Agency Information Collection Activities: Proposed Collection; Comment Request, 23260-23263 [2012-9105]
Download as PDF
<![CDATA[
23260
Federal Register / Vol. 77, No. 75 / Wednesday, April 18, 2012 / Notices
Dated: March 27, 2012.
Kathleen Sebelius,
Secretary.
[FR Doc. 2012–9238 Filed 4–16–12; 11:15 am]
BILLING CODE 4150–03–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Agency for Healthcare Research and
Quality
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Agency for Healthcare Research
and Quality, HHS.
ACTION: Notice.
AGENCY:
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: ‘‘CHIPRA
Pediatric Quality Measures Program
Candidate Measure Submission Form.’’
In accordance with the Paperwork
Reduction Act, 44 U.S.C. 3501–3521,
AHRQ invites the public to comment on
this proposed information collection.
DATES: Comments on this notice must be
received by June 18, 2012.
ADDRESSES: Written comments should
be submitted to: Doris Lefkowitz,
Reports Clearance Officer, AHRQ, by
email at doris.lefkowitz@AHRQ.hhs.gov.
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
email at doris.lefkowitz@AHRQ.hhs.gov.
SUPPLEMENTARY INFORMATION:
SUMMARY:
Proposed Project
mstockstill on DSK4VPTVN1PROD with NOTICES
Pediatric Quality Measures Program
Section 401(a) of the Children’s
Health Insurance Program
Reauthorization Act of 2009 (CHIPRA),
Public Law 111–3, amended the Social
Security Act (‘‘the Act’’) to enact section
1139A (42 U.S.C. 1320b–9a). Section
1139A(b) charged the Department of
Health and Human Services (HHS) with
improving pediatric health care quality
measures. Since CHIPRA was passed,
AHRQ and the Centers for Medicare &
Medicaid Services (CMS) have been
working together to implement selected
provisions of the legislation related to
children’s health care quality. An initial
core measure set for voluntary use by
VerDate Mar<15>2010
16:25 Apr 17, 2012
Jkt 226001
Medicaid and Children’s Health
Insurance Programs (CHIP) was posted
December 29, 2009 (https://
www.gpo.gov/fdsys/pkg/FR–2009–12–
29/html/E9–30802.htm). In February
2010, CMS released a State Health
Official letter which outlined the initial
core measures and how these measures
would be reported to CMS.
Subsequently, AHRQ and CMS
established the CHIPRA Pediatric
Quality Measures Program (PQMP) in
accordance with section 1139A(b)(1) of
the Act to enhance select children’s
health care quality measures and
develop new measures (https://
www.ahrq.gov/chipra). The PQMP is
intended to increase the portfolio of
measures available to public and private
purchasers of children’s health care
services, providers, and consumers.
HHS anticipates that measures
ultimately included in the Improved
Core Set will also be used by public and
private purchasers to measure pediatric
healthcare quality. The PQMP consists
of the following:
(1) Seven Centers of Excellence (CoEs)
that are developing and/or enhancing
children’s health care quality measures
through cooperative agreements with
AHRQ in order to increase the portfolio
of measures available to the public and
private purchasers of children’s health
care services, providers and consumers
(https://www.ahrq.gov/chipra/
pqmpfact.htm);
(2) CHIPRA Coordinating and
Technical Assistance Center (CCTAC);
(3) Two CHIPRA quality
demonstration grantees (Illinois, a
partner to the Florida grantee, and
Massachusetts) funded by CMS to
undertake new quality measure
development as part of their grants
https://www.insurekidsnow.gov/
professionals/CHIPRA/
grants_summary.html; and
(4) The Subcommittee on Children’s
Healthcare Quality Measures of the
AHRQ National Advisory Council on
Healthcare Research and Quality
(SNAC) that will review measures
nominated through a public call for
measures, as well as measures
developed or enhanced by the CoEs, and
make recommendations for an improved
core set of children’s health care quality
measures and other CHIPRA purposes
(https://www.ahrq.gov/chipra/
panellist11.htm).
Section 1139A of the Act provides
that improved core sets of children’s
health care quality measures be
identified beginning January 1, 2013,
and annually thereafter, for potential
voluntary use by Medicaid and CHIP
programs and other CHIPRA purposes.
AHRQ intends to solicit nominations for
PO 00000
Frm 00040
Fmt 4703
Sfmt 4703
children’s health care quality measures
for these purposes using a standard
measure nomination form early in
calendar years 2013 and 2014 through a
public call for measures. These
solicitations will be undertaken by
AHRQ to identify children’s health care
quality measures for review by the
SNAC.
