Agency Information Collection Activities: Proposed Collection; Comment Request, 67291-67294 [2023-21473]
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Federal Register / Vol. 88, No. 188 / Friday, September 29, 2023 / Notices
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:
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Proposed Project
Generic Clearance for the Collection of
Qualitative Feedback on Agency Service
Delivery
The information collection activity
will garner qualitative customer and
stakeholder feedback in an efficient,
timely manner, in accordance with the
Administration’s commitment to
improving service delivery. By
qualitative feedback we mean
information that provides useful
insights on perceptions and opinions,
but are not statistical surveys that yield
quantitative results that can be
generalized to the population of study.
This feedback will provide insights into
customer or stakeholder perceptions,
experiences, and expectations, provide
an early warning of issues with service,
or focus attention on areas where
communication, training or changes in
operations might improve delivery of
products or services. These collections
will allow for ongoing, collaborative and
actionable communications between the
Agency and its customers and
stakeholders. It will also allow feedback
to contribute directly to the
improvement of program management.
The current clearance was approved on
November 2, 2020 (OMB Control
Number 0935–0179) and will expire on
November 30, 2023. Feedback collected
under this generic clearance will
provide useful information, but it will
not yield data that can be generalized to
the overall population. This type of
generic clearance for qualitative
information will not be used for
quantitative information collections that
are designed to yield reliably actionable
results, such as monitoring trends over
time or documenting program
performance. Such data uses require
more rigorous designs that address: (1)
the target population to which
generalizations will be made; (2) the
sampling frame; (3) the sample design
(including stratification and clustering);
(4) the precision requirements or power
calculations that justify the proposed
sample size; (5) the expected response
rate; (6) methods for assessing potential
nonresponse bias; (7) the protocols for
data collection; (8) and any testing
procedures that were or will be
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undertaken prior to fielding the study.
Depending on the degree of influence
the results are likely to have, such
collections may still be eligible for
submission for other generic
mechanisms that are designed to yield
quantitative results.
Below we provide AHRQ’s projected
average annual estimates for the next
three years:
Current Actions: New collection of
information.
Type of Review: New Collection.
Affected Public: Individuals and
Households, Businesses and
Organizations, State, Local or Tribal
Government.
Average Expected Annual Number of
Activities: 10.
Respondents: 10,900.
Annual responses: 10,900.
Frequency of Response: Once per
request.
The total number of respondents
across all 10 activities each year is
10,900.
Average minutes per response: 19.
Burden hours: 3,383.
An agency may not conduct or
sponsor, and a person is not required to
respond to, a collection of information
unless it displays a currently valid
Office of Management and Budget
control number.
Request for Comments
In accordance with the Paperwork
Reduction Act, comments on AHRQ’s
information collection are requested
with regard to any of the following: (a)
Whether the proposed collection of
information is necessary for the proper
performance of AHRQ healthcare
research and healthcare information
dissemination functions, including
whether the information will have
practical utility; (b) the accuracy of
AHRQ’s estimate of burden (including
hours and costs) of the proposed
collection(s) of information; (c) ways to
enhance the quality, utility, and clarity
of the information to be collected; and
(d) ways to minimize the burden of the
collection of information upon the
respondents, including the use of
automated collection techniques or
other forms of information technology.
Comments submitted in response to this
notice will be summarized and included
in the Agency’s subsequent request for
OMB approval of the proposed
information collection. All comments
will become a matter of public record.
Dated: September 26, 2023.
Marquita Cullom,
Associate Director.
[FR Doc. 2023–21551 Filed 9–28–23; 8:45 am]
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67291
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
updates to the currently approved
information collection project: ‘‘Medical
Expenditures Panel Survey—Household
and Medical Provider Components.’’ In
accordance with the Paperwork
Reduction Act of 1995, AHRQ invites
the public to comment on this proposed
information collection.
DATES: Comments on this notice must be
received by November 28, 2023.
ADDRESSES: Written comments should
be submitted to: Doris Lefkowitz,
Reports Clearance Officer, AHRQ, by
email at doris.lefkowitz@AHRQ.hhs.gov.
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 Expenditures Panel Survey—
Household and Medical Provider
Components
AHRQ requests that OMB approve a
change to AHRQ’s collection of
information for the Medical
Expenditures Panel Survey—Household
and Medical Provider Components:
OMB Control number 0935–0118,
expiration November 30, 2025.
