Agency Information Collection Activities: Proposed Collection; Comment Request, 29004-29009 [2015-12229]
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Federal Register / Vol. 80, No. 97 / Wednesday, May 20, 2015 / Notices
Performance Green Buildings and
provides advice regarding how the
Office can accomplish its mission most
effectively.
The Portfolio Prioritization task group
is pursuing the motion of two
committee members to ‘‘propose a
process for Federal agencies to
consistently incorporate green building
and resilience requirements into their
capital investment criteria and
strategies.’’ The Energy Use Index task
group is pursuing the motion of a
committee member to ‘‘develop
guidelines for creating a new energy
intensity metric [to reflect impacts of]
densified facilities, centrally located
workplace sites . . . and expansion of
telework and hoteling.’’
Both groups have met previously and
had their work endorsed by the full
Committee at its April 23, 2015 meeting.
The conference calls will focus on how
the task groups can further refine these
motions into final consensus
recommendations of each group to the
full Committee, which will in turn
decide whether to proceed with formal
advice to GSA based upon these
recommendations. Additional
background information and updates
will be posted on GSA’s Web site at
https://www.gsa.gov/gbac.
Dated: May 14, 2015.
Kevin Kampschroer,
Federal Director, Office of Federal HighPerformance Green Buildings, General
Services Administration.
[FR Doc. 2015–12210 Filed 5–19–15; 8:45 am]
BILLING CODE 6820–14–P
GOVERNMENT ACCOUNTABILITY
OFFICE
Appointment to the Methodology
Committee of the Patient-Centered
Outcomes Research Institute (PCORI)
Government Accountability
Office (GAO).
ACTION: Notice of appointment.
AGENCY:
The Methodology Committee
assists PCORI in developing and
updating methodological standards and
guidance for comparative clinical
effectiveness research. The Patient
Protection and Affordable Care Act
directs the Comptroller General to
appoint up to 15 members to PCORI’s
Methodology Committee. This notice
announces the appointment of a new
member, Adam Wilcox, Ph.D., Director
of Medical Informatics at Intermountain
Healthcare in Salt Lake City, Utah.
DATES: The appointment is effective
May 2015.
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SUMMARY:
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GAO: 441 G Street NW.,
Washington, DC 20548.
PCORI: 1828 L Street NW., Suite 900,
Washington, DC 20036.
FOR MORE INFORMATION CONTACT: GAO:
Office of Public Affairs, (202) 512–4800.
PCORI: Joe Selby, MD, MPH, (202)
827–7700.
[Sec. 6301, Pub. L. 111–148].
representative of health care providers
opening.
42 U.S.C. 300jj-12.
Gene L. Dodaro,
Comptroller General of the United States.
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
ADDRESSES:
Gene L. Dodaro,
Comptroller General of the United States.
[FR Doc. 2015–11957 Filed 5–19–15; 8:45 am]
BILLING CODE 1610–02–M
[FR Doc. 2015–11955 Filed 5–19–15; 8:45 am]
BILLING CODE 1610–02–M
Agency for Healthcare Research and
Quality
GOVERNMENT ACCOUNTABILITY
OFFICE
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Appointments to the Health
Information Technology (HIT) Policy
Committee
AGENCY:
Government Accountability
Office (GAO).
ACTION: Notice of appointments.
AGENCY:
The American Recovery and
Reinvestment Act requires the
Comptroller General of the United
States to appoint 13 of 20 members to
the HIT Policy Committee. As of April
2015, new appointees to the HIT Policy
Committee are Kathleen Blake, MD,
MPH, an expert in health care quality
measurement and reporting; Donna
Cryer, JD, an advocate for patients or
consumers; and Brent Snyder, Esq., a
representative of health care providers.
DATES: Appointments are effective as of
April 2015.
ADDRESSES: GAO: 441 G Street NW.,
Washington, DC 20548.
FOR MORE INFORMATION CONTACT: GAO:
Office of Public Affairs, (202) 512–4800.
SUPPLEMENTARY INFORMATION:
More information about the new
appointees is provided below. Kathleen
Blake, MD, MPH, is Vice President for
Performance Improvement at the
American Medical Association (AMA)
and resides in Chicago, Illinois, and
Santa Fe, New Mexico. She was
appointed to fill the health care quality
measurement and reporting opening.
