Agency Information Collection Activities: Proposed Collection; Comment Request, 21874-21876 [2016-08403]

Download as PDF 21874 Federal Register / Vol. 81, No. 71 / Wednesday, April 13, 2016 / Notices The GSA Labor-Management Relations Council (GLMRC) previously announced in its March 25, 2016 Federal Register notice that it planned to hold a meeting Tuesday, April 12, 2016 and Wednesday, April 13, 2016. The meeting is cancelled. DATES: April 13, 2016. FOR FURTHER INFORMATION CONTACT: Ms. Paula Lucak, GLMRC Designated Federal Officer (DFO) at the General Services Administration, OHRM, 1800 F Street NW., Washington, DC. 20405, telephone at 202–739–1730, or email at gmlrc@gsa.gov. SUPPLEMENTARY INFORMATION: The GSA Labor-Management Relations Council (GLMRC) previously announced in its March 25, 2016 Federal Register notice (81 FR 16183) that it planned to hold a meeting Tuesday, April 12, 2016 and Wednesday, April 13, 2016. The meeting is cancelled. A new notice will be posted in the Federal Register announcing the date and time when rescheduled. SUMMARY: Dated: April 7, 2016. Renee Y. Jones, Office of Human Resources Management, OHRM Director (Acting), Office of HR Strategy and Services, Center for Talent Engagement (COE4), General Services Administration. [FR Doc. 2016–08463 Filed 4–12–16; 8:45 am] BILLING CODE 6820–34–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: ‘‘AHRQ ACTION III—Measurement for Performance Improvement in Physician Practices.’’ In accordance with the Paperwork Reduction Act, 44 U.S.C. 3501–3521, AHRQ invites the public to comment on this proposed information collection. DATES: Comments on this notice must be received by June 13, 2016. ADDRESSES: Written comments should be submitted to: Doris Lefkowitz, asabaliauskas on DSK3SPTVN1PROD with NOTICES SUMMARY: VerDate Sep<11>2014 17:41 Apr 12, 2016 Jkt 238001 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 AHRQ ACTION III—Measurement for Performance Improvement in Physician Practices This two-year project is an important first step to fully understanding measurement for performance improvement in medical groups. This exploratory research is expected to set the stage for informing future research and policy discussions, both of which could ultimately have a more direct impact on providers, payers, and patients. As a critical first step this research breaks new ground in an important area of health care research by looking at the current landscape to better understand how medical groups are using measurement internally to improve performance and what that means to them, and how internal measurement relates to external measurement obligations and identifying where the gaps are. Project success for this exploratory work will be more relevant given the complete context of the current landscape of performance measurement, gleaned through an environmental scan, expert input, and qualitative data collection. Ultimately, success will be measured by our ability to answer the research questions that are guiding this research project (see below). The overall goal of AHRQ’s Measurement for Performance Improvement in Physician Practices project is to identify the current gaps in our knowledge about how practices are using data, if at all, for performance improvement. AHRQ has developed this project to address the lack of current evidence on internal performance measurement in medical groups, identifying the following research questions: • What gaps exist in the research literature regarding management for performance improvement in medical groups? • What factors, both internal and external, drive efforts to use measurement to improve medical group performance? PO 00000 Frm 00039 Fmt 4703 Sfmt 4703 • How are measures used to support internal management and improvement processes? • What additional activities support use of internal performance measures? • How are internal performance measures derived and reported? What specific measures, benchmarks, and comparisons are used? • How have physicians responded to these measurement processes? • What are the perceived benefits of internal measurement activities? What types of costs and other burdens are directly associated with internal measurement? How feasible is it to specify actual costs of reporting? • What implications does evidence on internal measurement for performance improvement have for payers, policy makers, executives in delivery systems, and clinical leaders? Specific Project Objectives • Identify specific measures/metrics used internally by medical groups to assess performance and support improvement activities. • Describe how internal measurement activities/measures are used in medical groups to support improvement in individual, team, or organizational performance including, but not limited to, how these activities are tied to ‘‘internal’’ financial incentives. • Identify types of costs and other types of burdens (e.g. staff resources, IT resources, etc.), directly related to internal measurement and reporting activities. Assess the feasibility of capturing information on costs and burdens of internal and external performance measurement, and, if feasible, collect data on the actual costs and other associated burdens of internal and external performance measurement. • Based on the findings, identify implications, potential impacts, and future research opportunities for payers, regulators, and medical groups regarding internal measurements for performance improvement. Efforts to improve performance among health care providers through measurement and reporting have evolved over time and have taken many forms and many names. For example, Triple Aim, Public Reporting, Performance Measurement, Quality Improvement, Pay for Performance are all common concepts today. And, most