Agency Information Collection Activities: Proposed Collection; Comment Request, 50000-50005 [2015-20358]
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desk officer for the agencies by mail to
the Office of Information and Regulatory
Affairs, Office of Management and
Budget, New Executive Office Building,
Room 10235, 725 17th Street NW.,
Washington, DC 20503; by fax to (202)
395–6974; or by email to oira_
submission@omb.eop.gov.
FOR FURTHER INFORMATION CONTACT:
Additional information or a copy of the
collections may be requested from Nuha
Elmaghrabi, Federal Reserve Board
Clearance Officer, (202) 452–3829,
Office of the Chief Data Officer, Board
of Governors of the Federal Reserve
System, 20th and C Streets NW.,
Washington, DC 20551.
Telecommunications Device for the Deaf
(TDD) users may call (202) 263–4869.
SUPPLEMENTARY INFORMATION: Proposal
to request approval from OMB of the
extension for three years, without
revision, of the following reports:
1. Report titles: Report of Assets and
Liabilities of U.S. Branches and
Agencies of Foreign Banks; Report of
Assets and Liabilities of a Non-U.S.
Branch that is Managed or Controlled by
a U.S. Branch or Agency of a Foreign
(Non-U.S.) Bank.
Agency form numbers: FFIEC 002;
FFIEC 002S.
OMB control number: 7100–0032.
Frequency of response: Quarterly.
Affected public: U.S. branches and
agencies of foreign banks.
Number of respondents: FFIEC 002—
223; FFIEC 002S—49.
Estimated average time per response:
FFIEC 002—25.43 hours; FFIEC 002S—
6.0 hours.
Estimated total annual burden: FFIEC
002—22,684 hours; FFIEC 002S—1,176
hours.
General description of reports: These
information collections are mandatory
(12 U.S.C. 3105(c)(2), 1817(a)(1) and (3),
and 3102(b)). Except for select sensitive
items, the FFIEC 002 is not given
confidential treatment; the FFIEC 002S
is given confidential treatment (5 U.S.C.
552(b)(4) and (8)).
Abstract: On a quarterly basis, all U.S.
branches and agencies of foreign banks
are required to file the FFIEC 002,
which is a detailed report of condition
with a variety of supporting schedules.
This information is used to fulfill the
supervisory and regulatory requirements
of the International Banking Act of
1978. The data are also used to augment
the bank credit, loan, and deposit
information needed for monetary policy
and other public policy purposes. The
FFIEC 002S is a supplement to the
FFIEC 002 that collects information on
assets and liabilities of any non-U.S.
branch that is managed or controlled by
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a U.S. branch or agency of the foreign
bank. Managed or controlled means that
a majority of the responsibility for
business decisions, including but not
limited to decisions with regard to
lending or asset management or funding
or liability management, or the
responsibility for recordkeeping in
respect of assets or liabilities for that
foreign branch, resides at the U.S.
branch or agency. A separate FFIEC
002S must be completed for each
managed or controlled non-U.S. branch.
The FFIEC 002S must be filed quarterly
along with the U.S. branch or agency’s
FFIEC 002. The data from both reports
are used for (1) monitoring deposit and
credit transactions of U.S. residents; (2)
monitoring the impact of policy
changes; (3) analyzing structural issues
concerning foreign bank activity in U.S.
markets; (4) understanding flows of
banking funds and indebtedness of
developing countries in connection with
data collected by the International
Monetary Fund and the Bank for
International Settlements that are used
in economic analysis; and (5) assisting
in the supervision of U.S. offices of
foreign banks. The Federal Reserve
System collects and processes these
reports on behalf of all three agencies.
No changes were proposed to the FFIEC
002 and FFIEC 002S reporting forms or
instructions.
2. Report title: Country Exposure
Report for U.S. Branches and Agencies
of Foreign Banks.
Agency form number: FFIEC 019.
OMB control number: 7100–0213.
Frequency of response: Quarterly.
Affected public: U.S. branches and
agencies of foreign banks.
Number of respondents: 167.
Estimated average time per response:
10 hours.
Estimated total annual burden: 6,680
hours.
General description of reports: This
information collection is mandatory (12
U.S.C. 3906 for all agencies); 12 U.S.C.
3105 and 3108 for the Board; 12 U.S.C.
1817 and 1820 for the FDIC; and 12
U.S.C. 161 for the OCC. This
information collection is given
confidential treatment under the
Freedom of Information Act (5 U.S.C.
552(b)(8)).
Abstract: All individual U.S. branches
and agencies of foreign banks that have
more than $30 million in direct claims
on residents of foreign countries must
file the FFIEC 019 report quarterly.