Donna Cryer, JD, is Founder and
President of the Global Liver Institute in
Washington, DC, which facilitates
collaboration among patient advocates,
policymakers, regulators, health
systems, and payers to solve challenges
to advancing liver health and treating
liver diseases. She was appointed to fill
the patients or consumers advocate
opening.
Brent Snyder, Esq. is Chief
Information Officer at Adventist Health
System (AHS) and lives in Springfield,
Tennessee. He was appointed to fill the
SUMMARY:
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Agency for Healthcare Research
and Quality, HHS.
ACTION: Notice.
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
changes to the currently approved
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 July 20, 2015.
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
Medical Expenditure Panel Survey
(MEPS) Household Component (HC)
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.
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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–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 or herself and for other
family members.
The goal of MEPS–HC is to provide
nationally representative estimates for
the U.S. civilian noninstitutionalized
population for health care use,
expenditures, sources of payment and
health insurance coverage
Medical Expenditure Panel Survey
(MEPS) Medical Provider Component
(MPC)
The 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 as a standalone survey. 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, Medicaid
enrollees are targeted for inclusion in
the MEPS–MPC because this group is
expected to have limited information
about payments for their medical care.
There is one addition to the MEPS–
MPC being implemented in this renewal
request, the MEPS MPC Medical
Organizations Survey (MOS). The MEPS
MOS will expand current MPC data
collection activities to include
information on the organization of the
practices of office-based care providers
identified as a usual source of care in
the MEPS MPC. This additional data
collection will be for a subset of officebased care providers already included
in the MEPS MPC sample. In the MEPS
MPC sample, for a nationally
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representative sample of adults, primary
location for individual’s office-based
usual sources of care will be identified.
The MEPS MPC will contact these
places where medical care is provided,
determine the appropriate respondent
and administer a MEPS MOS. The
design of the survey will be multimodal
including some telephone contact.
Additional data collection methods may
include phone, fax, mail, selfadministration, electronic transmission,
and the Web. The data collection
method chosen for a provider shall be
the method that results in the most
complete and accurate data with least
burden to the provider.
The MEPS–MPC collects event level
data about medical care received by
sampled persons during the relevant
time period. The data collected from
medical providers include:
• Dates on which medical encounters
during the reference period occurred
• Data on the medical content of each
encounter, including ICD–9 (or ICD–10)
and CPT–4 codes
• Data on the charges associated with
each encounter, the sources paying for
the medical care. including the patient/
family, public sources, and private
insurance, and amounts paid by each
source
Data collected from pharmacies
include:
• Date of prescription fill.
• National drug code (NDC) or
prescription name, strength and form.
• Quantity.
• Payments, by source.
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:
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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. All
sections of the current core instrument
are available on the AHRQ Web site at
https://meps.ahrq.gov/mepsweb/survey_
comp/survey_questionnaires.jsp.
2. Adult Self-Administered
Questionnaire. A brief self-administered
questionnaire 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
(see https://meps.ahrq.gov/mepsweb/
survey_comp/survey.jsp#supplemental).
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 selfreported health status in the United
States, the Kessler Index (K6) of nonspecific psychological distress, and the
Patient Health Questionnaire (PHQ–2).
This questionnaire is unchanged from
the previous OMB clearance.
3. Diabetes Care Self Administered
Questionnaire. A brief self-administered
paper-and-pencil questionnaire on the
quality of diabetes care is administered
once a year (during round 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. This
questionnaire is unchanged from the
previous OMB clearance. See https://
meps.ahrq.gov/mepsweb/survey_comp/
survey.jsp#supplemental.
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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. See https://
meps.ahrq.gov/mepsweb/survey_comp/
survey.jsp#MPC_AF for the pharmacy
and provider authorization forms.
5. MEPS Validation Interview. Each
interviewer is required to have at least
15 percent of his/her caseload validated
to insure that computer-assisted
personal interview (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
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
these seven provider types in the
MEPS–MPC, except for the two home
care provider types which use the same
screening form; see https://
meps.ahrq.gov/mepsweb/survey_comp/
survey.jsp#MPC_CG.
