Agency Information Collection Activities: Proposed Collection; Comment Request, 60741-60744 [2017-27605]
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Federal Register / Vol. 82, No. 245 / Friday, December 22, 2017 / Notices
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
[FR Doc. 2017–27629 Filed 12–21–17; 8:45 am]
BILLING CODE 8070–01–C
Agency for Healthcare Research and
Quality
FEDERAL MARITIME COMMISSION
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Notice of Agreement Filed
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The Commission hereby gives notice
of the filing of the following agreement
under the Shipping Act of 1984.
Interested parties may submit comments
on the agreement to the Secretary,
Federal Maritime Commission,
Washington, DC 20573, within twelve
days of the date this notice appears in
the Federal Register. A copy of the
agreement is available through the
Commission’s website (www.fmc.gov) or
by contacting the Office of Agreements
at (202) 523–5793 or tradeanalysis@
fmc.gov.
Agreement No.: 012439–002.
Title: THE Alliance Agreement.
Parties: Hapag-Lloyd AG and HapagLloyd USA LLC (acting as one party);
Kawasaki Kisen Kaisha, Ltd.; Mitsui
O.S.K. Lines, Ltd.; Nippon Yusen
Kaisha; and Yang Ming Marine
Transport Corp and Yang Ming (UK)
Ltd. (acting as one party).
Filing Party: Joshua Stein, Cozen
O’Conner, 1200 Nineteenth Street NW,
Washington, DC 20036.
Synopsis: The Amendment revises the
Agreement to provide for the transition
that will occur following the acquisition
of the assets of the container liner
operations of Kawasaki Kisen Kaisha,
Ltd.; Mitsui O.S.K. Lines, Ltd.; and
Nippon Yusen Kaisha by a new
company known as Ocean Network
Express Pte. Ltd. effective April 1, 2018.
Ocean Network Express Pte. Ltd. is
added as a party effective on the date of
the transition referenced above. In
addition, the Amendment adds Yang
Ming (UK) Ltd. as a party (operating as
a single party with Yang Ming Marine
Transport Corp.) and adds Guatemala
and India to the geographic scope of the
Agreement.
By Order of the Federal Maritime
Commission.
Dated: December 19, 2017.
Rachel E. Dickon,
Assistant Secretary.
[FR Doc. 2017–27640 Filed 12–21–17; 8:45 am]
BILLING CODE 6731–AA–P
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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
changes to the currently approved
information collection project: ‘‘Medical
Expenditure Panel Survey (MEPS)
Household Component and the MEPS
Medical Provider Component.’’
DATES: Comments on this notice must be
received by February 20, 2018.
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 changes to
questions asked of household
respondents, data collection
instruments, collection plans, and
specific details on the estimated burden
can be obtained from the AHRQ Reports
Clearance Officer.
FOR FURTHER INFORMATION CONTACT:
Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427–1477, or by
email at doris.lefkowitz@AHRQ.hhs.gov.
SUPPLEMENTARY INFORMATION:
SUMMARY:
Proposed Project
Medical Expenditure Panel Survey
(MEPS) Household Component (HC)
In accordance with the Paperwork
Reduction Act, 44 U.S.C. 3501–3521,
AHRQ invites the public to comment on
this proposed information collection.
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
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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/herself and for other
family members.
The only change to the MEPS–HC
from the previous OMB clearance is an
update to the existing Adult SelfAdministered Questionnaire (SAQ).
The MEPS–HC has the following goal:
D To provide nationally representative
estimates for the U.S. civilian
noninstitutionalized population for:
• Health care use, expenditures,
sources of payment
• 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.
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
occurred during the reference period
• 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, such as the sources
paying for the medical care-including
the patient/family, public sources,
and private insurance, and amounts
paid by each source
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Data collected from pharmacies
include:
• Date on which a prescription was
filled
• 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.
There are no changes to the MEPS–
MPC from the previous OMB clearance.
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.
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Method of Collection
To achieve the goals of the MEPS–HC
the following data collections are
implemented:
1. Household Component Core
Instrument. The core instrument
collects data about persons in sample
households. Topical areas asked in each
round of interviewing include condition
enumeration, health status, health care
utilization including prescribed
medicines, expense and payment,
employment, and health insurance.
