Proposed Collection; Comment Request, 35399-35402 [2012-14204]
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Federal Register / Vol. 77, No. 114 / Wednesday, June 13, 2012 / Notices
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: ‘‘Medical
Expenditure Panel Survey (MEPS)
Household Component and the MEPS
Medical Provider Component’’ 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 August 13, 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
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Medical Expenditure Panel Survey
(MEPS) Household Component and the
MEPS Medical Provider Component
For over thirty years, results from the
MEPS and its predecessor surveys (the
1977 National Medical Care
Expenditure Survey, the 1980 National
Medical Care Utilization and
Expenditure Survey and the 1987
National Medical Expenditure Survey)
have been used by OMB, DHHS,
Congress and a wide number of health
services researchers to analyze health
care use, expenses and health policy.
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 MEPS permits annual
estimates of use of health care and
expenditures and sources of payment
for that health care. It also permits
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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 MEPS analytic capacity by
providing another data point for
comparisons over time.
Households selected for participation
in the MEPS Household Component
(MEPS–HC) 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.
The MEPS–HC has the following goal:
• To provide nationally
representative estimates for the U.S.
civilian noninstitutionalized population
for health care use, expenditures,
sources of payment and health
insurance coverage.
The MEPS Medical Provider
Component (MEPS–MPC) will contact
medical providers (hospitals,
physicians, home health agencies and
institutions) identified by household
respondents in the MEPS–HC as sources
of medical care for the time period
covered by the interview, and all
pharmacies providing prescription
drugs to household members during the
covered time period. The MEPS–MPC is
not designed to yield national estimates.
The sample is designed to target the
types of individuals and providers for
whom household reported expenditure
data was expected to be insufficient. For
example, households with one or more
Medicaid enrollees are targeted for
inclusion in the MEPSMPC because this
group is expected to have limited
information about payments for their
medical care.
The MEPS–MPC has the following
goal:
• To provide an imputation source to
supplement/replace household reported
expenditure and source of payment
information. 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.
This study is being conducted by
AHRQ through its contractors, Westat
and RTI International, pursuant to
AHRQ’s statutory authority to conduct
and support research on healthcare and
on systems for the delivery of such care,
including activities with respect to the
cost and use of health care services and
with respect to health statistics and
surveys. 42 U.S.C. 299a(a)(3) and (8); 42
U.S.C. 299b–2.
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35399
Method of Collection
To achieve the goals of the MEPS–HC
the following data collections are
implemented:
1. 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,
income, assets, satisfaction with health
plans and providers, children’s health,
and 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.
2. Adult Self Administered
Questionnaire. A brief self-administered
questionnaire (SAQ) 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. The satisfaction with
health care items are a subset of items
from the Consumer Assessment of
Healthcare Providers and Systems
(CAHPS®). The health status items are
from the Short Form 12 Version 2 (SF–
12 version 2), which has been widely
used as a measure of self-reported
health status in the United States, the
Kessler Index (K6) of non-specific
psychological distress, and the Patient
Health Questionnaire (PHQ–2).
3. Diabetes Care SAQ. A brief self
administered paper-and-pencil
questionnaire on the quality of diabetes
care is administered once a year (during
rounds 3 and 5) to persons identified as
having diabetes. Included are questions
about the number of times the
respondent reported having a
hemoglobin A1c blood test, whether the
respondent reported having his or her
feet checked for sores or irritations,
whether the respondent reported having
an eye exam in which the pupils were
dilated, the last time the respondent had
his or her blood cholesterol checked and
whether the diabetes has caused kidney
or eye problems. Respondents are also
asked if their diabetes is being treated
with diet, oral medications or insulin.
4. Permission forms for the MEPS–
MPC Provider and Pharmacy Survey. As
in previous panels of the MEPS, we will
ask respondents for permission to obtain
supplemental information from their
medical providers (hospitals,
physicians, home health agencies and
institutions) and pharmacies.
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To achieve the goal of the MEPS–MPC
the following data collections are
implemented:
1. MPC Screening Call. An initial
screening call is placed to determine the
type of facility, whether the practice or
facility is in scope for the MEPS–MPC,
the appropriate MEPS–MPC respondent
and some details about the organization
and availability of medical records and
billing at the practice/facility. All
hospitals, physician offices, home
health agencies, institutions and
pharmacies are screened by telephone.