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. See
https://meps.ahrq.gov/mepsweb/survey_
comp/survey.jsp#MPC.
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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. See https://
meps.ahrq.gov/mepsweb/survey_comp/
survey.jsp#MPC.
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.
See https://meps.ahrq.gov/mepsweb/
survey_comp/survey.jsp#MPC.
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. See https://meps.ahrq.gov/
mepsweb/survey_comp/
survey.jsp#MPC.
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. See
https://meps.ahrq.gov/mepsweb/survey_
comp/survey.jsp#MPC.
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
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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. See https://meps.ahrq.gov/
mepsweb/survey_comp/
survey.jsp#MPC).
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. See https://
meps.ahrq.gov/mepsweb/survey_comp/
survey.jsp#MPC.
9. Medical Organizations Survey
Questionnaire. This questionnaire will
collect essential information on
important features of the staffing,
organization, policies, and financing for
identified usual source of office based
care providers. This additional data
collection will be a subset of office
based care providers already included
in the MEPS MPC sample and will be
a nationally representative sample of
adults’ primary location for individuals
office based usual sources of care.
Dentists, optometrists, psychologists,
podiatrists, chiropractors, and others
not providing care under the
supervision of a MD or DO are
considered out of scope for the MEPS–
MPC.
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, 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
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for individuals, families and population
subgroups of interest. Data obtained in
this study are used to provide, among
others, the following national estimates:
• Annual estimates of health care use
and expenditures for persons and
families.
• Annual estimates of sources of
payment for health care utilizations,
including public programs such as
Medicare and Medicaid, private
insurance, and out of pocket payments.
• Annual estimates of health care use,
expenditures and sources of payment of
persons and families by type of
utilization including inpatient stay,
ambulatory care, home health, dental
care and prescribed medications.
• The number and characteristics of
the population eligible for public
programs including the use of services
and expenditures of the population(s)
eligible for benefits under Medicare and
Medicaid.
• The number, characteristics, and
use of services and expenditures of
persons and families with various forms
of insurance.
• Annual estimates of consumer
satisfaction with health care, and
indicators of health care quality for key
conditions.
• Annual estimates to track
disparities in health care use and access.
In addition to national estimates, data
collected in this ongoing, longitudinal
study are used to study the
determinants of the use of services and
expenditures, and changes in the access
to and the provision of health care in
relation to:
• Socio-economic and demographic
factors such as employment or income.
• The health status and satisfaction
with health care of individuals and
families.
• The health needs and
circumstances of specific subpopulation
groups such as the elderly and children.
To meet the need for national data on
health care use, access, cost and quality,
MEPS–HC collects information on:
• Access to care and barriers to
receiving needed care.
• Satisfaction with usual providers.
• Health status and limitations in
activities.
• Medical conditions for which
health care was used.
• Use, expense and payment (as well
as insurance status of person receiving
care) for health services.
Given the twin problems of
nonresponse and response error of some
household reported data, information is
collected directly from medical
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providers in the MEPS–MPC to improve
the accuracy of expenditure estimates
derived from the MEPS–HC. Because of
their greater level of precision and
detail, we also use MEPS–MPC data as
the main source of imputations of
missing expenditure data. Thus, the
MEPS–MPC is designed to satisfy the
following analytical objectives:
• Serve as source data for household
reported events with missing
expenditure information.
• Serve as an imputation source to
reduce the level of bias in survey
estimates of medical expenditures due
to item nonresponse and less complete
and less accurate household data.
• Serve as the primary data source for
expenditure estimates of medical care
provided by separately billing doctors in
hospitals, emergency rooms, and
outpatient departments, Medicaid
recipients and expenditure estimates for
pharmacies.
• Allow for an examination of the
level of agreement in reported
expenditures from household
respondents and medical providers.
Data from the MEPS, both the HC and
MPC components, are intended for a
number of annual reports produced by
AHRQ, including the National
Healthcare Quality and Disparities
Report.
The MEPS MPC MOS data will be
used to create a database that will be
unique in providing an internally
consistent source of information both on
individuals’ characteristics and health
care utilization and expenditures, and
on the characteristics of the providers
they use. The following areas will be
addressed in the MOS as they
potentially affect individuals’ access to,
use of and affordability of health care
services:
• Organizational characteristics, e.g.,
size, specialties covered, practice rules
and procedures, patient mix and scope
of care provided, membership in an
ACO, certification as a primary care
medical home.