health care providers, including medical groups, are monitoring their performance using a wide array of quality measures that reflect care processes, clinical outcomes, and patient experiences. Increasing numbers of providers are required to report their performance on quality measures by E:\FR\FM\13APN1.SGM 13APN1 21875 Federal Register / Vol. 81, No. 71 / Wednesday, April 13, 2016 / Notices payers such as the Centers for Medicare and Medicaid Services (CMS) and external regulatory bodies such as the National Committee for Quality Assurance (NCQA) or the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Little is known, however, about how providers make use internally of measures that are required by external bodies for payment or reporting. Nor is it known what other measures providers collect and use to improve performance. This project aims to fill this knowledge gap. In doing so, it may also inform payment and reporting initiatives by providing indications of the degree to which providers view externally mandated measures as valuable for their internal quality assessment and reporting efforts. As an initial step in understanding the landscape of measurement for performance improvement, this research will look to understand how medical groups define and measure performance improvement. This work is being conducted by AHRQ through its contractor, Westat, 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 quality, effectiveness, efficiency, appropriateness and value of health care services and with respect to quality measurement and improvement. 42 U.S.C. 299a(a)(1) and (2). Method of Collection For this study, AHRQ will conduct field data collection through semistructured in-depth interviews. The unit of analysis for this work is the medical group. To understand measurement for performance improvement in each medical group, AHRQ will interview up to 5 administrators and frontline clinicians per medical group. Interviews with both administrators and clinicians will be facilitated using the same protocol. As discussed below, given the different levels of involvement and experience with internal performance measurement, interviews will vary in detail and thus length. But, as AHRQ works to uncover the story of each medical group involved in the study, the same guiding protocol will apply. AHRQ will audio-record and professionally transcribe each interview conducted. And, all interviews will be loaded into Dedoose for coding and analysis. The information collected in the data collection effort will be used for one main purpose: Identify the current gaps in internal measurement in physician practices. The results from the data collection will give AHRQ a snapshot on the current practices being undertaken for internal performance measurement and inform best next steps to move beyond this exploratory research phase. The intended target audiences expected to benefit most from the project include the medical groups using this information to improve performance, the health care professionals who work in these medical groups working to improve their care to patients, and the patients that can benefit from improved care. One way this research could benefit these audiences is by informing payment and reporting initiatives by providing indications of the degree to which providers view externally mandated measures as valuable for their internal quality assessment and reporting efforts. Estimated Annual Respondent Burden Exhibit 1 shows the estimated annualized burden hours for the participants’ time to take part in this research. To recruit medical groups to participate, AHRQ will engage groups in a short call to assess interest and obtain a commitment to participate. AHRQ expects the need to reach out to approximately 100 medical groups to obtain a sample of 45 groups that are conducting some type of measurement for internal performance improvement, are interested in taking part, and are able to take part during the data collection window. In-depth, semistructured qualitative interviews will then be conducted with up to 5 staff members at 45 medical groups using a single protocol. AHRQ will target small (2–9 eligible professionals (EP)), medium (10–24 EPs), and large (25+ EPs) medical groups from across the Unites States. The goal is to recruit approximately 3 administrators and 2 frontline clinicians in each Group, understanding that depending on the size and organization of the medical group staff members may operate in multiple roles. Based on the pilot study conducted for this project, AHRQ estimates that the recruitment call will average 15 minutes, and that the longest interviews will be 1.5 hours. These longest interviews will be with the highest level administrators working on internal performance measurement at the most complex medical groups. AHRQ believes these will be the largest medical groups that are part of complex systems and payment relationships. These complex organizational relationships will require more time to understand in order to understand the place, role, and operation of internal measurement for performance improvement within the group. For equivalent administrators from medium and small groups, AHRQ estimates the longest interviews will be 1.25 hours. For all other administrators and frontline clinicians, AHRQ estimates the interviews will be 1 hour. The total annualized burden is estimated to be 295 hours. Again, interviews with both frontline clinicians and all medical group administrators will use the same protocol. The screening call will be an informal conversation in which AHRQ looks to learn if the medical group self-identifies as using measurement for performance improvement and provides consent to take part. AHRQ will answer any questions the medical group has about