A unique screening instrument is used
for each of the seven provider types in
the MEPS–MPC.
2. Home Care Provider Questionnaire
for Health Care Providers. 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.
3. Home Care Provider Questionnaire
for Non-Health Care Providers. This
questionnaire 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.
4. Medical Event Questionnaire for
Office-Based Providers. This
questionnaire is for office-based
physicians, including doctors of
medicine (MDs) and osteopathy (DOs),
as well as providers practicing under
the direction or supervision of an MD or
DO (e.g., physician assistants and nurse
practitioners working in clinics).
Providers of care in private offices as
well as staff model HMOs are included.
5. Medical Event Questionnaire for
Separately Billing Doctors. This
questionnaire collects information from
physicians identified by hospitals
(during the Hospital Event data
collection) as providing care to sampled
persons during the course of inpatient,
outpatient department or emergency
room care, but who bill separately from
the hospital.
6. Hospital Event 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
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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;
the doctors that do bill separately from
the hospital will be contacted as part of
the Medical Event Questionnaire for
Separately Billing Doctors. HMOs are
included in this provider type.
7. Institutions Event Questionnaire.
This questionnaire is used to collect
information about institution events,
including nursing homes, rehabilitation
facilities and skilled nursing facilities.
Institution 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. In
many cases, the institution
administrative office also has to be
contacted to determine whether the
doctors identified by medical records
billed separately from the institution
itself.
8. Pharmacy Data Collection
Questionnaire. This questionnaire
requests the national drug code (NDC)
and when that is not available the
prescription name, date prescription
was filled, payments by source,
prescription strength and form (when
the NDC is not available), quantity, and
person for whom the prescription was
filled. When the NDC is available, we do
not ask for prescription name, strength
or form because that information is
embedded in the NDC; this reduces
burden on the respondent. 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. Pharmacies are
also able to provide a CD–ROM with the
requested information if that is
preferred. HMOs are included in this
provider type.
The MEPS is a multi-purpose survey.
In addition to collecting data to yield
annual estimates for a variety of
measures related to health care use and
expenditures, the MEPS also provides
estimates of measures related to health
status, consumer assessment of health
care, health insurance coverage,
demographic characteristics,
employment and access to health care
indicators. Estimates can be provided
for individuals, families and population
subgroups of interest. Data from the
MEPS, both the HC and MPC
components, are intended for a number
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of annual reports required to be
produced by AHRQ, including the
National Health Care Quality Report and
the National Health Care Disparities
Report.
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
12,500 ‘‘family level’’ respondents, also
referred to as RU respondents. Since the
MEPS–HC consists of 5 rounds of
interviewing covering a full two years of
data, the annual average number of
responses per respondent is 2.5
responses per year. The MEPS–HC core
requires an average response time of 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 22,000 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 1,700
persons, and takes about 3 minutes to
complete. The permission form for the
MEPS–MPC Provider Survey will be
completed once for each medical
provider seen by any RU member. Each
of the 12,500 RUs in the MEPS–HC will
complete an average of 5.2 forms, which
require about 3 minutes each to
complete. The permission form for the
MEPS–MPC Pharmacy Survey will be
completed once for each pharmacy for
any RU member who has obtained a
prescription medication. Each RU will
complete an average of 3.1 forms, which
take about 3 minutes to complete. The
total annual burden hours for the
MEPS–HC are estimated to be 54,715
hours.
All 37,600 medical providers and
pharmacies included in the MEPS–MPC
will receive a screening call which will
take 2 minutes on average. 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 are
estimated to be 20,565 hours. The total
annual burden hours for the MEPS–HC
and MPC is estimated to be 75,280
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
$1,189,505; the annual cost burden for
the MEPS–MPC is estimated to be
$309,798. The total annual cost burden
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for the MEPS–HC and MPC is estimated
to be $1,499,303.
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 form for the MEPS–MPC Provider Survey ...................................
Permission form for the MEPS–MPC Pharmacy Survey ................................
12,500
22,000
1,700
12,500
12.500
2.5
1
1
5.2
3.1
1.5
7/60
3/60
3/60
3/60
46,875
2,567
85
3,250
1,938
Subtotal for the MEPS–HC .......................................................................
61,200
na
na
54,715
MPC Screening Call* .......................................................................................