• Use of health information
technology.
• Policies and practices related to the
ACA.
• Financial arrangements, e.g.,
reimbursement methods, number and
types of insurance contracts,
compensation arrangements within the
practice.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated
annualized burden hours for the
respondents’ time to participate in the
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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 92 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
5.4 forms, which require about 3minutes
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 67,826 hours.
All medical providers and pharmacies
included in the MEPS–MPC will receive
a screening call and the MEPS–MPC
uses 7 different questionnaires; 6 for
medical providers and 1 for pharmacies.
Each questionnaire is relatively short
and requires 2 to 19 minutes to
complete. The total annual burden
hours for the MEPS–MPC are estimated
to be 18,876 hours. The total annual
burden for the MEPS–HC and MPC is
estimated to be 86,702 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 $1,680,727; the annual cost burden
for the MEPS–MPC is estimated to be
$299,477. The total annual cost burden
for the MEPS–HC and MPC is estimated
to be $1,980,204.
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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
5.4
3.1
1
92/60
7/60
3/60
3/60
3/60
5/60
57,857
3,296
117
3,912
2,246
398
Subtotal for the MEPS–HC .......................................................................
79,451
Na
na
67,826
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 ...............................................................................
Medical Organizations Survey questionnaire ..................................................
Subtotal for the MEPS–MPC ...........................................................................
35,222
532
25
11,785
12,693
5,077
117
4,993
6,000
76,444
1
1.49
1
1.44
3.43
3.51
2.03
4.44
1
na
2/60
9/60
11/60
10/60
13/60
9/60
9/60
3/60
15/60
na
1,174
119
5
2,828
9,433
2,673
36
1,108
1,500
18,876
Grand Total .......................................................................................
155,895
na
na
86,702
MEPS–MPC/MOS
* 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 office based, separately billing doctor, hospital, institution, and pharmacy provider types, and
the two home care provider types use the same contact guide.
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 ..........................................................................................
Authorization forms 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
57,857
3,296
117
3,912
2,246
398
* $24.78
24.78
24.78
24.78
24.78
24.78
1,433,696
81,675
2,899
96,939
55,656
9,862
Subtotal for the MEPS–HC .......................................................................
79,451
67,826
Na
$1,680,727
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 ...............................................................................
Medical Organizations Survey questionnaire ..................................................
Subtotal for the MEPS–MPC ...........................................................................
35,222
532
25
11,785
12,693
5,077
117
4,993
6,000
76,444
1,174
119
5
2,828
9,433
2,673
36
1,108
1,500
18,876
* * $15.93
* * $15.93
* * $15.93
* * $15.93
* * $15.93
* * $15.93
* * 15.93
* * 14.83 *
* * 15.93
na
18,702
1,896
$80
$45,050
$150,268
$42,581
$573
$16,432
$23,895
$299,477
Grand Total ...............................................................................................
155,895
86,073
na
$1,980,204
MEPS–MPC/MOS
mstockstill on DSK4VPTVN1PROD with NOTICES
* 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 2013 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.
VerDate Sep<11>2014
23:50 May 19, 2015
Jkt 235001
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
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performance of AHRQ health care
research and health care information
dissemination functions, including
whether the information will have
practical utility; (b) the accuracy of
AHRQ’s estimate of burden (including
hours and costs) of the proposed
collection(s) of information; (c) ways to
E:\FR\FM\20MYN1.SGM
20MYN1
Federal Register / Vol. 80, No. 97 / Wednesday, May 20, 2015 / Notices
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.
Sharon B. Arnold,
Deputy Director.
[FR Doc. 2015–12229 Filed 5–19–15; 8:45 am]
BILLING CODE 4160–90–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
[Docket No. CDC–2015–0016]
Proposed Revised Vaccine Information
Materials for Seasonal Influenza
Vaccines
Centers for Disease Control and
Prevention (CDC), Department of Health
and Human Services (HHS).
ACTION: Notice with comment period.