the study on this call and confirm some basic, publicly available background information about the group that AHRQ has obtained is accurate and up to date. This background information will help put the information learned during the interview in better context. The types of background information AHRQ is looking at includes medical group size, organizational structure, specialty mix, and payment relationships. asabaliauskas on DSK3SPTVN1PROD with NOTICES EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS Number of respondents Form name Frontline clinicians ....................................................................................................................... Medical group administrators ............................................................................................... Medical group administrators: Administrator with authority to agree to participate in the study Medical group administrators: Initial, highest level administrators .............................................. Medical group administrators: All other administrators ............................................................... VerDate Sep<11>2014 17:41 Apr 12, 2016 Jkt 238001 PO 00000 Frm 00040 Fmt 4703 Sfmt 4703 E:\FR\FM\13APN1.SGM 90 235 100 45 90 13APN1 Hours per response 1 0.25 1.5 1.25 Total burden hours 90 25 67.5 112.5 21876 Federal Register / Vol. 81, No. 71 / Wednesday, April 13, 2016 / Notices EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS—Continued Number of respondents Form name Total ...................................................................................................................................... Exhibit 2 shows the estimated annualized cost burden associated with the participants’ time to take part in this 325 Hours per response Total burden hours NA 295 research. The total cost burden is estimated to be $27,270.45. EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN Total burden hours Interviewee type Average hourly age rate * Total cost burden Frontline clinicians ....................................................................................................................... Medical group administrators ............................................................................................... 90 205 $103.54 a 87.57 b $9,318.60 17,951.85 Total ...................................................................................................................................... 295 NA 27,270.45 a Based on the average hourly wage for one physician (29–1060; $103.54). on the average hourly wage for one Chief Executive (11–1011; $87.57). * National Industry-Specific Occupational Employment and Wage Estimates, May 2014, from the Bureau of Labor Statistics (available at http:// www.bls.gov/oes/current/naics4_621100.htm [for Offices of Physicians, NAICS 622100]). b Based Request for Comments asabaliauskas on DSK3SPTVN1PROD with NOTICES 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, Acting Director. [FR Doc. 2016–08403 Filed 4–12–16; 8:45 am] BILLING CODE 4160–90–P VerDate Sep<11>2014 17:41 Apr 12, 2016 Jkt 238001 DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Toxic Substances and Disease Registry [60Day–16–0041; Docket No. ATSDR–2016– 0005] Proposed Data Collection Submitted for Public Comment and Recommendations Agency for Toxic Substances and Disease Registry (ATSDR), Department of Health and Human Services (HHS). ACTION: Notice with comment period. AGENCY: The Agency for Toxic Substances and Disease Registry (ATSDR), as part of its continuing efforts to reduce public burden and maximize the utility of government information, invites the general public and other Federal agencies to take this opportunity to comment on proposed and/or continuing information collections, as required by the Paperwork Reduction Act of 1995. This notice invites comment on the ‘‘National Amyotrophic Lateral Sclerosis (ALS) Registry.’’ The National ALS Registry collects information from persons with ALS to better describe the prevalence and potential risk factors for ALS. DATES: Written comments must be received on or before June 13, 2016. ADDRESSES: You may submit comments, identified by Docket No. ATSDR–2016– 0005 by any of the following methods: SUMMARY: PO 00000 Frm 00041 Fmt 4703 Sfmt 4703 • Federal eRulemaking Portal: Regulation.gov. Follow the instructions for submitting comments. • Mail: Leroy A. Richardson, Information Collection Review Office, Centers for Disease Control and Prevention, 1600 Clifton Road NE., MS– D74, Atlanta, Georgia 30329. Instructions: All submissions received must include the agency name and Docket Number. All relevant comments received will be posted without change to Regulations, gov, including any personal information provided. For access to the docket to read background documents or comments received, go to Regulations.gov. Please note: All public comment should be submitted through the Federal eRulemaking portal (Regulations.gov) or by U.S. mail to the address listed above. To request more information on the proposed project or to obtain a copy of the information collection plan and instruments, contact the Information Collection Review Office, Centers for Disease Control and Prevention, 1600 Clifton Road NE., MS–D74, Atlanta, Georgia 30329; phone: 404–639–7570; Email: omb@cdc.gov. SUPPLEMENTARY INFORMATION: Under the Paperwork Reduction Act of 1995 (PRA) (44 U.S.C. 3501–3520), Federal agencies must obtain approval from the Office of Management and Budget (OMB) for each collection of information they conduct or sponsor. In addition, the PRA also requires Federal agencies to provide a 60-day notice in the Federal Register concerning each proposed collection of FOR FURTHER INFORMATION CONTACT: E:\FR\FM\13APN1.SGM 13APN1