Other topical areas that are asked only
once a year include access to care,
income, assets, satisfaction with health
plans and providers, children’s health,
and adult preventive care. While many
of the questions are asked about the
entire reporting unit, which is typically
a family, only one person normally
provides this information. All sections
of the current core instrument are
available on the AHRQ website at https://
meps.ahrq.gov/mepsweb/survey_comp/
survey_questionnaires.jsp.
2. Adult Self Administered
Questionnaire. A brief self-administered
questionnaire (SAQ) will be used to
collect self-reported (rather than
through household proxy) information
on health status, health opinions and
satisfaction with health care for adults
18 and older. The health status items are
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from the Veterans Rand 12-item health
survey (VR–12). Additionally there are
questions addressing adult preventive
care for both males and females. This
questionnaire has changed from the
previous OMB clearance.
3. Diabetes Care SAQ. A brief selfadministered, 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.
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 CAPI questionnaire
content was asked appropriately and
procedures followed, for example the
use of show cards. Validation flags are
set programmatically for cases preselected by data processing staff before
each round of interviewing. Home office
and field management may also request
that other cases be validated throughout
the field period. When an interviewer
fails a validation all his or her 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
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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 using a unique
screening instrument, except for the two
home care provider types which use the
same screening form; see https://
meps.ahrq.gov/mepsweb/survey_comp/
survey.jsp#MPC_CG.
2. Home Care Provider Questionnaire
for Health Care Providers. This
questionnaire is used to collect data
from home health care agencies which
provide medical care services to
household respondents. Information
collected includes type of personnel
providing care, hours or visits provided
per month, and the charges and
payments for services received. See
https://meps.ahrq.gov/mepsweb/survey_
comp/survey.jsp#MPC.
3. Home Care Provider Questionnaire
for Non-Health Care Providers. This
questionnaire is used to collect
information about services provided in
the home by non-health care workers to
household respondents because of a
medical condition; for example,
cleaning or yard work, transportation,
shopping, or child care. See https://
meps.ahrq.gov/mepsweb/survey_comp/
survey.jsp#MPC.
4. Medical Event Questionnaire for
Office-Based Providers. This
questionnaire is for office-based
physicians, including doctors of
medicine (MDs) and osteopathy (DOs),
as well as providers practicing under
the direction or supervision of an MD or
DO (e.g., physician assistants and nurse
practitioners working in clinics).
Providers of care in private offices as
well as staff model HMOs are included.
See https://meps.ahrq.gov/mepsweb/
survey_comp/survey.jsp#MPC.
5. Medical Event Questionnaire for
Separately Billing Doctors. This
questionnaire collects information from
physicians identified by hospitals
(during the Hospital Event data
collection) as providing care to sampled
persons during the course of inpatient,
outpatient department or emergency
room care, but who bill separately from
the hospital. See https://meps.ahrq.gov/
mepsweb/survey_comp/survey.jsp#MPC.
6. Hospital Event Questionnaire. This
questionnaire is used to collect
information about hospital events,
including inpatient stays, outpatient
department, and emergency room visits.
Hospital data are collected not only
from the billing department, but from
medical records and administrative
records departments as well. Medical
records departments are contacted to
determine the names of all the doctors
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who treated the patient during a stay or
visit. In many cases, the hospital
administrative office also has to be
contacted to determine whether the
doctors identified by medical records
billed separately from the hospital itself;
the doctors that do bill separately from
the hospital will be contacted as part of
the Medical Event Questionnaire for
Separately Billing Doctors. HMOs are
included in this provider type. See
https://meps.ahrq.gov/mepsweb/survey_
comp/survey.jsp#MPC.
7. Institutions Event Questionnaire.
This questionnaire is used to collect
information about institution events,
including nursing homes, rehabilitation
facilities and skilled nursing facilities.
Institution data are collected not only
from the billing department, but from
medical records and administrative
records departments as well. Medical
records departments are contacted to
determine the names of all the doctors
who treated the patient during a stay. In
many cases, the institution
administrative office also has to be
contacted to determine whether the
doctors identified by medical records
billed separately from the institution
itself. See https://meps.ahrq.gov/
mepsweb/survey_comp/
survey.jsp#MPC).