Section 1139A(b)(2) of the Act
requires that the measures in the
improved core sets shall, at a minimum,
be:
(A) Evidence-based and, where
appropriate, risk adjusted;
(B) Designed to identify and eliminate
racial and ethnic disparities in child
health and the provision of health care;
(C) Designed to ensure that the data
required for such measures is collected
and reported in a standard format that
permits comparison of quality and data
at a State, plan, and provider level;
(D) Periodically updated; and
(E) Responsive to the child health
needs, services, and domains of health
care quality described in clauses (i), (ii),
and (iii) of subsection (a)(6)(A).
Hence, AHRQ, CMS, and PQMP
developed a CHIPRA Pediatric Quality
Measures Program (PQMP) Candidate
Measure Submission Form (hereinafter
referred to as ‘‘CHIPRA PQMP
Candidate Measure Submission Form’’)
and a Glossary of Terms. The CHIPRA
PQMP Candidate Measure Submission
Form and Glossary of Terms detail the
measure evaluation criteria and related
definitions to provide operational
guidance for the minimum evaluation
criteria as specified in section
1139A(b)(2) of the Act. AHRQ intends to
use this CHIPRA PQMP Candidate
Measure Submission Form to conduct a
public call for measures early in
calendar years 2013 and 2014 to solicit
measures for consideration by the SNAC
for the 2014 and 2015 improved core
sets of children’s health care quality
measures for voluntary use by Medicaid
and CHIP programs and for other
CHIPRA purposes.
The goals of the CHIPRA PQMP
Candidate Measure Form project are to:
(1) Solicit nominations for children’s
health care quality measures early in
calendar years 2013 and 2014 through
public calls for measures, using a
standardized data collection form;
(2) Use the information provided
through the standardized data collection
form to support SNAC review of
children’s health care quality measures
nominated by the public and measures
developed by the seven CoEs; and
(3) Identify measures for improved
core sets of children’s health care
quality measures and for other CHIPRA
purposes.
E:\FR\FM\18APN1.SGM
18APN1
Federal Register / Vol. 77, No. 75 / Wednesday, April 18, 2012 / Notices
mstockstill on DSK4VPTVN1PROD with NOTICES
The process for review of the
measures developed by the seven COEs
will be the same as that for measures
submitted in response to calls for public
nominations.
Respondents to these public calls for
measures in 2013 and 2014 are expected
to include pediatricians, researchers,
measure developers, and measure
stewards of children’s health care
quality measures.
This project is being conducted by
AHRQ pursuant to AHRQ’s statutory
authority under Title IX of the Public
Health Service Act to conduct and
support research to improve health care
quality, and to fulfill a number of
requirements under Title IV of CHIPRA,
including requirements to identify
candidate measures for public posting of
an improved core set of children’s
health care quality measures by January
1, 2014 and January 1, 2015.
Method of Collection
To achieve the goals of this project,
AHRQ intends to solicit submission of
measures from the members of the
public using the CHIPRA PQMP
Candidate Measure Submission Form, a
standardized data collection tool. Data
collection using the CHIPRA PQMP
Candidate Measure Submission Form
will be adequate to achieve the goals of
the project. Below is an outline of the
type of data collected through the
CHIPRA PQMP Candidate Measure
Submission Form and description of the
information solicited from each
nominator pursuant to section
1139A(b)(2) of the Act.
1. Basic measure information,
including: measure name, measure
description, denominator statement (if
applicable), numerator statement (if
applicable), data sources, exclusions,
measure owner and/or copyright owner
and any other applicable proprietary
rights (e.g., patent or data rights), any
confidentiality or trade secret
protections, National Quality Forum
(NQF) identification number (if
applicable; i.e., if the measure has been
endorsed by NQF), and whether part of
a measure hierarchy (e.g., a collection of
measures, a measure set, a measure
subset as defined at https://
www.qualitymeasures.ahrq.gov/about/
hierarchy.aspx).
2. Detailed measure specifications:
Description of how a measure would be
calculated from appropriate data
sources.
3. Importance of the measure:
Description of how the measure meets
one or more of the following criteria for
importance, citing scientific literature
and providing references: importance to
Medicaid and/or CHIP program,
VerDate Mar<15>2010
16:25 Apr 17, 2012
Jkt 226001
including the extent to which Medicaid/
CHIP policies can stimulate
improvement on the measure, and
relevance to Early Periodic Screening,
Diagnosis, and Treatment benefit;
potential for quality improvement and
reduction of disparities in quality;
health importance/prevalence of
condition; health importance/severity
and burden (including impact on
children, families and societies); overall
cost burden to patients, families, public
and private payers, or society more
generally currently and over the life
span of the child; association of measure
topic to children’s current or future
health; how the underlying concept of
the measure changes in meaning and
manifestation (if at all) across
developmental stages.
