Agency Information Collection Activities: Proposed Collection; Comment Request, 58386-58389 [2012-23163]
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58386
Federal Register / Vol. 77, No. 183 / Thursday, September 20, 2012 / Notices
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: September 13, 2012.
Carolyn M. Clancy,
Director.
[FR Doc. 2012–23165 Filed 9–19–12; 8:45 am]
BILLING CODE 4160–90–M
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.
This proposed information collection
was previously published in the Federal
Register on June 13th, 2012 and allowed
60 days for public comment. One
comment was received. The purpose of
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SUMMARY:
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this notice is to allow an additional 30
days for public comment.
DATES: Comments on this notice must be
received by October 22, 2012.
ADDRESSES: Written comments should
be submitted to: AHRQ’s OMB Desk
Officer by fax at (202) 395–6974
(attention: AHRQ’s desk officer) or by
email at
OIRA_submission@omb.eop.gov
(attention: AHRQ’s desk officer).
Copies of the proposed collection
plans, data collection instruments, and
specific details on the estimated burden
can be obtained from the AHRQ Reports
Clearance Officer.
FOR FURTHER INFORMATION CONTACT:
Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427–1477, or by
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,
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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 serve as an imputation source
for and 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
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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. Authorization forms for the MEPS–
MPC Provider and Pharmacy Survey. As
in previous panels of the MEPS, we will
ask respondents for authorization to
obtain supplemental information from
their medical providers (hospitals,
physicians, home health agencies and
institutions) and pharmacies.
5. MEPS Validation Interview. Each
interviewer is required to have at least
15 percent of his/her caseload validated
to insure that CAPI questionnaire
content was asked appropriately and
procedures followed, for example the
use of show cards. Validation flags are
set programmatically for cases preselected by data processing staff before
each round of interviewing. Home office
and field management may also request
that other cases be validated throughout
the field period. When an interviewer
fails a validation all their work is
subject to 100 percent validation.
Additionally, any case completed in less
than 30 minutes is validated. A
validation abstract form containing
selected data collected in the CAPI
interview is generated and used by the
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validator to guide the validation
interview.
To achieve the goal of the MEPS–MPC
the following data collections are
implemented:
1. MPC Contact Guide/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
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58387
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
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Federal Register / Vol. 77, No. 183 / Thursday, September 20, 2012 / Notices
subgroups of interest. Data from the
MEPS, both the HC and MPC, 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 the MEPS–MPC. The
MEPS–HC Core Interview will be
completed by 15,093* (see note below
Exhibit 1) ‘‘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 86 minutes 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 28,254
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 2,345 persons, and takes
about 3 minutes to complete. The
authorization form for the MEPS–MPC
Provider Survey will be completed once
for each medical provider seen by any
RU member. The 14,489* RUs in the
MEPS–HC will complete an average of
5.2 forms, which require about 3
minutes each to complete. The
authorization form for the MEPS–MPC
Pharmacy Survey will be completed
once for each pharmacy for any RU
member who has obtained a
prescription medication. RUs will
complete an average of 3.1 forms, which
take about 3 minutes to complete. About
one third of all interviewed RUs will
complete a validation interview as part
of the MEPS–HC quality control, which
takes an average of 5 minutes to
complete. The total annual burden
hours for the MEPS–HC are estimated to
be 63,907 hours.
All 34,000 medical providers and
pharmacies included in the MEPS–MPC
will receive a screening call which will
take 3 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 18,914 hours. The total
annual burden for the MEPS–HC and
MPC is estimated to be 82,821 hours.
Exhibit 2 shows the estimated annual
cost burden associated with the
respondents’ time to participate in this
information collection. The annual cost
burden for the MEPS–HC is estimated to
be $1,389,339; the annual cost burden
for the MEPS–MPC is estimated to be
$285,680. The total annual cost burden
for the MEPS–HC and MPC is estimated
to be $1,675,019.
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 ..........................................................................................
Authorization form for the MEPS–MPC Provider Survey ................................
Authorization form for the MEPS–MPC Pharmacy Survey .............................
MEPS–HC Validation Interview .......................................................................
*15,093
28,254
2,345
14,489
14,489
4,781
2.5
1
1
5.2
3.1
1
86/60
7/60
3/60
3/60
3/60
5/60
54,083
3,296
117
3,767
2,246
398
Subtotal for the MEPS–HC .......................................................................
79,451
na
na
63,907
MPC Contact Guide/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 ...............................................................................
34,000
465
35
10,800
10,800
5,000
100
6,800
1
6.5
6.6
5.8
2
6.5
1.5
23.3
3/60
5/60
5/60
5/60
3/60
5/60
5/60
3/60
1,700
252
19
5,220
1,080
2,708
13
7,922
Subtotal for the MEPS–MPC ....................................................................
68,000
na
na
18,914
Grand Total .......................................................................................