AGENCY:
Under the National
Childhood Vaccine Injury Act (NCVIA)
(42 U.S.C. 300aa–26), the Centers for
Disease Control and Prevention (CDC)
within the Department of Health and
Human Services (HHS) develops
vaccine information materials that all
health care providers are required to
give to patients/parents prior to
administration of specific vaccines.
HHS/CDC seeks written comment on the
proposed updated vaccine information
statements for inactivated and live
attenuated influenza vaccines.
DATES: Written comments must be
received on or before July 20, 2015.
ADDRESSES: You may submit comments,
identified by Docket No. CDC–2015–
0016, by any of the following methods:
• Federal eRulemaking Portal: https://
www.regulations.gov. Follow the
instructions for submitting comments.
• Mail: Written comments should be
addressed to Suzanne Johnson-DeLeon
(msj1@cdc.gov), National Center for
Immunization and Respiratory Diseases,
Centers for Disease Control and
Prevention, Mailstop A–19, 1600 Clifton
Road NE., Atlanta, Georgia 30329.
Instructions: All submissions received
must include the agency name and
docket number. All relevant comments
mstockstill on DSK4VPTVN1PROD with NOTICES
SUMMARY:
VerDate Sep<11>2014
23:50 May 19, 2015
Jkt 235001
received will be posted without change
to https://regulations.gov, including any
personal information provided. For
access to the docket to read background
documents or comments received, go to
https://www.regulations.gov.
FOR FURTHER INFORMATION CONTACT: Skip
Wolfe (crw4@cdc.gov), National Center
for Immunization and Respiratory
Diseases, Centers for Disease Control
and Prevention, Mailstop A–19, 1600
Clifton Road NE., Atlanta, Georgia
30329.
The
National Childhood Vaccine Injury Act
of 1986 (Pub. L. 99–660), as amended by
section 708 of Public Law 103–183,
added section 2126 to the Public Health
Service Act. Section 2126, codified at 42
U.S.C. 300aa-26, requires the Secretary
of Health and Human Services to
develop and disseminate vaccine
information materials for distribution by
all health care providers in the United
States to any patient (or to the parent or
legal representative in the case of a
child) receiving vaccines covered under
the National Vaccine Injury
Compensation Program (VICP).
Development and revision of the
vaccine information materials, also
known as Vaccine Information
Statements (VIS), have been delegated
by the Secretary to the Centers for
Disease Control and Prevention (CDC).
Section 2126 requires that the materials
be developed, or revised, after notice to
the public, with a 60-day comment
period, and in consultation with the
Advisory Commission on Childhood
Vaccines, appropriate health care
provider and parent organizations, and
the Food and Drug Administration. The
law also requires that the information
contained in the materials be based on
available data and information, be
presented in understandable terms, and
include:
(1) A concise description of the
benefits of the vaccine,
(2) A concise description of the risks
associated with the vaccine,
(3) A statement of the availability of
the National Vaccine Injury
Compensation Program, and
(4) Such other relevant information as
may be determined by the Secretary.
The vaccines initially covered under
the National Vaccine Injury
Compensation Program were diphtheria,
tetanus, pertussis, measles, mumps,
rubella and poliomyelitis vaccines.
Since April 15, 1992, any health care
provider in the United States who
intends to administer one of these
covered vaccines is required to provide
copies of the relevant vaccine
information materials prior to
SUPPLEMENTARY INFORMATION:
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29009
administration of any of these vaccines.
Since then, the following vaccines have
been added to the National Vaccine
Injury Compensation Program, requiring
use of vaccine information materials for
them as well: Hepatitis B, Haemophilus
influenzae type b (Hib), varicella
(chickenpox), pneumococcal conjugate,
rotavirus, hepatitis A, meningococcal,
human papillomavirus (HPV), and
seasonal influenza vaccines.
Instructions for use of the vaccine
information materials are found on the
CDC Web site at: https://www.cdc.gov/
vaccines/hcp/vis/.
HHS/CDC is proposing updated
versions of the inactivated and live
attenuated seasonal influenza vaccine
information statements.
The vaccine information materials
referenced in this notice are being
developed in consultation with the
Advisory Commission on Childhood
Vaccines, the Food and Drug
Administration, and parent and health
care provider groups.
