information technology to
minimize the information collection
burden.
1. Type of Information Collection
Request: New collection; Title of
Information Collection: Medicare
Quality of Care Complaint Form; Use: In
accordance with section 1154(a)(14) of
the Social Security Act, Quality
Improvement Organizations (QIOs) are
required to conduct appropriate reviews
of all written complaints submitted by
beneficiaries concerning the quality of
care received. The Medicare Quality of
Care Complaint Form will be used by
Medicare beneficiaries to submit quality
of care complaints. This form will
establish a standard form for all
beneficiaries to utilize and ensure
pertinent information is obtained by
QIOs to effectively process these
complaints. Form Number: CMS–10287
(OMB#: 0938–New); Frequency:
Reporting—On occasion; Affected
Public: Individuals or Households;
Number of Respondents: 3,500; Total
Annual Responses: 3,500; Total Annual
Hours: 583. (For policy questions
regarding this collection contact Tom
Kessler at 410–786–1991. For all other
issues call 410–786–1326.)
To obtain copies of the supporting
statement and any related forms for the
proposed paperwork collections
referenced above, access CMS Web Site
address at https://www.cms.hhs.gov/
PaperworkReductionActof1995, or Email your request, including your
address, phone number, OMB number,
and CMS document identifier, to
Paperwork@cms.hhs.gov, or call the
Reports Clearance Office on (410) 786–
1326.
To be assured consideration,
comments and recommendations for the
proposed information collections must
be received by the OMB desk officer at
the address below, no later than 5 p.m.
on November 9, 2009.
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 (0MB) 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 6, 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 November 9, 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 OIRA_submissionomb.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:
OMB, Office of Information and
Regulatory Affairs, Attention: CMS
Desk Officer, Fax Number: (202) 395–
6974, E-mail:
OIRA_submission@omb.eop.gov.
Proposed Project
Dated: October 1, 2009.
Michelle Shortt,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
[FR Doc. E9–24233 Filed 10–8–09; 8:45 am]
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
BILLING CODE 4120–01–P
PO 00000
Frm 00065
Fmt 4703
Sfmt 4703
‘‘Medical Expenditure Panel Survey
(MEPS) Household Component and the
MEPS Medical Provider Component
Through 2012’’
E:\FR\FM\09OCN1.SGM
09OCN1
Federal Register / Vol. 74, No. 195 / Friday, October 9, 2009 / Notices
mstockstill on DSKH9S0YB1PROD with NOTICES
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:
• 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 21⁄2 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.
• 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.
• 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,
VerDate Nov<24>2008
16:05 Oct 08, 2009
Jkt 220001
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 CAPI 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
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.
PO 00000
Frm 00066
Fmt 4703
Sfmt 4703
52239
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 officebased physician sample, including
doctors of medicine (MDs) and
osteopathy (DOs), as well as providers
practicing under the direction or
supervision of an MO 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
questionnaires.
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
E:\FR\FM\09OCN1.SGM
09OCN1
52240
Federal Register / Vol. 74, No. 195 / Friday, October 9, 2009 / Notices
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 1 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 MEPSHC core
requires an average response time of 11⁄2
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. 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.
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
Total burden
hours
Average hourly wage rate*
Total cost
burden
MEPS–HC
mstockstill on DSKH9S0YB1PROD with NOTICES
MEPS–HC Core lnterview ...............................................................................
Adult SAQ ........................................................................................................
Diabetes care SAQ ..........................................................................................
Permission forms for the MEPS–MPC ............................................................
15,000
21,000
1,800
15,000
56,250
2,450
90
62,690
$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
441
23
13,665
12,450
5,402
239
13
6,605
1,245
2,926
14.24
19.56
14.24
14.24
14.24
3,403
254
94,055
17,729
41,666
MEPS–MPC
Home care for health care providers questionnaire ........................................
Home care for non-health care questionnaire .................................................
Office-based providers questionnaire ..............................................................
Separately billing doctors questionnaire ..........................................................
Hospitals questionnaire ...................................................................................
VerDate Nov<24>2008
16:05 Oct 08, 2009
Jkt 220001
PO 00000
Frm 00067
Fmt 4703
Sfmt 4703
E:\FR\FM\09OCN1.SGM
09OCN1
52241
Federal Register / Vol. 74, No. 195 / Friday, October 9, 2009 / Notices
EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN—Continued
Number of
respondents
Form name
Total burden
hours
Average hourly wage rate*
Total cost
burden
Institutions (non-hospital) questionnaire ..........................................................
Pharmacies questionnaire ...............................................................................