8. Pharmacy Data Collection
Questionnaire. This questionnaire
requests the national drug code (NDC)
and when that is not available the
prescription name, date prescription
was filled, payments by source,
prescription strength and form (when
the NDC is not available), quantity, and
person for whom the prescription was
filled. When the NDC is available, we do
not ask for prescription name, strength
or form because that information is
embedded in the NDC; this reduces
burden on the respondent. Most
pharmacies have the requested
information available in electronic
format and respond by providing a
computer generated printout of the
patient’s prescription information. If the
computerized form is unavailable, the
pharmacy can report their data to a
telephone interviewer. Pharmacies are
also able to provide a CD–ROM with the
requested information if that is
preferred. HMOs are included in this
provider type. See https://
meps.ahrq.gov/mepsweb/survey_comp/
survey.jsp#MPC.
9. Medical Organizations Survey
Questionnaire. This questionnaire will
collect essential information on
important features of the staffing,
organization, policies, and financing for
identified usual source of office based
care providers. This additional data are
linked to MEPS sample respondents to
enable analyses at the person-level
using characteristics of provider
practices.
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.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated
annualized burden hours for the
respondents’ time to participate in the
MEPS–HC and the MEPS–MPC. The
MEPS–HC Core Interview will be
completed by 15,093* (see note below
Exhibit 1) ‘‘family level’’ respondents,
also referred to as RU respondents.
Since the MEPS–HC consists of 5
rounds of interviewing covering a full
two years of data, the annual average
number of responses per respondent is
2.5 responses per year. The MEPS–HC
core requires an average response time
of 92 minutes to administer. The Adult
SAQ will be completed once a year by
each person in the RU that is 18 years
old and older, an estimated 28,254
persons. The Adult SAQ requires an
average of 7 minutes to complete. The
Diabetes care SAQ will be completed
once a year by each person in the RU
identified as having diabetes, an
estimated 2,345 persons, and takes
about 3 minutes to complete. The
authorization form for the MEPS–MPC
Provider Survey will be completed once
for each medical provider seen by any
RU member. The 14,489 RUs in the
MEPS–HC will complete an average of
5.4 forms, which require about 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 $1,618,328; the annual cost burden
for the MEPS–MPC is estimated to be
$316,532. The total annual cost burden
for the MEPS–HC and MPC is estimated
to be $1,934,860.
EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS
Number of
respondents
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Form name
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 ................................................................
Subtotal for the MEPS–HC ...............................................................
MEPS–MPC/MOS:
MPC Contact Guide/Screening Call ** ......................................................
Home care for health care providers questionnaire .................................
Home care for non-health care providers questionnaire ..........................
Office-based providers questionnaire .......................................................
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Number of
responses per
respondent
Hours per
response
Total burden
hours
* 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
79,451
Na
na
67,826
35,222
532
25
11,785
1
1.49
1
1.44
2/60
9/60
11/60
10/60
1,174
119
5
2,828
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EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS—Continued
Number of
respondents
Form name
Number of
responses per
respondent
Hours per
response
Total burden
hours
Separately billing doctors questionnaire ...................................................
Hospitals questionnaire ............................................................................
Institutions (non-hospital) questionnaire ...................................................
Pharmacies questionnaire ........................................................................
Medical Organizations Survey questionnaire ...........................................
12,693
5,077
117
4,993
6,000
3.43
3.51
2.03
4.44
1
13/60
9/60
9/60
3/60
15/60
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
* 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
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 ................................................................
Total burden
hours
Average
hourly wage
rate
Total cost
burden
15,093
28,254
2,345
14,489
14,489
4,781
57,857
3,296
117
3,912
2,246
398
* $23.86
* 23.86
* 23.86
* 23.86
* 23.86
* 23.86
$1,380,468
78,643
2,792
93,340
53,590
9,496
Subtotal for the MEPS–HC ...............................................................
MEPS–MPC/MOS:
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 ...........................................