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 ...............................................................................
37,600
465
35
12,000
12,000
5,000
100
8,000
1
6.5
6.6
5.8
2
6.5
1.5
23.3
2/60
5/60
5/60
5/60
3/60
5/60
5/60
3/60
1,253
252
19
5,800
1,200
2,708
13
9,320
Subtotal for the MEPS–MPC ....................................................................
75,200
na
na
20,565
Grand Total .......................................................................................
136,400
na
na
75,280
MEPS–MPC
* There are 7 different screening forms; one for each event type. The burden estimates for the individual forms ranges from 1 to 3 minutes.
The estimate of 2 minutes used here is an average across all 7 screening forms.
EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN
Number of
respondents
Form name
Total burden
hours
Average hourly wage rate
Total cost
burden
MEPS–HC
MEPS–HC Core Interview ...............................................................................
Adult SAQ ........................................................................................................
Diabetes care SAQ ..........................................................................................
Permission form for the MEPS–MPC Provider Survey ...................................
Permission form for the MEPS–MPC Pharmacy Survey ................................
12,500
22,000
1,700
12,500
12.500
46,875
2,567
85
3,250
1,938
$21.74*
21.74
21.74
21.74
21.74
$1,019,06
55,807
1,848
70,655
V42,132
Subtotal for the MEPS–HC .......................................................................
61,200
54,715
na
1,189,505
MPC Screening Call ........................................................................................
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 ...............................................................................
37,600
465
35
12,000
12,000
5,000
100
8,000
1,253
252
19
5,800
1,200
2,708
13
9,320
15.59**
15.59
15.59
15.59
15.59
15.59
15.59
14.43***
19,534
3,929
296
90,422
18,708
42,218
203
134,488
Subtotal for the MEPS–MPC ....................................................................
75,200
20,560
na
309,798
Grand Total .......................................................................................
136,400
75,275
na
1,499,303
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MEPS–MPC
* Based upon the mean of the average wages for All Occupations (00–0000).
** Based upon the mean of the average wages for Medical Secretaries (43–6013).
*** Based upon the mean of the average wages for Pharmacy Technicians (29–2052).
Occupational Employment Statistics, May 2011 National Occupational Employment and Wage Estimates United States, U.S. Department of
Labor, Bureau of Labor Statistics. https://www.bls.gov/oes/current/oes_nat.htm#b29-0000.
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Federal Register / Vol. 77, No. 114 / Wednesday, June 13, 2012 / Notices
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
$51,401,596 in each of the three years
covered by this information collection
request.
EXHIBIT 3—ESTIMATED TOTAL AND ANNUALIZED COST
Cost component
Total cost
Annualized cost
Sampling Activities .......................................................................................................................................
Interviewer Recruitment and Training .........................................................................................................
Data Collection Activities .............................................................................................................................
Data Processing ..........................................................................................................................................
Production of Public Use Data Files ...........................................................................................................
Project Management ....................................................................................................................................
$3,002,731
9,190,168
93,611,428
23,087,605
21,079,118
4,233,739
$1,000,910
3,063,389
31,203,809
7,695,868
7,026,373
1,411,246
Total ......................................................................................................................................................
154,204,789
51,401,596
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: June 1, 2012.
Carolyn M. Clancy,
Director.
Proposed Project
[FR Doc. 2012–14204 Filed 6–12–12; 8:45 am]
School Environment Study:
Evaluating the Effects of CTG-supported
School-based Nutrition and Physical
Activity Policies on Students’ Diet,
Physical Activity, and Weight Status—
New—National Center for Chronic
Disease Prevention and Health
Promotion (NCCDPHP), Centers for
Disease Control and Prevention (CDC).
BILLING CODE 4160–90–M
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
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Centers for Disease Control and
Prevention
[60-Day-12–12NF]
Proposed Data Collections Submitted
for Public Comment and
Recommendations
In compliance with the requirement
of Section 3506(c)(2)(A) of the
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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,
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.
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
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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
over time of measures relating to each
of the five strategic directions. CDC is
requesting OMB approval to collect
information needed for these
assessments. This information
collection will enable a multi-method
evaluation of the school nutrition and
physical activity environments and on
related health indictors among students.