72
7,760
9
9,040
14.24
14.24
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
*Based upon the mean of the average
wages for Healthcare Support Workers, All
Other (31–9099) 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
(millions)
Cost Component
Annualized
cost
(millions)
Sampling Activities ...................................................................................................................................................
Interviewer Recruitment and Training .....................................................................................................................
Data Collection Activities .........................................................................................................................................
Data Processing ......................................................................................................................................................
Production of Public Use Data Files .......................................................................................................................
Project Management ................................................................................................................................................
$2.79
8.52
86.7
21.39
19.53
3.93
$0.93
2.84
28.9
7.13
6.51
1.31
Total ..................................................................................................................................................................
142.8
47.6
mstockstill on DSKH9S0YB1PROD with NOTICES
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 0MB approval of the
proposed information collection. All
comments will become a matter of
public record.
VerDate Nov<24>2008
16:05 Oct 08, 2009
Jkt 220001
Dated: September 16, 2009.
Carol M. Clancy,
Director.
[FR Doc. E9–24305 Filed 10–8–09; 8:45 am]
BILLING CODE 4160–90–M
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket Nos. FDA–2009–E–0073 and FDA–
2009–E–0015]
Determination of Regulatory Review
Period for Purposes of Patent
Extension; ENTEREG; U.S. Patent Nos.
5,250,542 and 5,434,171
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Notice.
SUMMARY: The Food and Drug
Administration (FDA) has determined
the regulatory review period for
ENTEREG and is publishing this notice
of that determination as required by
law. FDA has made the determination
because of the submission of
applications to the Director of Patents
and Trademarks, Department of
Commerce, for the extension of patents
which claim that human drug product.
PO 00000
Frm 00068
Fmt 4703
Sfmt 4703
ADDRESSES: Submit written comments
and petitions to the Division of Dockets
Management (HFA–305), Food and Drug
Administration, 5630 Fishers Lane, rm.
1061, Rockville, MD 20852. Submit
electronic comments to https://
www.regulations.gov.
FOR FURTHER INFORMATION CONTACT:
Beverly Friedman, Office of Regulatory
Policy, Food and Drug Administration,
10903 New Hampshire Ave., Bldg. 51,
rm. 6222, Silver Spring, MD 20993–
0002, 301–796–3602.
SUPPLEMENTARY INFORMATION: The Drug
Price Competition and Patent Term
Restoration Act of 1984 (Public Law 98–
417) and the Generic Animal Drug and
Patent Term Restoration Act (Public
Law 100–670) generally provide that a
patent may be extended for a period of
up to 5 years so long as the patented
item (human drug product, animal drug
product, medical device, food additive,
or color additive) was subject to
regulatory review by FDA before the
item was marketed. Under these acts, a
product’s regulatory review period
forms the basis for determining the
amount of extension an applicant may
receive.
A regulatory review period consists of
two periods of time: A testing phase and
an approval phase. For human drug
E:\FR\FM\09OCN1.SGM
09OCN1
]]>Agencies
[Federal Register Volume 74, Number 195 (Friday, October 9, 2009)]
[Notices]
[Pages 52238-52241]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-24305]
-----------------------------------------------------------------------
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 (0MB) 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 6, 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 November 9, 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 OIRA--submissionomb.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
[[Page 52239]]
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:
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\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.
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.
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
CAPI 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 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 MO 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
questionnaires.
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
[[Page 52240]]
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 1 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 MEPSHC core requires an average response time of 1\1/2\
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. 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.
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
----------------------------------------------------------------------------------------------------------------
Number of Total burden Average hourly Total cost
Form name respondents hours wage rate* burden
----------------------------------------------------------------------------------------------------------------
MEPS-HC
----------------------------------------------------------------------------------------------------------------
MEPS-HC Core lnterview.......................... 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 62,690 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 questionnaire..... 23 13 19.56 254
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
[[Page 52241]]
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 (31-9099) 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
------------------------------------------------------------------------
Annualized
Cost Component Total cost cost
(millions) (millions)
------------------------------------------------------------------------
Sampling Activities..................... $2.79 $0.93
Interviewer Recruitment and Training.... 8.52 2.84
Data Collection Activities.............. 86.7 28.9
Data Processing......................... 21.39 7.13
Production of Public Use Data Files..... 19.53 6.51
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 0MB approval of the
proposed information collection. All comments will become a matter of
public record.
Dated: September 16, 2009.
Carol M. Clancy,
Director.
[FR Doc. E9-24305 Filed 10-8-09; 8:45 am]
BILLING CODE 4160-90-M