4. Settings, services, measure
domains, and populations addressed by
the measure. CHIPRA asks that the
improved core sets cover the following
domains of healthcare quality for
children at a minimum: the duration of
children’s coverage over a 12 month
time period; the availability and
effectiveness of a full range of: (i)
Preventive services, treatments, and
services for acute conditions, including
services to promote healthy birth,
prevent and treat premature birth, and
detect the presence or risk of physical
or mental conditions that could
adversely affect growth and
development; (ii) treatments to correct
or ameliorate the effects of physical and
mental conditions, including chronic
conditions, in infants, young children,
school-age children, and adolescents;
(iii) the availability of care in a range of
ambulatory and inpatient health care
settings in which such care is furnished;
and, (iv) the types of measures that,
taken together, can be used to estimate
the overall national quality of health
care for children, including children
with special needs, and to perform
comparative analyses of pediatric health
care quality and racial, ethnic, and
socioeconomic disparities in child
health and healthcare for children.
Nominations will need to identify all
settings, services, measure domains, and
populations that a measure addresses.
5. Evidence for focus of the measure:
The evidence base for the focus of the
measures included in the January 1,
2014 and January 1, 2015 improved core
sets will be made explicit and
transparent; thus, it is critical for
nominations to specify the scientific
evidence or other basis for the focus of
the measure, including a brief
description of the evidence base or
rationale for the relationship between
the measure and a significant structure,
PO 00000
Frm 00041
Fmt 4703
Sfmt 4703
23261
process, or outcome that influences
children’s health and health care.
6. Scientific soundness of the
measure: Explanation of methods to
determine the scientific soundness of
the measure itself, including results of
all tests of validity and reliability,
including description(s) of the study
sample(s) and methods used to arrive at
the results. Also, information on how
characteristics of the data system/data
sources may affect validity and
reliability of the measure.
7. Identification of disparities:
CHIPRA requires that quality measures
be able to identify disparities by race,
and ethnicity, and be responsive to
domains of health care quality such as
socioeconomic status, and special
health care needs. Nominations will
provide evidence (if available) from
testing of measures with diverse
populations (considering that diversity
may include race, ethnicity, rural
populations, inner city populations,
special health care needs,
socioeconomic status, and/or insurance
source, especially Medicaid or CHIP) to
assess measure’s performance for
disparities identification.
8. Feasibility: Description of the
measure’s feasibility, including:
availability of data in existing data
systems; opportunities/pathways for
implementation; extent to which the
measure has been used or is in use (or
has not been used), including settings in
which it has been used; data collection
methods that have been used; eligible
populations and results of testing in the
eligible populations, including an
estimation of the population size
required to gain adequate numbers of
observations for reliable comparisons,
such as estimates of the required
population sizes to gain adequate
numbers for stratification by race,
ethnicity, special health care need, and
socioeconomic status.
9. Levels of aggregation: CHIPRA
states that data used in quality measures
must be collected and reported in a
standard format that permits
comparison (at minimum) at State,
health plan, and provider levels.
Nominations will provide information
on all levels of aggregation at which the
measure is primarily intended to apply
(e.g., State (Medicaid and CHIP
populations), health plan, hospital,
practice, provider, patient) and at which
the measure has been tested.
10. Understandability: CHIPRA states
that the core set should allow
purchasers, families, and health care
providers to understand the quality of
care for children. Nominations will
include a description of the usefulness
of the measure to purchasers, families,
E:\FR\FM\18APN1.SGM
18APN1
23262
Federal Register / Vol. 77, No. 75 / Wednesday, April 18, 2012 / Notices
and health care providers and present
results from efforts to assess the
understandability of the measure.
11. Health Information Technology:
Nominations will provide information
on health information technology (HIT)
that has been or could be incorporated
into the measure calculation.
12. Additional Disclosures and
Notices: All nominations will include
contact information for the measure
submitter, including: (a) Name, (b) Title,
(c) Organization, (d) Mailing address, (e)
Telephone number, and (f) email
address. Further, all nominations will
include a written statement disclosing
the proprietary and/or confidentiality
status of the measure and full measure
specifications, as described in the Basic
Measure Information category. This
statement must be signed by the
applicable rights holder(s) or an
individual authorized to act on its
behalf for each submitted measure or
instrument. If signed by an authorized
individual, the statement must describe
the basis for such authorization.
Submitters are encouraged to disclose
the terms under which the measure and
full measure specifications are currently
made available to interested parties—for
example, a standard license and/or
nondisclosure agreement, or a statement
describing the terms thereof. Should
HHS accept the measure for the 2014
and/or 2015 Improved Core Measure
Sets, full measure specifications for the
accepted measure will be subject to
public disclosure (e.g., on the AHRQ
and/or CMS Web sites). In addition,
AHRQ expects that measures and full
measure specifications will be made
reasonably available to all interested
parties.