Agencies

[Federal Register Volume 81, Number 71 (Wednesday, April 13, 2016)]
[Notices]
[Pages 21874-21876]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-08403]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Agency for Healthcare Research and Quality


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Agency for Healthcare Research and Quality, HHS.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: This notice announces the intention of the Agency for 
Healthcare Research and Quality (AHRQ) to request that the Office of 
Management and Budget (OMB) approve the proposed information collection 
project: ``AHRQ ACTION III--Measurement for Performance Improvement in 
Physician Practices.'' In accordance with the Paperwork Reduction Act, 
44 U.S.C. 3501-3521, AHRQ invites the public to comment on this 
proposed information collection.

DATES: Comments on this notice must be received by June 13, 2016.

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

AHRQ ACTION III--Measurement for Performance Improvement in Physician 
Practices

    This two-year project is an important first step to fully 
understanding measurement for performance improvement in medical 
groups. This exploratory research is expected to set the stage for 
informing future research and policy discussions, both of which could 
ultimately have a more direct impact on providers, payers, and 
patients. As a critical first step this research breaks new ground in 
an important area of health care research by looking at the current 
landscape to better understand how medical groups are using measurement 
internally to improve performance and what that means to them, and how 
internal measurement relates to external measurement obligations and 
identifying where the gaps are.
    Project success for this exploratory work will be more relevant 
given the complete context of the current landscape of performance 
measurement, gleaned through an environmental scan, expert input, and 
qualitative data collection. Ultimately, success will be measured by 
our ability to answer the research questions that are guiding this 
research project (see below).
    The overall goal of AHRQ's Measurement for Performance Improvement 
in Physician Practices project is to identify the current gaps in our 
knowledge about how practices are using data, if at all, for 
performance improvement. AHRQ has developed this project to address the 
lack of current evidence on internal performance measurement in medical 
groups, identifying the following research questions:
     What gaps exist in the research literature regarding 
management for performance improvement in medical groups?
     What factors, both internal and external, drive efforts to 
use measurement to improve medical group performance?
     How are measures used to support internal management and 
improvement processes?
     What additional activities support use of internal 
performance measures?
     How are internal performance measures derived and 
reported? What specific measures, benchmarks, and comparisons are used?
     How have physicians responded to these measurement 
processes?
     What are the perceived benefits of internal measurement 
activities? What types of costs and other burdens are directly 
associated with internal measurement? How feasible is it to specify 
actual costs of reporting?
     What implications does evidence on internal measurement 
for performance improvement have for payers, policy makers, executives 
in delivery systems, and clinical leaders?
Specific Project Objectives
     Identify specific measures/metrics used internally by 
medical groups to assess performance and support improvement 
activities.
     Describe how internal measurement activities/measures are 
used in medical groups to support improvement in individual, team, or 
organizational performance including, but not limited to, how these 
activities are tied to ``internal'' financial incentives.
     Identify types of costs and other types of burdens (e.g. 
staff resources, IT resources, etc.), directly related to internal 
measurement and reporting activities. Assess the feasibility of 