Requested changes are for the
Household Component (MEPS–HC)
only.
The MEPS was initiated in 1996. Each
year a new panel of sample households
is selected. Recent annual MEPS–HC
sample sizes average about 13,500
households. Data can be analyzed at
either the person, family, or event level.
The panel design of the survey, which
includes 5 rounds of interviews
covering 2 full calendar years, provides
data for examining person level changes
in selected variables such as
expenditures, health insurance
coverage, and health status.
This research has the following goals:
(1) To produce nationally
representative estimates of health care
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use, expenditures, sources of payment,
and health insurance coverage for the
U.S. civilian noninstitutionalized
population.
(2) To produce nationally
representative estimates of respondents’
health status, demographic and socioeconomic characteristics, employment,
access to care, and satisfaction with
health care.
Proposed Changes for the Fall 2024
MEPS–HC:
• Core MEPS Interview—Seven
economic burden questions will be
added to the Core interview. Five of
these questions come from the
Preventive Care Services SelfAdministered Questionnaire (PSAQ),
and two are new to the MEPS. The
specific topics of the five questions
moving from the PSAQ are partial and
late payments for bills, having been
contacted by debt collection agencies,
and ability to pay for unexpected
expenses. The questions were modified
to be asked at the household level.
These topics are important for
understanding the context families face
in paying for health care. The new
questions asking about medical debt are
modified versions of questions used in
the Survey of Income and Program
Participation (SIPP). The SIPP asks the
question at a person level; AHRQ has
modified it to be asked at the household
level. Collecting medical debt amounts
will enable analyses of how medical
debt is related to health care access, use,
health outcomes, and financial status. In
addition, the wording for eight food
security questions has been slightly
modified to allow for proxy responses;
thus, all households will be asked these
questions.
Preventive Care Services SelfAdministered Questionnaire (PSAQ)—
The PSAQ will have the following
changes for Fall 2024:
• Removing five economic burden
questions, which will be added to the
Core interview;
• Combining the Male and Female
PSAQ questionnaires into a single
questionnaire and revising the sexspecific questions accordingly;
• Adding Sexual Orientation and
Gender Identity (SOGI) questions to the
end of the questionnaire;
• Changing the age-specific skips to
reflect new recommendations for
specific preventive health screening
procedures;
• Creating a web-based mode of
completion as an alternative option to
the traditional pen-and-paper-based
survey.
The incorporation of SOGI questions
into the PSAQ aligns with the objectives
outlined in Executive Order 14075,
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titled ‘‘Advancing Equality for Lesbian,
Gay, Bisexual, Transgender, Queer, and
Intersex Individuals.’’ The inclusion of
these questions necessitated further
adjustments to the questionnaires,
including the consolidation of the
traditionally segregated male and female
questionnaires into a unified form.
Optimally incorporating sex-specific
preventive care questions (e.g., prostate
cancer screening) in surveys in a
manner that respects all gender
identities requires balancing multiple
competing factors. AHRQ consulted
with federal agencies fielding surveys
with SOGI and preventive care
questions, and they have not yet
modified their preventive care questions
to account for gender minorities. For
this initial attempt in the MEPS, AHRQ
balanced the following considerations:
respect for gender minority respondents,
cognitive burden among cisgender
respondents, minimizing skip patterns
to maintain consistency between penand-paper and web-based modes of the
PSAQ, and the strong expectation that
the number of gender minority
respondents in the relevant age ranges
will be too small to support estimates of
receipt of sex-specific preventive
services in this population. AHRQ will
continue to monitor best practices and
empirical studies by consulting with
NCHS and the National Cancer Institute
(NCI) to revise the PSAQ when it is
fielded again in the future.
• Cancer Self-Administered
Questionnaire (Cancer SAQ)—The NCI
has collaborated in previous years with
AHRQ to create the MEPS Experiences
with Cancer Supplement, which
oversampled households with cancer
survivors from the prior year National
Health Interview Survey (NHIS) and
fielded a special survey about economic
burden and access to care in cancer
survivors. Due to a change in the NHIS
sample design, MEPS will not be able to
oversample cancer survivors in the 2024
data collection. The current effort will
field an updated version of the MEPS
Experiences with Cancer Survey in the
Fall 2024 MEPS–HC. The new version
of the survey will include most of the
same questions as the earlier survey to
allow comparisons of trends and will
replace some survey items that are now
less critical or available from other data
sources with new questions on
employment impacts and workplace
accommodations; survivorship care;
social determinants of health; and social
isolation and support.