147,451
na
na
82,821
MEPS–MPC
* While the expected number of responding units for the annual estimates is 14,489, it is necessary to adjust for survey attrition of initial respondents by a factor of 0.96 (15,093 = 14,489/0.96).
** There are 6 different contact guides; one for each provider type, except for the two home care provider types which use the same contact
guide.
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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 ........................................................................................................
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15,093
28,254
54,083
3,296
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* $21.74
21.74
$1,175,764
71,655
58389
Federal Register / Vol. 77, No. 183 / Thursday, September 20, 2012 / Notices
EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN—Continued
Number of
respondents
Form name
Total
burden hours
Average
hourly wage
rate
Total
cost burden
Diabetes care SAQ ..........................................................................................
Authorization forms for the MEPS–MPC Provider Survey ..............................
Authorization form for the MEPS–MPC Pharmacy Survey .............................
MEPS–HC Validation Interview .......................................................................
2,345
14,489
14,489
4,781
117
3,767
2,246
398
21.74
21.74
21.74
21.74
2,544
81,895
48,828
8,653
Subtotal for the MEPS–HC .......................................................................
79,451
63,907
na
1,389,339
MPC Contact Guide/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 ...............................................................................
34,000
465
35
10,800
10,800
5,000
100
6,800
1,700
252
19
5,220
1,080
2,708
13
7,922
** 15.59
15.59
15.59
15.59
15.59
15.59
15.59
*** 14.43
26,503
3,929
296
81,380
16,837
42,218
203
114,314
Subtotal for the MEPS–MPC ....................................................................
68,000
18,347
na
285,680
Grand Total .......................................................................................
147,451
82,254
na
1,675,019
MEPS–MPC
* Mean hourly wage for All Occupations (00–0000).
** Mean hourly wage for Medical Secretaries (43–6013)
*** Mean hourly wage 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.
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
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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
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16:11 Sep 19, 2012
Jkt 226001
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: September 6, 2012.
Carolyn M. Clancy,
Director.
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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
SUMMARY:
[FR Doc. 2012–23163 Filed 9–19–12; 8:45 am]
BILLING CODE 4160–90–M
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
E:\FR\FM\20SEN1.SGM
20SEN1
]]>Agencies
[Federal Register Volume 77, Number 183 (Thursday, September 20, 2012)]
[Notices]
[Pages 58386-58389]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-23163]
-----------------------------------------------------------------------
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.
This proposed information collection was previously published in
the Federal Register on June 13th, 2012 and allowed 60 days for public
comment. One comment was received. The purpose of this notice is to
allow an additional 30 days for public comment.
DATES: Comments on this notice must be received by October 22, 2012.
ADDRESSES: Written comments should be submitted to: AHRQ's OMB Desk
Officer by fax at (202) 395-6974 (attention: AHRQ's desk officer) or by
email at OIRA_submission@omb.eop.gov (attention: AHRQ's desk officer).
Copies of the proposed collection plans, data collection
instruments, and specific details on the estimated burden can be
obtained from the AHRQ Reports Clearance Officer.
FOR FURTHER INFORMATION CONTACT: Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427-1477, or by 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 serve as an imputation source for and 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
[[Page 58387]]
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. Authorization forms for the MEPS-MPC Provider and Pharmacy
Survey. As in previous panels of the MEPS, we will ask respondents for
authorization to obtain supplemental information from their medical
providers (hospitals, physicians, home health agencies and
institutions) and pharmacies.
5. MEPS Validation Interview. Each interviewer is required to have
at least 15 percent of his/her caseload validated to insure that CAPI
questionnaire content was asked appropriately and procedures followed,
for example the use of show cards. Validation flags are set
programmatically for cases pre-selected by data processing staff before
each round of interviewing. Home office and field management may also
request that other cases be validated throughout the field period. When
an interviewer fails a validation all their work is subject to 100
percent validation. Additionally, any case completed in less than 30
minutes is validated. A validation abstract form containing selected
data collected in the CAPI interview is generated and used by the
validator to guide the validation interview.
To achieve the goal of the MEPS-MPC the following data collections
are implemented:
1. MPC Contact Guide/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
[[Page 58388]]
subgroups of interest. Data from the MEPS, both the HC and MPC, 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 the MEPS-MPC. The
MEPS-HC Core Interview will be completed by 15,093* (see note below
Exhibit 1) ``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 86 minutes 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 28,254 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 2,345 persons, and takes about 3 minutes
to complete. The authorization form for the MEPS-MPC Provider Survey
will be completed once for each medical provider seen by any RU member.
The 14,489* RUs in the MEPS-HC will complete an average of 5.2 forms,
which require about 3 minutes each to complete. The authorization form
for the MEPS-MPC Pharmacy Survey will be completed once for each
pharmacy for any RU member who has obtained a prescription medication.
RUs will complete an average of 3.1 forms, which take about 3 minutes
to complete. About one third of all interviewed RUs will complete a
validation interview as part of the MEPS-HC quality control, which
takes an average of 5 minutes to complete. The total annual burden
hours for the MEPS-HC are estimated to be 63,907 hours.