The information resulting from this
data collection will be used to: (a)
Improve and strengthen the initial core
set of measures of health care quality
measures established under CHIPRA in
December 2009 (https://www.gpo.gov/
fdsys/pkg/FR-2009–12-29/html/E930802.htm), (b) expand on existing
pediatric quality measures used by
public and private health care
purchasers, and (c) increase the
portfolio of evidence-based consensus
pediatric quality measures available to
public and private purchasers of
children’s health care services,
providers, and consumers.
Each measure nominated by members
of the public will be reviewed by
members of SNAC using the categories
of evaluation criteria detailed in the
CHIPRA PQMP Candidate Measure
Submission Form. SNAC will make
recommendations to NAC which in turn
make recommendations to the AHRQ
Director for consideration of select
measures for inclusion in the public
posting of an improved core set by
January 1, 2014 and January 1, 2015 for
voluntary use by Medicaid and CHIP
programs and other CHIPRA purposes.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated
annualized burden hours for members
of the public who will nominate
measures through use of the online
CHIPRA PQMP Candidate Measure
Submission Form. We anticipate a
maximum of 50 nominations each year
with each nomination requiring three
hours. The total burden is estimated to
be 150 hours annually.
Exhibit 2 shows the estimated
annualized cost burden for respondents’
to complete the online submission form
for the public call for measures. The
total cost burden is estimated to be
$11,801 annually.
EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS
Data collection
Number of
nominations
Number of
responses per
nominations
Hours per
response
Total burden
hours
CHIPRA PQMP Candidate Measure Submission Form ..................................
50
1
3
150
EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN
Data collection
Number of
nominations
Total burden
hours
Average
hourly wage
rate*
Total cost
burden
CHIPRA PQMP Candidate Measure Submission Form ..................................
50
150
$78.67
$11,801
*Based upon the mean of the average wages for 29–1065 (Pediatricians, General), $78.67 per hour, National Compensation Survey: Occupational wages in the United States May 2009, U.S. Department of Labor, Bureau of Labor Statistics. Although the measure nominations will be solicited from the general public, AHRQ is using the wage rate for pediatricians since our expectation is that respondents to the 2013 and 2014
public call for measures will primarily be pediatricians who will be measure developers or measure stewards of children’s health care quality
measures.
Estimated Annual Costs to the Federal
Government
Exhibit 3 shows the estimated total
and annualized cost over 3 years to the
government for conducting this project.
The total cost is estimated to be
$275,270.
mstockstill on DSK4VPTVN1PROD with NOTICES
EXHIBIT 3—ESTIMATED TOTAL AND ANNUALIZED COST
Cost component
Total cost
Project Development .......................................................................................................................................................
Data Collection Activities .................................................................................................................................................
Data Processing and Analysis .........................................................................................................................................
Publication of Results ......................................................................................................................................................
Project Management ........................................................................................................................................................
Overhead .........................................................................................................................................................................
VerDate Mar<15>2010
16:25 Apr 17, 2012
Jkt 226001
PO 00000
Frm 00042
Fmt 4703
Sfmt 4703
E:\FR\FM\18APN1.SGM
18APN1
$16,205
46,553
43,190
53,938
22,620
92,764
Annualized
cost
$5,402
15,518
14,397
17,979
7,540
30,921
23263
Federal Register / Vol. 77, No. 75 / Wednesday, April 18, 2012 / Notices
EXHIBIT 3—ESTIMATED TOTAL AND ANNUALIZED COST—Continued
Cost component
Total cost
Total ..........................................................................................................................................................................
Request for Comments
In accordance with the Paperwork
Reduction Act, 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 healthcare
research and healthcare 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.
CDC 1600 Clifton Road, MS–D74,
Atlanta, GA 30333 or send an email to
omb@cdc.gov.
Comments are invited on: (a) Whether
the proposed collection of information
is necessary for the proper performance
of the functions of the agency, including
whether the information shall have
practical utility; (b) the accuracy of the
agency’s estimate of the burden of the
proposed collection 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
on respondents, including through the
use of automated collection techniques
or other forms of information
technology. Written comments should
be received within 60 days of this
notice.
Dated: April 6, 2012.
Carolyn M. Clancy,
Director.
Background and Brief Description
The Prevention and Public Health
Fund (PPHF) of the Patient Protection
and Affordable Care Act of 2010 (ACA)
provides an important opportunity for
states, counties, territories and tribes to
advance public health across the
lifespan and to reduce health
disparities. The PPHF authorizes
Community Transformation Grants
(CTG) for the implementation,
evaluation, and dissemination of
evidence-based community preventive
health activities. The CTG Program
emphasizes five strategic directions: (1)
Tobacco-free living, (2) active lifestyles
and healthy eating, (3) high impact,
evidence-based clinical and other
preventive services, (4) social and
emotional well-being, and (5) healthy
and safe physical environments.