This study is being conducted by
AHRQ through its contractor, Westat,
pursuant to AHRQ’s statutory authority
to conduct and support research on
healthcare and on systems for the
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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
The MEPS–HC uses a combination of
computer assisted personal interviewing
(CAPI), computer assisted video
interviewing (CAVI), and selfadministered paper and web
questionnaires, to collect information
about each household member, and the
survey builds on this information from
interview to interview. CAVI is a new
data collection technology and offers the
best of both telephone and in-person
interviewing, while offering
opportunities for cost savings and more
accurate reporting.
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 11,750 ‘‘family level’’
respondents. Since the MEPS–HC
typically 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 88
minutes to administer. The Adult SAQ
is completed once during the 2-year
panel, in rounds 2 and 4 during odd
numbered years, making the annualized
average 0.5 times per year. The Adult
SAQ will be completed by 5,688 adults
and requires an average of 7 minutes to
complete. The PSAQ is completed once
during the 2-year panel, in rounds 2 and
4 during even numbered years, making
the annualized average 0.5 times per
year. The PSAQ will be completed by
5,688 adults and requires an average of
7 minutes to complete. The Diabetes
Care Survey will be completed by 1,000
persons each year and requires 3
minutes to complete. The Cancer SAQ
will be completed by 1,500 persons each
year and requires 20 minutes to
complete. Authorization forms for the
MEPS–MPC and Pharmacy Survey will
be completed by 11,750 respondents.
Each respondent will complete an
average of 4.66 forms each year, with
each form requiring an average of 3
minutes to complete. A validation
interview will be conducted with 4,225
respondents each year and requires 5
minutes to complete. The total burden
hours for the respondents’ time to
participate in the MEPS–HC is
estimated to be 47,387 hours.
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The MEPS–MPC Contact Guide/
Screening Call will be conducted with
54,758 providers and pharmacies each
year and requires 5 minutes to
complete. The Home Care Providers
Event Form will be completed by 886
providers, with each provider
completing an average of 5.8 forms and
each form requiring 3 minutes to
complete. The Office-based Providers
Event Form will be completed by 14,950
providers. Each provider will complete
an average of 4.3 forms and each form
requires 3 minutes to complete. The
Separately Billing Doctors Event Form
will be completed by 12,690 providers,
with each provider completing 1.4
forms on average, and each form
requiring 3 minutes to complete. The
Hospital Event Form will be completed
by 8,302 hospitals or HMOs. Each
hospital or HMO will complete 7.5
forms on average, with each form
requiring 3 minutes to complete. The
Institutions (non-hospital) Event Form
will be completed by 118 institutions,
with each institution completing 1.3
forms on average, and each form
requiring 3 minutes to complete. The
Pharmacy Event Form will be
completed by 9,079 pharmacies. Each
pharmacy will complete 37.6 forms on
average, with each form requiring 3
minutes to complete. The total burden
hours for the respondent’s time to
participate in the MEPS–MPC is
estimated to be 29,111 hours. The total
annual burden hours for the MEPS–HC
and MPC is estimated to be 76,498
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 $1,410,236; the annual cost burden
for the MEPS–MPC is estimated to be
$569,200. The total annual cost burden
for the MEPS–HC and MPC is estimated
to be $1,979,436.
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 * ......................................................................................................................
Preventive Care SAQ (PSAQ) ** .....................................................................................
Diabetes Care Survey (DCS) ..........................................................................................
Cancer SAQ .....................................................................................................................
Authorization forms for the MEPS–MPC .........................................................................
Provider and Pharmacy Survey
MEPS Validation Interview ..............................................................................................
11,750
5,688
5,688
1,000
1,500
11,750
2.5
0.5
0.5
1
1
4.66
88/60
7/60
7/60
3/60
20/60
3/60
43,083
332
332
50
500
2,738
4,225
1
5/60
352
Subtotal for the MEPS–HC ......................................................................................
41,600
....................
....................
47,387
MPC Contact Guide/Screening Call ................................................................................
Home Care Providers Event Form ..................................................................................