We invite written comment on the
proposed vaccine information materials
entitled ‘‘Influenza (Flu) Vaccine
(Inactivated or Recombinant): What you
need to know’’ and ‘‘Influenza (Flu)
Vaccine (Live, Intranasal): What you
need to know.’’ Copies of the proposed
vaccine information materials are
available at https://www.regulations.gov
(see Docket Number CDC–2015–0016).
Comments submitted will be considered
in finalizing these materials. When the
final materials are published in the
Federal Register, the notice will include
an effective date for their mandatory
use.
Dated: May 14, 2015.
Ron A. Otten,
Acting Deputy Associate Director for Science,
Centers for Disease Control and Prevention.
[FR Doc. 2015–12240 Filed 5–19–15; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
[Docket No. CDC–2015–0014]
Proposed Revised Vaccine Information
Materials for Pneumococcal Conjugate
Vaccine (PCV13)
Centers for Disease Control and
Prevention (CDC), Department of Health
and Human Services (HHS).
ACTION: Notice with comment period.
AGENCY:
Under the National
Childhood Vaccine Injury Act (NCVIA)
(42 U.S.C. 300aa–26), the Centers for
SUMMARY:
E:\FR\FM\20MYN1.SGM
20MYN1
Agencies
[Federal Register Volume 80, Number 97 (Wednesday, May 20, 2015)]
[Notices]
[Pages 29004-29009]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-12229]
=======================================================================
-----------------------------------------------------------------------
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 changes to the
currently approved 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 July 20, 2015.
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 (HC)
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.
[[Page 29005]]
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-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 or herself and for other
family members.
The goal of MEPS-HC is to provide nationally representative
estimates for the U.S. civilian noninstitutionalized population for
health care use, expenditures, sources of payment and health insurance
coverage
Medical Expenditure Panel Survey (MEPS) Medical Provider Component
(MPC)
The 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 as a stand-
alone survey. 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, Medicaid enrollees are targeted for
inclusion in the MEPS-MPC because this group is expected to have
limited information about payments for their medical care.
There is one addition to the MEPS-MPC being implemented in this
renewal request, the MEPS MPC Medical Organizations Survey (MOS). The
MEPS MOS will expand current MPC data collection activities to include
information on the organization of the practices of office-based care
providers identified as a usual source of care in the MEPS MPC. This
additional data collection will be for a subset of office-based care
providers already included in the MEPS MPC sample. In the MEPS MPC
sample, for a nationally representative sample of adults, primary
location for individual's office-based usual sources of care will be
identified. The MEPS MPC will contact these places where medical care
is provided, determine the appropriate respondent and administer a MEPS
MOS. The design of the survey will be multimodal including some
telephone contact. Additional data collection methods may include
phone, fax, mail, self-administration, electronic transmission, and the
Web. The data collection method chosen for a provider shall be the
method that results in the most complete and accurate data with least
burden to the provider.
The MEPS-MPC collects event level data about medical care received
by sampled persons during the relevant time period. The data collected
from medical providers include:
Dates on which medical encounters during the reference
period occurred
Data on the medical content of each encounter, including
ICD-9 (or ICD-10) and CPT-4 codes
Data on the charges associated with each encounter, the
sources paying for the medical care. including the patient/family,
public sources, and private insurance, and amounts paid by each source
Data collected from pharmacies include:
Date of prescription fill.
National drug code (NDC) or prescription name, strength
and form.
Quantity.
Payments, by source.
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 typically a family, only one
person normally provides this information. All sections of the current
core instrument are available on the AHRQ Web site at https://meps.ahrq.gov/mepsweb/survey_comp/survey_questionnaires.jsp.
2. Adult Self-Administered Questionnaire. A brief self-administered
questionnaire 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 (see https://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#supplemental). 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). This questionnaire is unchanged from the
previous OMB clearance.
3. Diabetes Care Self Administered Questionnaire. A brief self-
administered paper-and-pencil questionnaire on the quality of diabetes
care is administered once a year (during round 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. This
questionnaire is unchanged from the previous OMB clearance. See https://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#supplemental.
[[Page 29006]]
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. See https://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC_AF for the pharmacy and provider
authorization forms.