79,451
67,826
Na
1,618,328
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
** 16.85
** 16.85
** 16.85
** 16.85
** 16.85
** 16.85
** 16.85
*** 15.47
** 16.85
19,782
2,005
84
47,652
158,946
45,040
607
17,141
25,275
Subtotal for the MEPS–MPC .............................................................
76,444
18,876
na
316,532
Grand Total ................................................................................
155,895
86,073
na
1,934,860
* 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 2016 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.
sradovich on DSK3GMQ082PROD with NOTICES
Request for Comments
In accordance with the Paperwork
Reduction Act, comments on AHRQ’s
information collection are requested
with regard to any of the following: (a)
Whether the proposed collection of
information is necessary for the proper
performance of AHRQ healthcare
research and healthcare information
dissemination functions, including
whether the information will have
practical utility; (b) the accuracy of
AHRQ’s estimate of burden (including
hours and costs) of the proposed
collection(s) of information; (c) ways to
enhance the quality, utility, and clarity
of the information to be collected; and
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(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.
[FR Doc. 2017–27605 Filed 12–21–17; 8:45 am]
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Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–R–262]
Agency Information Collection
Activities: Submission for OMB
Review; Comment Request
ACTION:
Notice; partial withdrawal.
On Wednesday, December 13,
2017, the Centers for Medicare &
Medicaid Services (CMS) published a
notice document entitled, ‘‘Agency
Information Collection Activities:
SUMMARY:
Sharon B. Arnold,
Deputy Director.
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HUMAN SERVICES
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]]>Agencies
[Federal Register Volume 82, Number 245 (Friday, December 22, 2017)]
[Notices]
[Pages 60741-60744]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-27605]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Agency for Healthcare Research and Quality, HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: This notice announces the intention of the Agency for
Healthcare Research and Quality (AHRQ) to request that the Office of
Management and Budget (OMB) approve the proposed changes to the
currently approved information collection project: ``Medical
Expenditure Panel Survey (MEPS) Household Component and the MEPS
Medical Provider Component.''
DATES: Comments on this notice must be received by February 20, 2018.
ADDRESSES: Written comments should be submitted to: Doris Lefkowitz,
Reports Clearance Officer, AHRQ, by email at
[email protected].
Copies of the proposed changes to questions asked of household
respondents, data collection instruments, collection plans, 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
[email protected].
SUPPLEMENTARY INFORMATION:
Proposed Project
Medical Expenditure Panel Survey (MEPS) Household Component (HC)
In accordance with the Paperwork Reduction Act, 44 U.S.C. 3501-
3521, AHRQ invites the public to comment on this proposed information
collection. 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/herself and for other family
members.
The only change to the MEPS-HC from the previous OMB clearance is
an update to the existing Adult Self-Administered Questionnaire (SAQ).
The MEPS-HC has the following goal:
[ssquf] To provide nationally representative estimates for the U.S.
civilian noninstitutionalized population for:
Health care use, expenditures, sources of payment
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.
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 occurred during the
reference period
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, such as
the sources paying for the medical care-including the patient/family,
public sources, and private insurance, and amounts paid by each source
[[Page 60742]]
Data collected from pharmacies include:
Date on which a prescription was filled
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.
There are no changes to the MEPS-MPC from the previous OMB
clearance.
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 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, which is typically a family, only one person
normally provides this information. All sections of the current core
instrument are available on the AHRQ website at https://meps.ahrq.gov/mepsweb/survey_comp/survey_questionnaires.jsp.
2. Adult Self Administered Questionnaire. A brief self-administered
questionnaire (SAQ) will be used to collect self-reported (rather than
through household proxy) information on health status, health opinions
and satisfaction with health care for adults 18 and older. The health
status items are from the Veterans Rand 12-item health survey (VR-12).
Additionally there are questions addressing adult preventive care for
both males and females. This questionnaire has changed from the
previous OMB clearance.
3. Diabetes Care SAQ. 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. 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 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 his or her 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 using a unique screening instrument, except
for the two home care provider types which use the same screening form;
see https://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC_CG.
2. Home Care Provider Questionnaire for Health Care Providers. This
questionnaire is used to collect data from home health care agencies
which provide medical care services to household respondents.
Information collected includes type of personnel providing care, hours
or visits provided per month, and the charges and payments for services
received. See https://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC.