Office-based Providers Event Form ................................................................................
Separately Billing Doctors Event Form ...........................................................................
Hospitals & HMOs (Hospital Event Form) .......................................................................
Institutions (non-hospital) Event Form .............................................................................
Pharmacies Event Form ..................................................................................................
Subtotal for the MEPS–MPC ...........................................................................................
54,758
886
14,950
12,690
8,302
118
9,079
100,783
1
5.8
4.3
1.4
7.5
1.3
37.6
....................
5/60
3/60
3/60
3/60
3/60
3/60
3/60
....................
4,563
257
3,214
888
3,113
8
17,068
29,111
Grand Total ...............................................................................................................
142,383
....................
....................
76,498
Total
burden
hours
Average
hourly wage
rate
Total cost
burden
MEPS–MPC
* The Adult SAQ is completed once every two years, on the odd numbered years.
** The PSAQ is completed once every two years, on the even numbered years.
EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN
Number of
respondents
Form name
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MEPS–HC
MEPS–HC Core Interview ...............................................................................................
Adult SAQ ........................................................................................................................
Preventive Care SAQ (PSAQ) .........................................................................................
Diabetes Care Survey (DCS) ..........................................................................................
Cancer SAQ .....................................................................................................................
Authorization forms for the MEPS–MPC Provider and Pharmacy Survey .....................
MEPS Validation Interview ..............................................................................................
Subtotal for the MEPS–HC ..............................................................................................
11,750
5,688
5,688
1,000
1,500
11,750
4,225
41,600
43,083
332
332
50
500
2,738
352
47,387
* $29.76
* 29.76
* 29.76
* 29.76
* 29.76
* 29.76
* 29.76
....................
$1,282,150
9,880
9,880
1,488
14,880
81,483
10,475
1,410,236
54,758
886
4,563
257
** 19.84
** 19.84
90,530
5,099
MEPS–MPC
MPC Contact Guide/Screening Call ................................................................................
Home care Providers Event Form ...................................................................................
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Federal Register / Vol. 88, No. 188 / Friday, September 29, 2023 / Notices
EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN—Continued
Number of
respondents
Form name
Total
burden
hours
Average
hourly wage
rate
Total cost
burden
Office-based Providers Event Form ................................................................................
Separately Billing Doctors (SBD) Event Form ................................................................
Hospitals & HMOs (Hospital Event Form ........................................................................
Institutions (non-hospital) Event Form .............................................................................
Pharmacies Event Form ..................................................................................................
Subtotal for the MEPS–MPC ...........................................................................................
14,950
12,690
8,302
118
9,079
100,783
3,214
888
3,113
8
17,068
29,111
** 19.84
** 19.84
** 19.84
** 19.84
*** 19.35
....................
63,766
17,618
61,762
159
330,266
569,200
Grand Total ...............................................................................................................
142,383
77,067
....................
1,979,436
* 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 2022 National Occupational Employment and Wage Estimates United States, U.S. Department of
Labor, Bureau of Labor Statistics.
Request for Comments
Dated: September 26, 2023.
Marquita Cullom,
Associate Director.
The Agency for Healthcare
Research and Quality (AHRQ) is seeking
scientific information submissions from
the public. Scientific information is
being solicited to inform our review on
Healthcare Industry Waste and Lifecycle
Assessment, which is currently being
conducted by the AHRQ’s Evidencebased Practice Centers (EPC) Program.
Access to published and unpublished
pertinent scientific information will
improve the quality of this review.
DATES: Submission Deadline on or
before October 30, 2023.
ADDRESSES:
Email submissions: epc@
ahrq.hhs.gov.
Print submissions:
Mailing Address: Center for Evidence
and Practice Improvement, Agency for
Healthcare Research and Quality,
ATTN: EPC SEADs Coordinator, 5600
Fishers Lane, Mail Stop 06E53A,
Rockville, MD 20857.
Shipping Address (FedEx, UPS, etc.):
Center for Evidence and Practice
Improvement, Agency for Healthcare
Research and Quality, ATTN: EPC
SEADs Coordinator, 5600 Fishers Lane,
Mail Stop 06E77D, Rockville, MD
20857.
[FR Doc. 2023–21473 Filed 9–28–23; 8:45 am]
FOR FURTHER INFORMATION CONTACT:
BILLING CODE 4160–90–P
Kelly Carper, Telephone: 301–427–1656
or Email: epc@ahrq.hhs.gov.