The CTG Program is administered by
the Centers for Disease Control and
Prevention (CDC), National Center for
Chronic Disease Prevention and Health
Promotion (NCCDPHP). As required by
Section 4201 of the ACA, CDC is
responsible for conducting a
comprehensive evaluation of the CTG
Program which includes assessment
[FR Doc. 2012–9105 Filed 4–17–12; 8:45 am]
BILLING CODE 4160–90–M
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
[60Day–12–12IG]
mstockstill on DSK4VPTVN1PROD with NOTICES
Proposed Data Collections Submitted
for Public Comment and
Recommendations
In compliance with the requirement
of Section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995 for
opportunity for public comment on
proposed data collection projects, the
Centers for Disease Control and
Prevention (CDC) will publish periodic
summaries of proposed projects. To
request more information on the
proposed projects or to obtain a copy of
the data collection plans and
instruments, call 404–639–7570 and
send comments to Kimberly S. Lane, at
VerDate Mar<15>2010
16:25 Apr 17, 2012
Jkt 226001
Proposed Project
Targeted Surveillance and Biometric
Studies for Enhanced Evaluation of
Community Transformation Grants—
New—National Center for Chronic
Disease Prevention and Health
Promotion (NCCDPHP), Centers for
Disease Control and Prevention (CDC).
PO 00000
Frm 00043
Fmt 4703
Sfmt 4703
275,270
Annualized
cost
91,757
over time of measures relating to each
of the five strategic directions. CDC is
requesting OMB approval to collect
information needed for these
assessments. The information collection
will include population-level and
targeted surveillance of high interest
indicators for a range of age groups in
select CTG communities, as well as
enhanced evaluation studies designed to
assess the potential impact of specific
CTG strategies on health outcomes.
CDC plans to conduct the Adult
Targeted Surveillance Survey (ATSS) in
20 CTG communities. Ten communities
that have already received CTG
cooperative agreements (group A) will
participate in the ATSS in 2012, 2014,
and 2016, and ten communities that will
receive CTG funding in fiscal year 2013
(group B) will participate in the ATSS
in 2013, 2015, and 2017. The ATSS will
be administered by telephone to a
representative sample of 1,000 adult
residents in each community for an
estimated annualized number of
respondents of 10,000. Respondents will
be asked to provide information about
household practices and their personal
behaviors specific to the five strategic
directions (e.g., nutrition). Responses
will be used to monitor changes in
relevant attitudes, risk behaviors, and
other behavioral factors in specific
geographic areas where CTG cooperative
agreement awardees are implementing
interventions related to CTG strategic
directions. Information from the
targeted surveillance surveys will be
compared with data from other local,
state or national surveillance systems.
During the initial three-year OMB
clearance period, the ATSS will be
administered to a total of 20,000
respondents in group A communities
and 10,000 respondents in group B
communities.
CDC’s CTG Program evaluation plans
also include enhanced evaluation
activities and special studies fulfilling
the congressional mandate to expand
the evidence base of effective public
health interventions across a range of
settings, population subgroups, and
health outcomes. These studies will
include use of mixed-method
approaches and observational and
outcome data collection in select
communities. The initial selected
studies will address biometric changes
specific to CTG interventions; the
E:\FR\FM\18APN1.SGM
18APN1
]]>Agencies
[Federal Register Volume 77, Number 75 (Wednesday, April 18, 2012)]
[Notices]
[Pages 23260-23263]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-9105]
-----------------------------------------------------------------------
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: ``CHIPRA Pediatric Quality Measures Program Candidate Measure
Submission Form.'' In accordance with the Paperwork Reduction Act, 44
U.S.C. 3501-3521, AHRQ invites the public to comment on this proposed
information collection.
DATES: Comments on this notice must be received by June 18, 2012.
ADDRESSES: Written comments should be submitted to: Doris Lefkowitz,
Reports Clearance Officer, AHRQ, by email at
doris.lefkowitz@AHRQ.hhs.gov.
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 email at
doris.lefkowitz@AHRQ.hhs.gov.
SUPPLEMENTARY INFORMATION:
Proposed Project
Pediatric Quality Measures Program
Section 401(a) of the Children's Health Insurance Program
Reauthorization Act of 2009 (CHIPRA), Public Law 111-3, amended the
Social Security Act (``the Act'') to enact section 1139A (42 U.S.C.
1320b-9a). Section 1139A(b) charged the Department of Health and Human
Services (HHS) with improving pediatric health care quality measures.
Since CHIPRA was passed, AHRQ and the Centers for Medicare & Medicaid
Services (CMS) have been working together to implement selected
provisions of the legislation related to children's health care
quality. An initial core measure set for voluntary use by Medicaid and
Children's Health Insurance Programs (CHIP) was posted December 29,
2009 (https://www.gpo.gov/fdsys/pkg/FR-2009-12-29/html/E9-30802.htm). In
February 2010, CMS released a State Health Official letter which
outlined the initial core measures and how these measures would be
reported to CMS.