3. Home Care Provider Questionnaire for Non-Health Care Providers.
This questionnaire is used to collect information about services
provided in the home by non-health care workers to household
respondents because of a medical condition; for example, cleaning or
yard work, transportation, shopping, or child care. See https://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC.
4. Medical Event Questionnaire for Office-Based Providers. This
questionnaire is for office-based physicians, including doctors of
medicine (MDs) and osteopathy (DOs), as well as providers practicing
under the direction or supervision of an MD or DO (e.g., physician
assistants and nurse practitioners working in clinics). Providers of
care in private offices as well as staff model HMOs are included. See
https://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC.
5. Medical Event Questionnaire for Separately Billing Doctors. This
questionnaire collects information from physicians identified by
hospitals (during the Hospital Event data collection) as providing care
to sampled persons during the course of inpatient, outpatient
department or emergency room care, but who bill separately from the
hospital. See https://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC.
6. Hospital Event Questionnaire. This questionnaire is used to
collect information about hospital events, including inpatient stays,
outpatient department, and emergency room visits. Hospital data are
collected not only from the billing department, but from medical
records and administrative records departments as well. Medical records
departments are contacted to determine the names of all the doctors
[[Page 60743]]
who treated the patient during a stay or visit. In many cases, the
hospital administrative office also has to be contacted to determine
whether the doctors identified by medical records billed separately
from the hospital itself; the doctors that do bill separately from the
hospital will be contacted as part of the Medical Event Questionnaire
for Separately Billing Doctors. HMOs are included in this provider
type. See https://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC.
7. Institutions Event Questionnaire. This questionnaire is used to
collect information about institution events, including nursing homes,
rehabilitation facilities and skilled nursing facilities. Institution
data are collected not only from the billing department, but from
medical records and administrative records departments as well. Medical
records departments are contacted to determine the names of all the
doctors who treated the patient during a stay. In many cases, the
institution administrative office also has to be contacted to determine
whether the doctors identified by medical records billed separately
from the institution itself. See https://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC).
8. Pharmacy Data Collection Questionnaire. This questionnaire
requests the national drug code (NDC) and when that is not available
the prescription name, date prescription was filled, payments by
source, prescription strength and form (when the NDC is not available),
quantity, and person for whom the prescription was filled. When the NDC
is available, we do not ask for prescription name, strength or form
because that information is embedded in the NDC; this reduces burden on
the respondent. Most pharmacies have the requested information
available in electronic format and respond by providing a computer
generated printout of the patient's prescription information. If the
computerized form is unavailable, the pharmacy can report their data to
a telephone interviewer. Pharmacies are also able to provide a CD-ROM
with the requested information if that is preferred. HMOs are included
in this provider type. See https://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp#MPC.
9. Medical Organizations Survey Questionnaire. This questionnaire
will collect essential information on important features of the
staffing, organization, policies, and financing for identified usual
source of office based care providers. This additional data are linked
to MEPS sample respondents to enable analyses at the person-level using
characteristics of provider practices.
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.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated annualized burden hours for the
respondents' time to participate in the MEPS-HC and the MEPS-MPC. The
MEPS-HC Core Interview will be completed by 15,093* (see note below
Exhibit 1) ``family level'' respondents, also referred to as RU
respondents. Since the MEPS-HC consists of 5 rounds of interviewing
covering a full two years of data, the annual average number of
responses per respondent is 2.5 responses per year. The MEPS-HC core
requires an average response time of 92 minutes to administer. The
Adult SAQ will be completed once a year by each person in the RU that
is 18 years old and older, an estimated 28,254 persons. The Adult SAQ
requires an average of 7 minutes to complete. The Diabetes care SAQ
will be completed once a year by each person in the RU identified as
having diabetes, an estimated 2,345 persons, and takes about 3 minutes
to complete. The authorization form for the MEPS-MPC Provider Survey
will be completed once for each medical provider seen by any RU member.
The 14,489 RUs in the MEPS-HC will complete an average of 5.4 forms,
which require about 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 $1,618,328;
the annual cost burden for the MEPS-MPC is estimated to be $316,532.