5. MEPS Validation Interview. Each interviewer is required to have
at least 15 percent of his/her caseload validated to insure that
computer-assisted personal interview (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 these seven provider types in the MEPS-MPC, except for the two
home care provider types which use the same screening form; see https://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC_CG.
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. See https://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC.
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. See https://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC.
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. See
https://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC.
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. See https://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC.
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.
See https://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC.
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. See https://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC).
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. See https://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC.
9. Medical Organizations Survey Questionnaire. This questionnaire
will collect essential information on important features of the
staffing, organization, policies, and financing for identified usual
source of office based care providers. This additional data collection
will be a subset of office based care providers already included in the
MEPS MPC sample and will be a nationally representative sample of
adults' primary location for individuals office based usual sources of
care.
Dentists, optometrists, psychologists, podiatrists, chiropractors,
and others not providing care under the supervision of a MD or DO are
considered out of scope for the MEPS-MPC.
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, 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
[[Page 29007]]
for individuals, families and population subgroups of interest. Data
obtained in this study are used to provide, among others, the following
national estimates:
Annual estimates of health care use and expenditures for
persons and families.
Annual estimates of sources of payment for health care
utilizations, including public programs such as Medicare and Medicaid,
private insurance, and out of pocket payments.
Annual estimates of health care use, expenditures and
sources of payment of persons and families by type of utilization
including inpatient stay, ambulatory care, home health, dental care and
prescribed medications.
The number and characteristics of the population eligible
for public programs including the use of services and expenditures of
the population(s) eligible for benefits under Medicare and Medicaid.
The number, characteristics, and use of services and
expenditures of persons and families with various forms of insurance.
Annual estimates of consumer satisfaction with health
care, and indicators of health care quality for key conditions.
Annual estimates to track disparities in health care use
and access.
In addition to national estimates, data collected in this ongoing,
longitudinal study are used to study the determinants of the use of
services and expenditures, and changes in the access to and the
provision of health care in relation to:
Socio-economic and demographic factors such as employment
or income.
The health status and satisfaction with health care of
individuals and families.
The health needs and circumstances of specific
subpopulation groups such as the elderly and children.
To meet the need for national data on health care use, access, cost
and quality, MEPS-HC collects information on:
Access to care and barriers to receiving needed care.
Satisfaction with usual providers.
Health status and limitations in activities.
Medical conditions for which health care was used.
Use, expense and payment (as well as insurance status of
person receiving care) for health services.
Given the twin problems of nonresponse and response error of some
household reported data, information is collected directly from medical
providers in the MEPS-MPC to improve the accuracy of expenditure
estimates derived from the MEPS-HC. Because of their greater level of
precision and detail, we also use MEPS-MPC data as the main source of
imputations of missing expenditure data. Thus, the MEPS-MPC is designed
to satisfy the following analytical objectives:
Serve as source data for household reported events with
missing expenditure information.
Serve as an imputation source to reduce the level of bias
in survey estimates of medical expenditures due to item nonresponse and
less complete and less accurate household data.
Serve as the primary data source for expenditure estimates
of medical care provided by separately billing doctors in hospitals,
emergency rooms, and outpatient departments, Medicaid recipients and
expenditure estimates for pharmacies.
Allow for an examination of the level of agreement in
reported expenditures from household respondents and medical providers.
Data from the MEPS, both the HC and MPC components, are intended
for a number of annual reports produced by AHRQ, including the National
Healthcare Quality and Disparities Report.
The MEPS MPC MOS data will be used to create a database that will
be unique in providing an internally consistent source of information
both on individuals' characteristics and health care utilization and
expenditures, and on the characteristics of the providers they use. The
following areas will be addressed in the MOS as they potentially affect
individuals' access to, use of and affordability of health care
services:
Organizational characteristics, e.g., size, specialties
covered, practice rules and procedures, patient mix and scope of care
provided, membership in an ACO, certification as a primary care medical
home.
Use of health information technology.
Policies and practices related to the ACA.
Financial arrangements, e.g., reimbursement methods,
number and types of insurance contracts, compensation arrangements
within the practice.
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 92 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 5.4 forms,
which require about 3minutes 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 67,826 hours.