Subsequently, AHRQ and CMS established the CHIPRA Pediatric Quality
Measures Program (PQMP) in accordance with section 1139A(b)(1) of the
Act to enhance select children's health care quality measures and
develop new measures (https://www.ahrq.gov/chipra). The PQMP is intended
to increase the portfolio of measures available to public and private
purchasers of children's health care services, providers, and
consumers. HHS anticipates that measures ultimately included in the
Improved Core Set will also be used by public and private purchasers to
measure pediatric healthcare quality. The PQMP consists of the
following:
(1) Seven Centers of Excellence (CoEs) that are developing and/or
enhancing children's health care quality measures through cooperative
agreements with AHRQ in order to increase the portfolio of measures
available to the public and private purchasers of children's health
care services, providers and consumers (https://www.ahrq.gov/chipra/pqmpfact.htm);
(2) CHIPRA Coordinating and Technical Assistance Center (CCTAC);
(3) Two CHIPRA quality demonstration grantees (Illinois, a partner
to the Florida grantee, and Massachusetts) funded by CMS to undertake
new quality measure development as part of their grants https://www.insurekidsnow.gov/professionals/CHIPRA/grants_summary.html; and
(4) The Subcommittee on Children's Healthcare Quality Measures of
the AHRQ National Advisory Council on Healthcare Research and Quality
(SNAC) that will review measures nominated through a public call for
measures, as well as measures developed or enhanced by the CoEs, and
make recommendations for an improved core set of children's health care
quality measures and other CHIPRA purposes (https://www.ahrq.gov/chipra/panellist11.htm).
Section 1139A of the Act provides that improved core sets of
children's health care quality measures be identified beginning January
1, 2013, and annually thereafter, for potential voluntary use by
Medicaid and CHIP programs and other CHIPRA purposes. AHRQ intends to
solicit nominations for children's health care quality measures for
these purposes using a standard measure nomination form early in
calendar years 2013 and 2014 through a public call for measures. These
solicitations will be undertaken by AHRQ to identify children's health
care quality measures for review by the SNAC.
Section 1139A(b)(2) of the Act requires that the measures in the
improved core sets shall, at a minimum, be:
(A) Evidence-based and, where appropriate, risk adjusted;
(B) Designed to identify and eliminate racial and ethnic
disparities in child health and the provision of health care;
(C) Designed to ensure that the data required for such measures is
collected and reported in a standard format that permits comparison of
quality and data at a State, plan, and provider level;
(D) Periodically updated; and
(E) Responsive to the child health needs, services, and domains of
health care quality described in clauses (i), (ii), and (iii) of
subsection (a)(6)(A).
Hence, AHRQ, CMS, and PQMP developed a CHIPRA Pediatric Quality
Measures Program (PQMP) Candidate Measure Submission Form (hereinafter
referred to as ``CHIPRA PQMP Candidate Measure Submission Form'') and a
Glossary of Terms. The CHIPRA PQMP Candidate Measure Submission Form
and Glossary of Terms detail the measure evaluation criteria and
related definitions to provide operational guidance for the minimum
evaluation criteria as specified in section 1139A(b)(2) of the Act.
AHRQ intends to use this CHIPRA PQMP Candidate Measure Submission Form
to conduct a public call for measures early in calendar years 2013 and
2014 to solicit measures for consideration by the SNAC for the 2014 and
2015 improved core sets of children's health care quality measures for
voluntary use by Medicaid and CHIP programs and for other CHIPRA
purposes.
The goals of the CHIPRA PQMP Candidate Measure Form project are to:
(1) Solicit nominations for children's health care quality measures
early in calendar years 2013 and 2014 through public calls for
measures, using a standardized data collection form;
(2) Use the information provided through the standardized data
collection form to support SNAC review of children's health care
quality measures nominated by the public and measures developed by the
seven CoEs; and
(3) Identify measures for improved core sets of children's health
care quality measures and for other CHIPRA purposes.
[[Page 23261]]
The process for review of the measures developed by the seven COEs
will be the same as that for measures submitted in response to calls
for public nominations.
Respondents to these public calls for measures in 2013 and 2014 are
expected to include pediatricians, researchers, measure developers, and
measure stewards of children's health care quality measures.
This project is being conducted by AHRQ pursuant to AHRQ's
statutory authority under Title IX of the Public Health Service Act to
conduct and support research to improve health care quality, and to
fulfill a number of requirements under Title IV of CHIPRA, including
requirements to identify candidate measures for public posting of an
improved core set of children's health care quality measures by January
1, 2014 and January 1, 2015.