Currently, all respondents report
adjusted exposure amounts to the five
largest countries having at least $20
million in total adjusted exposure. The
agencies collect this data to monitor the
extent to which such branches and
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agencies are pursuing prudent country
risk diversification policies and limiting
potential liquidity pressures. No
changes were proposed to the FFIEC 019
reporting form or instructions.
Board of Governors of the Federal Reserve
System, August 12, 2015.
Robert deV. Frierson,
Secretary of the Board.
[FR Doc. 2015–20275 Filed 8–17–15; 8:45 am]
BILLING CODE 6210–01–P
FEDERAL RESERVE SYSTEM
Change in Bank Control Notices;
Acquisitions of Shares of a Bank or
Bank Holding Company
The notificants listed below have
applied under the Change in Bank
Control Act (12 U.S.C. 1817(j)) and
§ 225.41 of the Board’s Regulation Y (12
CFR 225.41) to acquire shares of a bank
or bank holding company. The factors
that are considered in acting on the
notices are set forth in paragraph 7 of
the Act (12 U.S.C. 1817(j)(7)).
The notices are available for
immediate inspection at the Federal
Reserve Bank indicated. The notices
also will be available for inspection at
the offices of the Board of Governors.
Interested persons may express their
views in writing to the Reserve Bank
indicated for that notice or to the offices
of the Board of Governors. Comments
must be received not later than
September 2, 2015.
A. Federal Reserve Bank of Richmond
(Adam M. Drimer, Assistant Vice
President) 701 East Byrd Street,
Richmond, Virginia 23261–4528:
1. Robert G. Lowe, Fort Myers,
Florida; to acquire voting shares of
Palmetto Heritage Bancshares, Inc., and
thereby indirectly acquire voting shares
of Palmetto Heritage Bank & Trust, both
in Pawleys Island, South Carolina.
Board of Governors of the Federal Reserve
System, August 13, 2015.
Margaret McCloskey Shanks,
Deputy Secretary of the Board.
[FR Doc. 2015–20321 Filed 8–17–15; 8:45 am]
BILLING CODE 6210–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Agency for Healthcare Research and
Quality
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Agency for Healthcare Research
and Quality, HHS.
AGENCY:
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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.
This proposed information collection
was previously published in the Federal
Register on September 20, 2015 and
allowed 60 days for public comment.
AHRQ received no substantive
comments. The purpose of this notice is
to allow an additional 30 days for public
comment.
DATES: Comments on this notice must be
received by September 17, 2015.
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).
SUMMARY:
FOR FURTHER INFORMATION CONTACT:
Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427–1477, or 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
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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.
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
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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
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,
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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 health care 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
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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 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.
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
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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 nonhealth 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 OfficeBased 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 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
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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. Institution 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
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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
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
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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 the lack
of response and response error of some
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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
Affordable Care Act
• 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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50003
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 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 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 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 15 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 $1,540,328; the annual cost burden
for the MEPS–MPC is estimated to be
$302,985. The total annual cost burden
for the MEPS–HC and MPC is estimated
to be $1,843,313.
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Federal Register / Vol. 80, No. 159 / Tuesday, August 18, 2015 / Notices
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 ..................................................
35,222
532
25
11,785
12,693
5,077
117
4,993
6,000
1
1.49
1
1.44
3.43
3.51
2.03
4.44
1
2/60
9/60
11/60
10/60
13/60
9/60
9/60
3/60
15/60
1,174
119
5
2,828
9,433
2,673
36
1,108
1,500
Subtotal for the MEPS–MPC ....................................................................
76,444
na
na
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
* $22.71
* 22.71
* 22.71
* 22.71
* 22.71
* 22.71
$1,313,932
74,852
2,657
88,842
51,007
9,039
Subtotal for the MEPS–HC .......................................................................
79,451
67,826
na
1,540,328
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 ..................................................
35,222
532
25
11,785
12,693
5,077
117
4,993
6,000
1,174
119
5
2,828
9,433
2,673
36
1,108
1,500
** 16.12
** 16.12
** 16.12
** 16.12
** 16.12
** 16.12
** 16.12
*** 14.95
** 16.12
18,925
1,918
81
45,587
152,060
43,089
580
16,565
24,180
Subtotal for the MEPS–MPC ....................................................................
76,444
18,876
na
302,985
Grand Total .......................................................................................
155,895
86,073
na
1,843,313
asabaliauskas on DSK5VPTVN1PROD with NOTICES
MEPS–MPC/MOS
* 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 2014 National Occupational Employment and Wage Estimates United States, U.S. Department of
Labor, Bureau of Labor Statistics. https://www.bls.gov/oes/current/oes_nat.htm#b29-0000.