All medical providers and pharmacies included in the MEPS-MPC will
receive a screening call and the MEPS-MPC uses 7 different
questionnaires; 6 for medical providers and 1 for pharmacies. Each
questionnaire is relatively short and requires 2 to 19 minutes to
complete. The total annual burden hours for the MEPS-MPC are estimated
to be 18,876 hours. The total annual burden for the MEPS-HC and MPC is
estimated to be 86,702 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 $1,680,727;
the annual cost burden for the MEPS-MPC is estimated to be $299,477.
The total annual cost burden for the MEPS-HC and MPC is estimated to be
$1,980,204.
[[Page 29008]]
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 92/60 57,857
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 5.4 3/60 3,912
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 67,826
----------------------------------------------------------------------------------------------------------------
MEPS-MPC/MOS
----------------------------------------------------------------------------------------------------------------
MPC Contact Guide/Screening Call * *............ 35,222 1 2/60 1,174
Home care for health care providers 532 1.49 9/60 119
questionnaire..................................
Home care for non[dash]health care providers 25 1 11/60 5
questionnaire..................................
Office[dash]based providers questionnaire....... 11,785 1.44 10/60 2,828
Separately billing doctors questionnaire........ 12,693 3.43 13/60 9,433
Hospitals questionnaire......................... 5,077 3.51 9/60 2,673
Institutions (non-hospital) questionnaire....... 117 2.03 9/60 36
Pharmacies questionnaire........................ 4,993 4.44 3/60 1,108
Medical Organizations Survey questionnaire...... 6,000 1 15/60 1,500
Subtotal for the MEPS-MPC....................... 76,444 na na 18,876
---------------------------------------------------------------
Grand Total............................. 155,895 na na 86,702
----------------------------------------------------------------------------------------------------------------
* 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 office based, separately billing doctor, hospital,
institution, and pharmacy provider types, and the two home care provider types use the same contact guide.
Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
Average
Form name Number of Total burden hourly wage Total cost
respondents hours rate burden
----------------------------------------------------------------------------------------------------------------
MEPS-HC
----------------------------------------------------------------------------------------------------------------
MEPS-HC Core Interview.......................... 15,093 57,857 * $24.78 1,433,696
Adult SAQ....................................... 28,254 3,296 24.78 81,675
Diabetes care SAQ............................... 2,345 117 24.78 2,899
Authorization forms for the MEPS-MPC Provider 14,489 3,912 24.78 96,939
Survey.........................................
Authorization form for the MEPS-MPC Pharmacy 14,489 2,246 24.78 55,656
Survey.........................................
MEPS-HC Validation Interview.................... 4,781 398 24.78 9,862
---------------------------------------------------------------
Subtotal for the MEPS-HC.................... 79,451 67,826 Na $1,680,727
----------------------------------------------------------------------------------------------------------------
MEPS-MPC/MOS
----------------------------------------------------------------------------------------------------------------
MPC Contact Guide/Screening Call................ 35,222 1,174 * * $15.93 18,702
Home care for health care providers 532 119 * * $15.93 1,896
questionnaire..................................
Home care for non[dash]health care providers 25 5 * * $15.93 $80
questionnaire..................................
Office[dash]based providers questionnaire....... 11,785 2,828 * * $15.93 $45,050
Separately billing doctors questionnaire........ 12,693 9,433 * * $15.93 $150,268
Hospitals questionnaire......................... 5,077 2,673 * * $15.93 $42,581
Institutions (non-hospital) questionnaire....... 117 36 * * 15.93 $573
Pharmacies questionnaire........................ 4,993 1,108 * * 14.83 * $16,432
Medical Organizations Survey questionnaire...... 6,000 1,500 * * 15.93 $23,895
Subtotal for the MEPS-MPC....................... 76,444 18,876 na $299,477
---------------------------------------------------------------
Grand Total................................. 155,895 86,073 na $1,980,204
----------------------------------------------------------------------------------------------------------------
* 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 2013 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.
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 health care research and
health care information dissemination functions, including whether the
information will have practical utility; (b) the accuracy of AHRQ's
estimate of burden (including hours and costs) of the proposed
collection(s) of information; (c) ways to
[[Page 29009]]
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.
Sharon B. Arnold,
Deputy Director.
[FR Doc. 2015-12229 Filed 5-19-15; 8:45 am]
BILLING CODE 4160-90-P