All 34,000 medical providers and pharmacies included in the MEPS-
MPC will receive a screening call which will take 3 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 18,914 hours. The total annual burden
for the MEPS-HC and MPC is estimated to be 82,821 hours.
Exhibit 2 shows the estimated annual cost burden associated with
the respondents' time to participate in this information collection.
The annual cost burden for the MEPS-HC is estimated to be $1,389,339;
the annual cost burden for the MEPS-MPC is estimated to be $285,680.
The total annual cost burden for the MEPS-HC and MPC is estimated to be
$1,675,019.
Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
Number of
Form name Number of responses per Hours per Total burden
respondents respondent response hours
----------------------------------------------------------------------------------------------------------------
MEPS-HC
----------------------------------------------------------------------------------------------------------------
MEPS-HC Core Interview........................... *15,093 2.5 86/60 54,083
Adult SAQ........................................ 28,254 1 7/60 3,296
Diabetes care SAQ................................ 2,345 1 3/60 117
Authorization form for the MEPS-MPC Provider 14,489 5.2 3/60 3,767
Survey..........................................
Authorization form for the MEPS-MPC Pharmacy 14,489 3.1 3/60 2,246
Survey..........................................
MEPS-HC Validation Interview..................... 4,781 1 5/60 398
--------------------------------------------------------------
Subtotal for the MEPS-HC..................... 79,451 na na 63,907
----------------------------------------------------------------------------------------------------------------
MEPS-MPC
----------------------------------------------------------------------------------------------------------------
MPC Contact Guide/Screening Call**............... 34,000 1 3/60 1,700
Home care for health care providers questionnaire 465 6.5 5/60 252
Home care for non-health care providers 35 6.6 5/60 19
questionnaire...................................
Office-based providers questionnaire............. 10,800 5.8 5/60 5,220
Separately billing doctors questionnaire......... 10,800 2 3/60 1,080
Hospitals questionnaire.......................... 5,000 6.5 5/60 2,708
Institutions (non-hospital) questionnaire........ 100 1.5 5/60 13
Pharmacies questionnaire......................... 6,800 23.3 3/60 7,922
--------------------------------------------------------------
Subtotal for the MEPS-MPC.................... 68,000 na na 18,914
--------------------------------------------------------------
Grand Total.............................. 147,451 na na 82,821
----------------------------------------------------------------------------------------------------------------
* While the expected number of responding units for the annual estimates is 14,489, it is necessary to adjust
for survey attrition of initial respondents by a factor of 0.96 (15,093 = 14,489/0.96).
** There are 6 different contact guides; one for each provider type, except for the two home care provider types
which use the same contact guide.
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.......................... 15,093 54,083 * $21.74 $1,175,764
Adult SAQ....................................... 28,254 3,296 21.74 71,655
[[Page 58389]]
Diabetes care SAQ............................... 2,345 117 21.74 2,544
Authorization forms for the MEPS-MPC Provider 14,489 3,767 21.74 81,895
Survey.........................................
Authorization form for the MEPS-MPC Pharmacy 14,489 2,246 21.74 48,828
Survey.........................................
MEPS-HC Validation Interview.................... 4,781 398 21.74 8,653
---------------------------------------------------------------
Subtotal for the MEPS-HC.................... 79,451 63,907 na 1,389,339
----------------------------------------------------------------------------------------------------------------
MEPS-MPC
----------------------------------------------------------------------------------------------------------------
MPC Contact Guide/Screening Call................ 34,000 1,700 ** 15.59 26,503
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............ 10,800 5,220 15.59 81,380
Separately billing doctors questionnaire........ 10,800 1,080 15.59 16,837
Hospitals questionnaire......................... 5,000 2,708 15.59 42,218
Institutions (non-hospital) questionnaire....... 100 13 15.59 203
Pharmacies questionnaire........................ 6,800 7,922 *** 14.43 114,314
---------------------------------------------------------------
Subtotal for the MEPS-MPC................... 68,000 18,347 na 285,680
---------------------------------------------------------------
Grand Total............................. 147,451 82,254 na 1,675,019
----------------------------------------------------------------------------------------------------------------
* Mean hourly wage for All Occupations (00-0000).
** Mean hourly wage for Medical Secretaries (43-6013)
*** Mean hourly wage 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.
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
------------------------------------------------------------------------
Annualized
Cost component Total cost cost
------------------------------------------------------------------------
Sampling Activities..................... $3,002,731 $1,000,910
Interviewer Recruitment and Training.... 9,190,168 3,063,389
Data Collection Activities.............. 93,611,428 31,203,809
Data Processing......................... 23,087,605 7,695,868
Production of Public Use Data Files..... 21,079,118 7,026,373
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: September 6, 2012.
Carolyn M. Clancy,
Director.
[FR Doc. 2012-23163 Filed 9-19-12; 8:45 am]
BILLING CODE 4160-90-M