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Federal Register / Vol. 80, No. 159 / Tuesday, August 18, 2015 / 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 health care
research and health care information
dissemination functions, including
whether the information will have
practical utility; (b) the accuracy of
AHRQ’s estimate of burden (including
hours and costs) of the proposed
collection(s) of information; (c) ways to
enhance the quality, utility, and clarity
of the information to be collected; and
(d) ways to minimize the burden of the
collection of information upon the
respondents, including the use of
automated collection techniques or
other forms of information technology.
Comments submitted in response to
this notice will be summarized and
included in the Agency’s subsequent
request for OMB approval of the
proposed information collection. All
comments will become a matter of
public record.
Sharon B. Arnold,
Deputy Director.
[FR Doc. 2015–20358 Filed 8–17–15; 8:45 am]
BILLING CODE 4160–90–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Agency for Healthcare Research and
Quality
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Agency for Healthcare Research
and Quality, HHS.
ACTION: Notice.
AGENCY:
This notice announces the
intention of the Agency for Healthcare
Research and Quality (AHRQ) to request
that the Office of Management and
Budget (OMB) approve the proposed
information collection project: ‘‘Pilot
Test of the Proposed Hospital Survey on
Patient Safety Culture Version 2.0.’’ 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 May 7, 2015 and allowed 60
days for public comment. AHRQ
received one comment of substance. The
purpose of this notice is to allow an
additional 30 days for public comment.
asabaliauskas on DSK5VPTVN1PROD with NOTICES
SUMMARY:
VerDate Sep<11>2014
17:02 Aug 17, 2015
Comments on this notice must be
received by September 17, 2015.
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).
DATES:
Jkt 235001
FOR FURTHER INFORMATION CONTACT:
Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427–1477, or by
email at doris.lefkowitz@AHRQ.hhs.gov.
SUPPLEMENTARY INFORMATION:
Pilot Test of the Proposed Hospital
Survey on Patient Safety Culture
Version 2.0
Proposed Project
In 2004, AHRQ developed and
published a measurement tool to assess
the culture of patient safety in hospitals
(OMB control no. 0935–0115). The
Hospital Survey on Patient Safety
Culture (HSOPS) is a survey of
providers and staff that can be
implemented by hospitals to identify
strengths and areas for patient safety
culture improvement as well as raise
awareness about patient safety. When
conducted routinely, the survey can be
used to examine trends in patient safety
culture over time and evaluate the
cultural impact of patient safety
initiatives and interventions. The data
can also be used to make comparisons
across hospital units. AHRQ also
produced a survey user’s guide to assist
hospitals in conducting the survey
successfully. The guide addresses issues
such as which providers and staff
should complete the survey, how to
select a sample of hospital providers
and staff, how to administer the
questionnaire, and how to analyze and
report on the resulting data.
Since 2004, thousands of hospitals
within the U.S. and internationally have
implemented the survey. In response to
requests for comparative data from other
hospitals, AHRQ funded the
development of a comparative database
on the survey in 2006 (OMB control no.
0935–0162). The database is currently
compiled every two years, using the
latest data provided by participating
hospitals (and retaining submitted data
for no more than 2 years). Reports
describing the findings from analysis of
the database are made available on the
AHRQ Web site to assist hospitals in
comparing their results. The 2014
database contains data from 405,281
hospital provider and staff respondents
within 653 participating hospitals. The
2014 User Comparative Database Report
presents results by hospital
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50005
characteristics (e.g., number of beds,
teaching status, geographic location)
and respondent characteristics (e.g.,
position type, work area/unit).
The survey constructed in 2004
remains in use today, more than 10
years after its initial launch. Since the
launch of HSOPS, AHRQ has funded
development of patient safety culture
surveys for other settings. In 2008,
surveys were published for outpatient
medical offices (OMB control no. 0935–
0131) and nursing homes (OMB control
no. 0935–0132). In 2012, a survey for
community pharmacies (OMB control
no. 0935–0183) was released. Surveys
for each setting built upon the strengths
of HSOPS but improved and updated
items where appropriate.
Users of HSOPS have provided
feedback over the years suggesting that
changes to the instrument would be
valuable and welcomed. The
comparative database registrants
provided feedback about potential
changes in 2013, and telephone
interviews were conducted with 8
current survey users and vendors to gain
an in-depth understanding of their
thoughts on the current survey and
possible changes. As a result of this
feedback, the Hospital Survey on Patient
Safety Culture Version 2.0 (HSOPS 2.0)
is being constructed with the following
8 objectives in mind.