Method of Collection
To achieve the goals of this project, AHRQ intends to solicit
submission of measures from the members of the public using the CHIPRA
PQMP Candidate Measure Submission Form, a standardized data collection
tool. Data collection using the CHIPRA PQMP Candidate Measure
Submission Form will be adequate to achieve the goals of the project.
Below is an outline of the type of data collected through the CHIPRA
PQMP Candidate Measure Submission Form and description of the
information solicited from each nominator pursuant to section
1139A(b)(2) of the Act.
1. Basic measure information, including: measure name, measure
description, denominator statement (if applicable), numerator statement
(if applicable), data sources, exclusions, measure owner and/or
copyright owner and any other applicable proprietary rights (e.g.,
patent or data rights), any confidentiality or trade secret
protections, National Quality Forum (NQF) identification number (if
applicable; i.e., if the measure has been endorsed by NQF), and whether
part of a measure hierarchy (e.g., a collection of measures, a measure
set, a measure subset as defined at https://www.qualitymeasures.ahrq.gov/about/hierarchy.aspx).
2. Detailed measure specifications: Description of how a measure
would be calculated from appropriate data sources.
3. Importance of the measure: Description of how the measure meets
one or more of the following criteria for importance, citing scientific
literature and providing references: importance to Medicaid and/or CHIP
program, including the extent to which Medicaid/CHIP policies can
stimulate improvement on the measure, and relevance to Early Periodic
Screening, Diagnosis, and Treatment benefit; potential for quality
improvement and reduction of disparities in quality; health importance/
prevalence of condition; health importance/severity and burden
(including impact on children, families and societies); overall cost
burden to patients, families, public and private payers, or society
more generally currently and over the life span of the child;
association of measure topic to children's current or future health;
how the underlying concept of the measure changes in meaning and
manifestation (if at all) across developmental stages.
4. Settings, services, measure domains, and populations addressed
by the measure. CHIPRA asks that the improved core sets cover the
following domains of healthcare quality for children at a minimum: the
duration of children's coverage over a 12 month time period; the
availability and effectiveness of a full range of: (i) Preventive
services, treatments, and services for acute conditions, including
services to promote healthy birth, prevent and treat premature birth,
and detect the presence or risk of physical or mental conditions that
could adversely affect growth and development; (ii) treatments to
correct or ameliorate the effects of physical and mental conditions,
including chronic conditions, in infants, young children, school-age
children, and adolescents; (iii) the availability of care in a range of
ambulatory and inpatient health care settings in which such care is
furnished; and, (iv) the types of measures that, taken together, can be
used to estimate the overall national quality of health care for
children, including children with special needs, and to perform
comparative analyses of pediatric health care quality and racial,
ethnic, and socioeconomic disparities in child health and healthcare
for children. Nominations will need to identify all settings, services,
measure domains, and populations that a measure addresses.
5. Evidence for focus of the measure: The evidence base for the
focus of the measures included in the January 1, 2014 and January 1,
2015 improved core sets will be made explicit and transparent; thus, it
is critical for nominations to specify the scientific evidence or other
basis for the focus of the measure, including a brief description of
the evidence base or rationale for the relationship between the measure
and a significant structure, process, or outcome that influences
children's health and health care.
6. Scientific soundness of the measure: Explanation of methods to
determine the scientific soundness of the measure itself, including
results of all tests of validity and reliability, including
description(s) of the study sample(s) and methods used to arrive at the
results. Also, information on how characteristics of the data system/
data sources may affect validity and reliability of the measure.
7. Identification of disparities: CHIPRA requires that quality
measures be able to identify disparities by race, and ethnicity, and be
responsive to domains of health care quality such as socioeconomic
status, and special health care needs. Nominations will provide
evidence (if available) from testing of measures with diverse
populations (considering that diversity may include race, ethnicity,
rural populations, inner city populations, special health care needs,
socioeconomic status, and/or insurance source, especially Medicaid or
CHIP) to assess measure's performance for disparities identification.
8. Feasibility: Description of the measure's feasibility,
including: availability of data in existing data systems;
opportunities/pathways for implementation; extent to which the measure
has been used or is in use (or has not been used), including settings
in which it has been used; data collection methods that have been used;
eligible populations and results of testing in the eligible
populations, including an estimation of the population size required to
gain adequate numbers of observations for reliable comparisons, such as
estimates of the required population sizes to gain adequate numbers for
stratification by race, ethnicity, special health care need, and
socioeconomic status.
9. Levels of aggregation: CHIPRA states that data used in quality
measures must be collected and reported in a standard format that
permits comparison (at minimum) at State, health plan, and provider
levels. Nominations will provide information on all levels of
aggregation at which the measure is primarily intended to apply (e.g.,
State (Medicaid and CHIP populations), health plan, hospital, practice,
provider, patient) and at which the measure has been tested.