capturing information on costs and burdens of internal and external 
performance measurement, and, if feasible, collect data on the actual 
costs and other associated burdens of internal and external performance 
measurement.
     Based on the findings, identify implications, potential 
impacts, and future research opportunities for payers, regulators, and 
medical groups regarding internal measurements for performance 
improvement.
    Efforts to improve performance among health care providers through 
measurement and reporting have evolved over time and have taken many 
forms and many names. For example, Triple Aim, Public Reporting, 
Performance Measurement, Quality Improvement, Pay for Performance are 
all common concepts today. And, most health care providers, including 
medical groups, are monitoring their performance using a wide array of 
quality measures that reflect care processes, clinical outcomes, and 
patient experiences. Increasing numbers of providers are required to 
report their performance on quality measures by

[[Page 21875]]

payers such as the Centers for Medicare and Medicaid Services (CMS) and 
external regulatory bodies such as the National Committee for Quality 
Assurance (NCQA) or the Joint Commission on Accreditation of Healthcare 
Organizations (JCAHO).
    Little is known, however, about how providers make use internally 
of measures that are required by external bodies for payment or 
reporting. Nor is it known what other measures providers collect and 
use to improve performance. This project aims to fill this knowledge 
gap. In doing so, it may also inform payment and reporting initiatives 
by providing indications of the degree to which providers view 
externally mandated measures as valuable for their internal quality 
assessment and reporting efforts.
    As an initial step in understanding the landscape of measurement 
for performance improvement, this research will look to understand how 
medical groups define and measure performance improvement.
    This work is being conducted by AHRQ through its contractor, 
Westat, 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 quality, effectiveness, 
efficiency, appropriateness and value of health care services and with 
respect to quality measurement and improvement. 42 U.S.C. 299a(a)(1) 
and (2).

Method of Collection

    For this study, AHRQ will conduct field data collection through 
semi-structured in-depth interviews. The unit of analysis for this work 
is the medical group. To understand measurement for performance 
improvement in each medical group, AHRQ will interview up to 5 
administrators and frontline clinicians per medical group. Interviews 
with both administrators and clinicians will be facilitated using the 
same protocol. As discussed below, given the different levels of 
involvement and experience with internal performance measurement, 
interviews will vary in detail and thus length. But, as AHRQ works to 
uncover the story of each medical group involved in the study, the same 
guiding protocol will apply. AHRQ will audio-record and professionally 
transcribe each interview conducted. And, all interviews will be loaded 
into Dedoose for coding and analysis.
    The information collected in the data collection effort will be 
used for one main purpose: Identify the current gaps in internal 
measurement in physician practices. The results from the data 
collection will give AHRQ a snapshot on the current practices being 
undertaken for internal performance measurement and inform best next 
steps to move beyond this exploratory research phase.
    The intended target audiences expected to benefit most from the 
project include the medical groups using this information to improve 
performance, the health care professionals who work in these medical 
groups working to improve their care to patients, and the patients that 
can benefit from improved care. One way this research could benefit 
these audiences is by informing payment and reporting initiatives by 
providing indications of the degree to which providers view externally 
mandated measures as valuable for their internal quality assessment and 
reporting efforts.