SUPPLEMENTARY INFORMATION: The
Agency for Healthcare Research and
Quality has commissioned the
Evidence-based Practice Centers (EPC)
Program to complete a review of the
evidence for Healthcare Industry Waste
and Lifecycle Assessment. AHRQ is
conducting this review pursuant to
section 902 of the Public Health Service
Act, 42 U.S.C. 299a.
The EPC Program is dedicated to
identifying as many studies as possible
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
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Request for supplemental
evidence and data submissions.
ACTION:
In accordance with the Paperwork
Reduction Act, 44 U.S.C. 3501–3520,
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’s 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.
Agency for Healthcare Research and
Quality
Supplemental Evidence and Data
Request on Healthcare Industry Waste
and Lifecycle Assessment
Agency for Healthcare Research
and Quality (AHRQ), HHS.
AGENCY:
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SUMMARY:
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that are relevant to the questions for
each of its reviews. In order to do so, we
are supplementing the usual manual
and electronic database searches of the
literature by requesting information
from the public (e.g., details of studies
conducted). We are looking for studies
that report on Healthcare Industry
Waste and Lifecycle Assessment. The
entire research protocol is available
online at: https://effectivehealthcare.
ahrq.gov/products/lifecycle-assessment.
This is to notify the public that the
EPC Program would find the following
information on Healthcare Industry
Waste and Lifecycle Assessment helpful:
D A list of completed studies that
your organization has sponsored for this
topic. In the list, please indicate
whether results are available on
ClinicalTrials.gov along with the
ClinicalTrials.gov trial number.
D For completed studies that do not
have results on ClinicalTrials.gov, a
summary, including the following
elements, if relevant: study number,
study period, design, methodology,
indication and diagnosis, proper use
instructions, inclusion and exclusion
criteria, primary and secondary
outcomes, baseline characteristics,
number of patients screened/eligible/
enrolled/lost to follow-up/withdrawn/
analyzed, effectiveness/efficacy, and
safety results.
D A list of ongoing studies that your
organization has sponsored for this
topic. In the list, please provide the
ClinicalTrials.gov trial number or, if the
trial is not registered, the protocol for
the study including, if relevant, a study
number, the study period, design,
methodology, indication and diagnosis,
proper use instructions, inclusion and
exclusion criteria, and primary and
secondary outcomes.
D Description of whether the above
studies constitute ALL Phase II and
above clinical trials sponsored by your
organization for this topic and an index
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]]>Agencies
[Federal Register Volume 88, Number 188 (Friday, September 29, 2023)]
[Notices]
[Pages 67291-67294]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-21473]
-----------------------------------------------------------------------
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 updates to the
currently approved information collection project: ``Medical
Expenditures Panel Survey--Household and Medical Provider Components.''
In accordance with the Paperwork Reduction Act of 1995, AHRQ invites
the public to comment on this proposed information collection.
DATES: Comments on this notice must be received by November 28, 2023.
ADDRESSES: Written comments should be submitted to: Doris Lefkowitz,
Reports Clearance Officer, AHRQ, by email at
[email protected].
FOR FURTHER INFORMATION CONTACT: Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427-1477, or by email at
[email protected].
SUPPLEMENTARY INFORMATION:
Proposed Project
Medical Expenditures Panel Survey--Household and Medical Provider
Components
AHRQ requests that OMB approve a change to AHRQ's collection of
information for the Medical Expenditures Panel Survey--Household and
Medical Provider Components: OMB Control number 0935-0118, expiration
November 30, 2025. Requested changes are for the Household Component
(MEPS-HC) only.
The MEPS was initiated in 1996. Each year a new panel of sample
households is selected. Recent annual MEPS-HC sample sizes average
about 13,500 households. Data can be analyzed at either the person,
family, or event level. The panel design of the survey, which includes
5 rounds of interviews covering 2 full calendar years, provides data
for examining person level changes in selected variables such as
expenditures, health insurance coverage, and health status.
This research has the following goals:
(1) To produce nationally representative estimates of health care
[[Page 67292]]
use, expenditures, sources of payment, and health insurance coverage
for the U.S. civilian noninstitutionalized population.