The School Environment Study involves
a quasi-experimental design that will
assess nutrition-, physical activity-, and
obesity-related outcomes and impacts,
and compare differential changes in
these outcomes and impacts between
students sampled in middle schools
supported by the CTG program and
students sampled in middle schools not
supported by the CTG program.
Four CTG program awardees
(Broward County, Florida; Travis
County, Texas; eight counties in
Massachusetts (excludes the city of
Boston and surrounding area); and Los
Angeles County, California) were
selected to participate in the School
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]]>Agencies
[Federal Register Volume 77, Number 114 (Wednesday, June 13, 2012)]
[Notices]
[Pages 35399-35402]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-14204]
[[Page 35399]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality Agency Information
Collection Activities
Proposed Collection; Comment Request
AGENCY: Agency for Healthcare Research and Quality, HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: This notice announces the intention of the Agency for
Healthcare Research and Quality (AHRQ) to request that the Office of
Management and Budget (OMB) approve the proposed information collection
project: ``Medical Expenditure Panel Survey (MEPS) Household Component
and the MEPS Medical Provider Component'' 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 August 13, 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
Medical Expenditure Panel Survey (MEPS) Household Component and the
MEPS Medical Provider Component
For over thirty years, results from the MEPS and its predecessor
surveys (the 1977 National Medical Care Expenditure Survey, the 1980
National Medical Care Utilization and Expenditure Survey and the 1987
National Medical Expenditure Survey) have been used by OMB, DHHS,
Congress and a wide number of health services researchers to analyze
health care use, expenses and health policy.
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 MEPS 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 MEPS
analytic capacity by providing another data point for comparisons over
time.
Households selected for participation in the MEPS Household
Component (MEPS-HC) 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.
The MEPS-HC has the following goal:
To provide nationally representative estimates for the
U.S. civilian noninstitutionalized population for health care use,
expenditures, sources of payment and health insurance coverage.
The MEPS Medical Provider Component (MEPS-MPC) will contact medical
providers (hospitals, physicians, home health agencies and
institutions) identified by household respondents in the MEPS-HC as
sources of medical care for the time period covered by the interview,
and all pharmacies providing prescription drugs to household members
during the covered time period. The MEPS-MPC is not designed to yield
national estimates. The sample is designed to target the types of
individuals and providers for whom household reported expenditure data
was expected to be insufficient. For example, households with one or
more Medicaid enrollees are targeted for inclusion in the MEPSMPC
because this group is expected to have limited information about
payments for their medical care.
The MEPS-MPC has the following goal:
To provide an imputation source to supplement/replace
household reported expenditure and source of payment information. 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.
This study is being conducted by AHRQ through its contractors,
Westat and RTI International, pursuant to AHRQ's statutory authority to
conduct and support research on healthcare and on systems for the
delivery of such care, including activities with respect to the cost
and use of health care services and with respect to health statistics
and surveys. 42 U.S.C. 299a(a)(3) and (8); 42 U.S.C. 299b-2.
Method of Collection
To achieve the goals of the MEPS-HC the following data collections
are implemented:
1. 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, income, assets,
satisfaction with health plans and providers, children's health, and
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.
2. Adult Self Administered Questionnaire. A brief self-administered
questionnaire (SAQ) 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. The
satisfaction with health care items are a subset of items from the
Consumer Assessment of Healthcare Providers and Systems
(CAHPS[supreg]). The health status items are from the Short Form 12
Version 2 (SF-12 version 2), which has been widely used as a measure of
self-reported health status in the United States, the Kessler Index
(K6) of non-specific psychological distress, and the Patient Health
Questionnaire (PHQ-2).
3. Diabetes Care SAQ. A brief self administered paper-and-pencil
questionnaire on the quality of diabetes care is administered once a
year (during rounds 3 and 5) to persons identified as having diabetes.
Included are questions about the number of times the respondent
reported having a hemoglobin A1c blood test, whether the respondent
reported having his or her feet checked for sores or irritations,
whether the respondent reported having an eye exam in which the pupils
were dilated, the last time the respondent had his or her blood
cholesterol checked and whether the diabetes has caused kidney or eye
problems. Respondents are also asked if their diabetes is being treated
with diet, oral medications or insulin.
4. Permission forms for the MEPS-MPC Provider and Pharmacy Survey.
As in previous panels of the MEPS, we will ask respondents for
permission to obtain supplemental information from their medical
providers (hospitals, physicians, home health agencies and
institutions) and pharmacies.