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated annualized burden hours for the 
participants' time to take part in this research. To recruit medical 
groups to participate, AHRQ will engage groups in a short call to 
assess interest and obtain a commitment to participate. AHRQ expects 
the need to reach out to approximately 100 medical groups to obtain a 
sample of 45 groups that are conducting some type of measurement for 
internal performance improvement, are interested in taking part, and 
are able to take part during the data collection window. In-depth, 
semi-structured qualitative interviews will then be conducted with up 
to 5 staff members at 45 medical groups using a single protocol. AHRQ 
will target small (2-9 eligible professionals (EP)), medium (10-24 
EPs), and large (25+ EPs) medical groups from across the Unites States. 
The goal is to recruit approximately 3 administrators and 2 frontline 
clinicians in each Group, understanding that depending on the size and 
organization of the medical group staff members may operate in multiple 
roles.
    Based on the pilot study conducted for this project, AHRQ estimates 
that the recruitment call will average 15 minutes, and that the longest 
interviews will be 1.5 hours. These longest interviews will be with the 
highest level administrators working on internal performance 
measurement at the most complex medical groups. AHRQ believes these 
will be the largest medical groups that are part of complex systems and 
payment relationships. These complex organizational relationships will 
require more time to understand in order to understand the place, role, 
and operation of internal measurement for performance improvement 
within the group. For equivalent administrators from medium and small 
groups, AHRQ estimates the longest interviews will be 1.25 hours. For 
all other administrators and frontline clinicians, AHRQ estimates the 
interviews will be 1 hour.
    The total annualized burden is estimated to be 295 hours. Again, 
interviews with both frontline clinicians and all medical group 
administrators will use the same protocol. The screening call will be 
an informal conversation in which AHRQ looks to learn if the medical 
group self-identifies as using measurement for performance improvement 
and provides consent to take part. AHRQ will answer any questions the 
medical group has about the study on this call and confirm some basic, 
publicly available background information about the group that AHRQ has 
obtained is accurate and up to date. This background information will 
help put the information learned during the interview in better 
context. The types of background information AHRQ is looking at 
includes medical group size, organizational structure, specialty mix, 
and payment relationships.

                                  Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                       Number of      Hours per     Total burden
                             Form name                                respondents      response        hours
----------------------------------------------------------------------------------------------------------------
Frontline clinicians..............................................              90           1              90
    Medical group administrators..................................             235
Medical group administrators: Administrator with authority to                  100           0.25           25
 agree to participate in the study................................
Medical group administrators: Initial, highest level                            45           1.5            67.5
 administrators...................................................
Medical group administrators: All other administrators............              90           1.25          112.5
                                                                   ---------------------------------------------

[[Page 21876]]

 
    Total.........................................................             325          NA             295
----------------------------------------------------------------------------------------------------------------
 

    Exhibit 2 shows the estimated annualized cost burden associated 
with the participants' time to take part in this research. The total 
cost burden is estimated to be $27,270.45.

                                   Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                        Interviewee type                           Total burden    hourly  wage     Total cost
                                                                       hours          rate *          burden
----------------------------------------------------------------------------------------------------------------
Frontline clinicians............................................              90     $103.54 \a\       $9,318.60
    Medical group administrators................................             205       87.57 \b\       17,951.85
                                                                 -----------------------------------------------
    Total.......................................................             295              NA       27,270.45
----------------------------------------------------------------------------------------------------------------
\a\ Based on the average hourly wage for one physician (29-1060; $103.54).
\b\ Based on the average hourly wage for one Chief Executive (11-1011; $87.57).
* National Industry-Specific Occupational Employment and Wage Estimates, May 2014, from the Bureau of Labor
  Statistics (available at http://www.bls.gov/oes/current/naics4_621100.htm [for Offices of Physicians, NAICS
  622100]).

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,
Acting Director.
[FR Doc. 2016-08403 Filed 4-12-16; 8:45 am]
 BILLING CODE 4160-90-P