The total annual cost burden for the MEPS-HC and MPC is estimated to be
$1,934,860.
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-based providers questionnaire........ 11,785 1.44 10/60 2,828
[[Page 60744]]
Separately billing doctors questionnaire.... 12,693 3.43 13/60 9,433
Hospitals questionnaire..................... 5,077 3.51 9/60 2,673
Institutions (non-hospital) questionnaire... 117 2.03 9/60 36
Pharmacies questionnaire.................... 4,993 4.44 3/60 1,108
Medical Organizations Survey questionnaire.. 6,000 1 15/60 1,500
---------------------------------------------------------------
Subtotal for the MEPS-MPC............... 76,444 na na 18,876
---------------------------------------------------------------
Grand Total......................... 155,895 na na 86,702
----------------------------------------------------------------------------------------------------------------
* While the expected number of responding units for the annual estimates is 14,489, it is necessary to adjust
for survey attrition of initial respondents by a factor of 0.96 (15,093 = 14,489/0.96).
** There are 6 different contact guides; one for office based, separately billing doctor, hospital, institution,
and pharmacy provider types, and the two home care provider types use the same contact guide.
Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
Average
Form name Number of Total burden hourly wage Total cost
respondents hours rate burden
----------------------------------------------------------------------------------------------------------------
MEPS-HC:
MEPS-HC Core Interview...................... 15,093 57,857 * $23.86 $1,380,468
Adult SAQ................................... 28,254 3,296 * 23.86 78,643
Diabetes care SAQ........................... 2,345 117 * 23.86 2,792
Authorization forms for the MEPS-MPC 14,489 3,912 * 23.86 93,340
Provider Survey............................
Authorization form for the MEPS-MPC Pharmacy 14,489 2,246 * 23.86 53,590
Survey.....................................
MEPS-HC Validation Interview................ 4,781 398 * 23.86 9,496
---------------------------------------------------------------
Subtotal for the MEPS-HC................ 79,451 67,826 Na 1,618,328
MEPS-MPC/MOS:
MPC Contact Guide/Screening Call............ 35,222 1,174 ** 16.85 19,782
Home care for health care providers 532 119 ** 16.85 2,005
questionnaire..............................
Home care for non[dash]health care providers 25 5 ** 16.85 84
questionnaire..............................
Office[dash]based providers questionnaire... 11,785 2,828 ** 16.85 47,652
Separately billing doctors questionnaire.... 12,693 9,433 ** 16.85 158,946
Hospitals questionnaire..................... 5,077 2,673 ** 16.85 45,040
Institutions (non-hospital) questionnaire... 117 36 ** 16.85 607
Pharmacies questionnaire.................... 4,993 1,108 *** 15.47 17,141
Medical Organizations Survey questionnaire.. 6,000 1,500 ** 16.85 25,275
---------------------------------------------------------------
Subtotal for the MEPS-MPC............... 76,444 18,876 na 316,532
---------------------------------------------------------------
Grand Total......................... 155,895 86,073 na 1,934,860
----------------------------------------------------------------------------------------------------------------
* 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 2016 National Occupational Employment and Wage Estimates United States,
U.S. Department of Labor, Bureau of Labor Statistics. https://www.bls.gov/oes/current/oes_nat.htm#b29-0000.
Request for Comments
In accordance with the Paperwork Reduction Act, comments on AHRQ's
information collection are requested with regard to any of the
following: (a) Whether the proposed collection of information is
necessary for the proper performance of AHRQ healthcare research and
healthcare information dissemination functions, including whether the
information will have practical utility; (b) the accuracy of AHRQ's
estimate of burden (including hours and costs) of the proposed
collection(s) of information; (c) ways to enhance the quality, utility,
and clarity of the information to be collected; and (d) ways to
minimize the burden of the collection of information upon the
respondents, including the use of automated collection techniques or
other forms of information technology.
Comments submitted in response to this notice will be summarized
and included in the Agency's subsequent request for OMB approval of the
proposed information collection. All comments will become a matter of
public record.
Sharon B. Arnold,
Deputy Director.
[FR Doc. 2017-27605 Filed 12-21-17; 8:45 am]
BILLING CODE 4160-90-P