[[Page 35400]]
To achieve the goal of the MEPS-MPC the following data collections
are implemented:
1. MPC Screening Call. An initial screening call is placed to
determine the type of facility, whether the practice or facility is in
scope for the MEPS-MPC, the appropriate MEPS-MPC respondent and some
details about the organization and availability of medical records and
billing at the practice/facility. All hospitals, physician offices,
home health agencies, institutions and pharmacies are screened by
telephone. A unique screening instrument is used for each of the seven
provider types in the MEPS-MPC.
2. Home Care Provider Questionnaire for Health Care Providers. 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.
3. Home Care Provider Questionnaire for Non-Health Care Providers.
This questionnaire 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.
4. Medical Event Questionnaire for Office-Based Providers. This
questionnaire is for office-based physicians, including doctors of
medicine (MDs) and osteopathy (DOs), as well as providers practicing
under the direction or supervision of an MD or DO (e.g., physician
assistants and nurse practitioners working in clinics). Providers of
care in private offices as well as staff model HMOs are included.
5. Medical Event Questionnaire for Separately Billing Doctors. This
questionnaire collects information from physicians identified by
hospitals (during the Hospital Event data collection) as providing care
to sampled persons during the course of inpatient, outpatient
department or emergency room care, but who bill separately from the
hospital.
6. Hospital Event 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; the doctors that do bill separately from the hospital
will be contacted as part of the Medical Event Questionnaire for
Separately Billing Doctors. HMOs are included in this provider type.
7. Institutions Event Questionnaire. This questionnaire is used to
collect information about institution events, including nursing homes,
rehabilitation facilities and skilled nursing facilities. Institution
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. In many cases, the
institution administrative office also has to be contacted to determine
whether the doctors identified by medical records billed separately
from the institution itself.
8. Pharmacy Data Collection Questionnaire. This questionnaire
requests the national drug code (NDC) and when that is not available
the prescription name, date prescription was filled, payments by
source, prescription strength and form (when the NDC is not available),
quantity, and person for whom the prescription was filled. When the NDC
is available, we do not ask for prescription name, strength or form
because that information is embedded in the NDC; this reduces burden on
the respondent. 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. Pharmacies are also able to provide a CD-ROM
with the requested information if that is preferred. HMOs are included
in this provider type.
The MEPS is a multi-purpose survey. In addition to collecting data
to yield annual estimates for a variety of measures related to health
care use and expenditures, the MEPS also provides estimates of measures
related to health status, consumer assessment of health care, health
insurance coverage, demographic characteristics, employment and access
to health care indicators. Estimates can be provided for individuals,
families and population subgroups of interest. Data from the MEPS, both
the HC and MPC components, are intended for a number of annual reports
required to be produced by AHRQ, including the National Health Care
Quality Report and the National Health Care Disparities Report.
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 12,500 ``family level''
respondents, also referred to as RU respondents. Since the MEPS-HC
consists of 5 rounds of interviewing covering a full two years of data,
the annual average number of responses per respondent is 2.5 responses
per year. The MEPS-HC core requires an average response time of 1\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
22,000 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 1,700
persons, and takes about 3 minutes to complete. The permission form for
the MEPS-MPC Provider Survey will be completed once for each medical
provider seen by any RU member. Each of the 12,500 RUs in the MEPS-HC
will complete an average of 5.2 forms, which require about 3 minutes
each to complete. The permission form for the MEPS-MPC Pharmacy Survey
will be completed once for each pharmacy for any RU member who has
obtained a prescription medication. Each RU will complete an average of
3.1 forms, which take about 3 minutes to complete. The total annual
burden hours for the MEPS-HC are estimated to be 54,715 hours.
All 37,600 medical providers and pharmacies included in the MEPS-
MPC will receive a screening call which will take 2 minutes on average.
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 are estimated to be 20,565 hours. The total annual burden
hours for the MEPS-HC and MPC is estimated to be 75,280 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 $1,189,505; the annual
cost burden for the MEPS-MPC is estimated to be $309,798. The total
annual cost burden
[[Page 35401]]
for the MEPS-HC and MPC is estimated to be $1,499,303.