(1) Shift to a Just Culture framework
for understanding responses to errors. In
the original HSOPS, questions around
responses to errors were negatively
worded to detect a ‘‘culture of blame’’
in organizations. For example,
respondents evaluated the extent to
which errors were held against them
and whether it felt as though the person
was being written up rather than the
problem. In contrast, a Just Culture
framework emphasizes learning from
mistakes, providing a safe environment
for reporting errors, and utilizing a
balanced approach to errors that
considers both system and individual
behavioral reasons as causes for errors.
New items will be constructed in
HSOPS 2.0 to capture the extent to
which positive responses to error
consistent with a Just Culture
framework are present in an
organization. For example, respondents
will be asked to evaluate the extent to
which the organization tries to
understand the factors that lead to
patient safety errors.
(2) Reduce the number of negatively
worded items. The original HSOPS had
negatively worded items. For example,
respondents are asked whether there are
‘‘patient safety problems in this unit’’
(negatively worded). Using some
negatively worded items was intended
E:\FR\FM\18AUN1.SGM
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]]>Agencies
[Federal Register Volume 80, Number 159 (Tuesday, August 18, 2015)]
[Notices]
[Pages 50000-50005]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-20358]
=======================================================================
-----------------------------------------------------------------------
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.
[[Page 50001]]
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.
This proposed information collection was previously published in
the Federal Register on September 20, 2015 and allowed 60 days for
public comment. AHRQ received no substantive comments. The purpose of
this notice is to allow an additional 30 days for public comment.
DATES: Comments on this notice must be received by September 17, 2015.
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).
FOR FURTHER INFORMATION CONTACT: Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427-1477, or 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.
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 health care 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
[[Page 50002]]
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.
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 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. Institution 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
[[Page 50003]]
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 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 the lack of response 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 Affordable Care Act
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 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 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 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 15 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 $1,540,328;
the annual cost burden for the MEPS-MPC is estimated to be $302,985.
The total annual cost burden for the MEPS-HC and MPC is estimated to be
$1,843,313.
[[Page 50004]]
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-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
----------------------------------------------------------------------------------------------------------------
Number of Total burden Average hourly Total cost
Form name respondents hours wage rate burden
----------------------------------------------------------------------------------------------------------------
MEPS-HC
----------------------------------------------------------------------------------------------------------------
MEPS-HC Core Interview.......................... 15,093 57,857 * $22.71 $1,313,932
Adult SAQ....................................... 28,254 3,296 * 22.71 74,852
Diabetes care SAQ............................... 2,345 117 * 22.71 2,657
Authorization forms for the MEPS-MPC Provider 14,489 3,912 * 22.71 88,842
Survey.........................................
Authorization form for the MEPS-MPC Pharmacy 14,489 2,246 * 22.71 51,007
Survey.........................................
MEPS-HC Validation Interview.................... 4,781 398 * 22.71 9,039
---------------------------------------------------------------
Subtotal for the MEPS-HC.................... 79,451 67,826 na 1,540,328
----------------------------------------------------------------------------------------------------------------
MEPS-MPC/MOS
----------------------------------------------------------------------------------------------------------------
MPC Contact Guide/Screening Call................ 35,222 1,174 ** 16.12 18,925
Home care for health care providers 532 119 ** 16.12 1,918
questionnaire..................................
Home care for non-health care providers 25 5 ** 16.12 81
questionnaire..................................
Office-based providers questionnaire............ 11,785 2,828 ** 16.12 45,587
Separately billing doctors questionnaire........ 12,693 9,433 ** 16.12 152,060
Hospitals questionnaire......................... 5,077 2,673 ** 16.12 43,089
Institutions (non-hospital) questionnaire....... 117 36 ** 16.12 580
Pharmacies questionnaire........................ 4,993 1,108 *** 14.95 16,565
Medical Organizations Survey questionnaire...... 6,000 1,500 ** 16.12 24,180
---------------------------------------------------------------
Subtotal for the MEPS-MPC................... 76,444 18,876 na 302,985
---------------------------------------------------------------
Grand Total............................. 155,895 86,073 na 1,843,313
----------------------------------------------------------------------------------------------------------------
* 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 2014 National Occupational Employment and Wage Estimates United States,
U.S. Department of Labor, Bureau of Labor Statistics. https://www.bls.gov/oes/current/oes_nat.htm#b29-0000.
[[Page 50005]]
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 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. 2015-20358 Filed 8-17-15; 8:45 am]
BILLING CODE 4160-90-P