10. Understandability: CHIPRA states that the core set should allow
purchasers, families, and health care providers to understand the
quality of care for children. Nominations will include a description of
the usefulness of the measure to purchasers, families,
[[Page 23262]]
and health care providers and present results from efforts to assess
the understandability of the measure.
11. Health Information Technology: Nominations will provide
information on health information technology (HIT) that has been or
could be incorporated into the measure calculation.
12. Additional Disclosures and Notices: All nominations will
include contact information for the measure submitter, including: (a)
Name, (b) Title, (c) Organization, (d) Mailing address, (e) Telephone
number, and (f) email address. Further, all nominations will include a
written statement disclosing the proprietary and/or confidentiality
status of the measure and full measure specifications, as described in
the Basic Measure Information category. This statement must be signed
by the applicable rights holder(s) or an individual authorized to act
on its behalf for each submitted measure or instrument. If signed by an
authorized individual, the statement must describe the basis for such
authorization. Submitters are encouraged to disclose the terms under
which the measure and full measure specifications are currently made
available to interested parties--for example, a standard license and/or
nondisclosure agreement, or a statement describing the terms thereof.
Should HHS accept the measure for the 2014 and/or 2015 Improved Core
Measure Sets, full measure specifications for the accepted measure will
be subject to public disclosure (e.g., on the AHRQ and/or CMS Web
sites). In addition, AHRQ expects that measures and full measure
specifications will be made reasonably available to all interested
parties.
The information resulting from this data collection will be used
to: (a) Improve and strengthen the initial core set of measures of
health care quality measures established under CHIPRA in December 2009
(https://www.gpo.gov/fdsys/pkg/FR-2009-12-29/html/E9-30802.htm), (b)
expand on existing pediatric quality measures used by public and
private health care purchasers, and (c) increase the portfolio of
evidence-based consensus pediatric quality measures available to public
and private purchasers of children's health care services, providers,
and consumers.
Each measure nominated by members of the public will be reviewed by
members of SNAC using the categories of evaluation criteria detailed in
the CHIPRA PQMP Candidate Measure Submission Form. SNAC will make
recommendations to NAC which in turn make recommendations to the AHRQ
Director for consideration of select measures for inclusion in the
public posting of an improved core set by January 1, 2014 and January
1, 2015 for voluntary use by Medicaid and CHIP programs and other
CHIPRA purposes.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated annualized burden hours for members
of the public who will nominate measures through use of the online
CHIPRA PQMP Candidate Measure Submission Form. We anticipate a maximum
of 50 nominations each year with each nomination requiring three hours.
The total burden is estimated to be 150 hours annually.
Exhibit 2 shows the estimated annualized cost burden for
respondents' to complete the online submission form for the public call
for measures. The total cost burden is estimated to be $11,801
annually.
Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
Number of
Data collection Number of responses per Hours per Total burden
nominations nominations response hours
----------------------------------------------------------------------------------------------------------------
CHIPRA PQMP Candidate Measure Submission 50 1 3 150
Form.......................................
----------------------------------------------------------------------------------------------------------------
Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
Number of Total burden Average hourly Total cost
Data collection nominations hours wage rate* burden
----------------------------------------------------------------------------------------------------------------
CHIPRA PQMP Candidate Measure Submission 50 150 $78.67 $11,801
Form.......................................
----------------------------------------------------------------------------------------------------------------
*Based upon the mean of the average wages for 29-1065 (Pediatricians, General), $78.67 per hour, National
Compensation Survey: Occupational wages in the United States May 2009, U.S. Department of Labor, Bureau of
Labor Statistics. Although the measure nominations will be solicited from the general public, AHRQ is using
the wage rate for pediatricians since our expectation is that respondents to the 2013 and 2014 public call for
measures will primarily be pediatricians who will be measure developers or measure stewards of children's
health care quality measures.
Estimated Annual Costs to the Federal Government
Exhibit 3 shows the estimated total and annualized cost over 3
years to the government for conducting this project. The total cost is
estimated to be $275,270.
Exhibit 3--Estimated Total and Annualized Cost
------------------------------------------------------------------------
Annualized
Cost component Total cost cost
------------------------------------------------------------------------
Project Development........................... $16,205 $5,402
Data Collection Activities.................... 46,553 15,518
Data Processing and Analysis.................. 43,190 14,397
Publication of Results........................ 53,938 17,979
Project Management............................ 22,620 7,540
Overhead...................................... 92,764 30,921
[[Page 23263]]
Total..................................... 275,270 91,757
------------------------------------------------------------------------
Request for Comments
In accordance with the Paperwork Reduction Act, 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 healthcare research and
healthcare 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: April 6, 2012.
Carolyn M. Clancy,
Director.
[FR Doc. 2012-9105 Filed 4-17-12; 8:45 am]
BILLING CODE 4160-90-M