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.......................... 12,500 2.5 1.5 46,875
Adult SAQ....................................... 22,000 1 7/60 2,567
Diabetes care SAQ............................... 1,700 1 3/60 85
Permission form for the MEPS-MPC Provider Survey 12,500 5.2 3/60 3,250
Permission form for the MEPS-MPC Pharmacy Survey 12.500 3.1 3/60 1,938
---------------------------------------------------------------
Subtotal for the MEPS-HC.................... 61,200 na na 54,715
----------------------------------------------------------------------------------------------------------------
MEPS-MPC
----------------------------------------------------------------------------------------------------------------
MPC Screening Call*............................. 37,600 1 2/60 1,253
Home care for health care providers 465 6.5 5/60 252
questionnaire..................................
Home care for non-health care providers 35 6.6 5/60 19
questionnaire..................................
Office-based providers questionnaire............ 12,000 5.8 5/60 5,800
Separately billing doctors questionnaire........ 12,000 2 3/60 1,200
Hospitals questionnaire......................... 5,000 6.5 5/60 2,708
Institutions (non-hospital) questionnaire....... 100 1.5 5/60 13
Pharmacies questionnaire........................ 8,000 23.3 3/60 9,320
---------------------------------------------------------------
Subtotal for the MEPS-MPC................... 75,200 na na 20,565
---------------------------------------------------------------
Grand Total............................. 136,400 na na 75,280
----------------------------------------------------------------------------------------------------------------
* There are 7 different screening forms; one for each event type. The burden estimates for the individual forms
ranges from 1 to 3 minutes. The estimate of 2 minutes used here is an average across all 7 screening forms.
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 Interview.......................... 12,500 46,875 $21.74* $1,019,06
Adult SAQ....................................... 22,000 2,567 21.74 55,807
Diabetes care SAQ............................... 1,700 85 21.74 1,848
Permission form for the MEPS-MPC Provider Survey 12,500 3,250 21.74 70,655
Permission form for the MEPS-MPC Pharmacy Survey 12.500 1,938 21.74 V42,132
---------------------------------------------------------------
Subtotal for the MEPS-HC.................... 61,200 54,715 na 1,189,505
----------------------------------------------------------------------------------------------------------------
MEPS-MPC
----------------------------------------------------------------------------------------------------------------
MPC Screening Call.............................. 37,600 1,253 15.59** 19,534
Home care for health care providers 465 252 15.59 3,929
questionnaire..................................
Home care for non-health care providers 35 19 15.59 296
questionnaire..................................
Office-based providers questionnaire............ 12,000 5,800 15.59 90,422
Separately billing doctors questionnaire........ 12,000 1,200 15.59 18,708
Hospitals questionnaire......................... 5,000 2,708 15.59 42,218
Institutions (non-hospital) questionnaire....... 100 13 15.59 203
Pharmacies questionnaire........................ 8,000 9,320 14.43*** 134,488
---------------------------------------------------------------
Subtotal for the MEPS-MPC................... 75,200 20,560 na 309,798
----------------------------------------------------------------------------------------------------------------
Grand Total............................. 136,400 75,275 na 1,499,303
----------------------------------------------------------------------------------------------------------------
* Based upon the mean of the average wages for All Occupations (00-0000).
** Based upon the mean of the average wages for Medical Secretaries (43-6013).
*** Based upon the mean of the average wages for Pharmacy Technicians (29-2052).
Occupational Employment Statistics, May 2011 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.
[[Page 35402]]
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 $51,401,596 in each of the
three years covered by this information collection request.
Exhibit 3--Estimated Total and Annualized Cost
------------------------------------------------------------------------
Cost component Total cost Annualized cost
------------------------------------------------------------------------
Sampling Activities............... $3,002,731 $1,000,910
Interviewer Recruitment and 9,190,168 3,063,389
Training.........................
Data Collection Activities........ 93,611,428 31,203,809
Data Processing................... 23,087,605 7,695,868
Production of Public Use Data 21,079,118 7,026,373
Files............................
Project Management................ 4,233,739 1,411,246
-------------------------------------
Total......................... 154,204,789 51,401,596
------------------------------------------------------------------------
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: June 1, 2012.
Carolyn M. Clancy,
Director.
[FR Doc. 2012-14204 Filed 6-12-12; 8:45 am]
BILLING CODE 4160-90-M