(2) To produce nationally representative estimates of respondents'
health status, demographic and socio-economic characteristics,
employment, access to care, and satisfaction with health care.
Proposed Changes for the Fall 2024 MEPS-HC:
Core MEPS Interview--Seven economic burden questions will
be added to the Core interview. Five of these questions come from the
Preventive Care Services Self-Administered Questionnaire (PSAQ), and
two are new to the MEPS. The specific topics of the five questions
moving from the PSAQ are partial and late payments for bills, having
been contacted by debt collection agencies, and ability to pay for
unexpected expenses. The questions were modified to be asked at the
household level. These topics are important for understanding the
context families face in paying for health care. The new questions
asking about medical debt are modified versions of questions used in
the Survey of Income and Program Participation (SIPP). The SIPP asks
the question at a person level; AHRQ has modified it to be asked at the
household level. Collecting medical debt amounts will enable analyses
of how medical debt is related to health care access, use, health
outcomes, and financial status. In addition, the wording for eight food
security questions has been slightly modified to allow for proxy
responses; thus, all households will be asked these questions.
Preventive Care Services Self-Administered Questionnaire (PSAQ)--
The PSAQ will have the following changes for Fall 2024:
Removing five economic burden questions, which will be
added to the Core interview;
Combining the Male and Female PSAQ questionnaires into a
single questionnaire and revising the sex-specific questions
accordingly;
Adding Sexual Orientation and Gender Identity (SOGI)
questions to the end of the questionnaire;
Changing the age-specific skips to reflect new
recommendations for specific preventive health screening procedures;
Creating a web-based mode of completion as an alternative
option to the traditional pen-and-paper-based survey.
The incorporation of SOGI questions into the PSAQ aligns with the
objectives outlined in Executive Order 14075, titled ``Advancing
Equality for Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex
Individuals.'' The inclusion of these questions necessitated further
adjustments to the questionnaires, including the consolidation of the
traditionally segregated male and female questionnaires into a unified
form. Optimally incorporating sex-specific preventive care questions
(e.g., prostate cancer screening) in surveys in a manner that respects
all gender identities requires balancing multiple competing factors.
AHRQ consulted with federal agencies fielding surveys with SOGI and
preventive care questions, and they have not yet modified their
preventive care questions to account for gender minorities. For this
initial attempt in the MEPS, AHRQ balanced the following
considerations: respect for gender minority respondents, cognitive
burden among cisgender respondents, minimizing skip patterns to
maintain consistency between pen-and-paper and web-based modes of the
PSAQ, and the strong expectation that the number of gender minority
respondents in the relevant age ranges will be too small to support
estimates of receipt of sex-specific preventive services in this
population. AHRQ will continue to monitor best practices and empirical
studies by consulting with NCHS and the National Cancer Institute (NCI)
to revise the PSAQ when it is fielded again in the future.
Cancer Self-Administered Questionnaire (Cancer SAQ)--The
NCI has collaborated in previous years with AHRQ to create the MEPS
Experiences with Cancer Supplement, which oversampled households with
cancer survivors from the prior year National Health Interview Survey
(NHIS) and fielded a special survey about economic burden and access to
care in cancer survivors. Due to a change in the NHIS sample design,
MEPS will not be able to oversample cancer survivors in the 2024 data
collection. The current effort will field an updated version of the
MEPS Experiences with Cancer Survey in the Fall 2024 MEPS-HC. The new
version of the survey will include most of the same questions as the
earlier survey to allow comparisons of trends and will replace some
survey items that are now less critical or available from other data
sources with new questions on employment impacts and workplace
accommodations; survivorship care; social determinants of health; and
social isolation and support.
This study is being conducted by AHRQ through its contractor,
Westat, pursuant to AHRQ's statutory authority to conduct and support
research on healthcare and on systems for the delivery of such care,
including activities with respect to the cost and use of health care
services and with respect to health statistics and surveys. 42 U.S.C.
299a(a)(3) and (8); 42 U.S.C. 299b-2.
Method of Collection
The MEPS-HC uses a combination of computer assisted personal
interviewing (CAPI), computer assisted video interviewing (CAVI), and
self-administered paper and web questionnaires, to collect information
about each household member, and the survey builds on this information
from interview to interview. CAVI is a new data collection technology
and offers the best of both telephone and in-person interviewing, while
offering opportunities for cost savings and more accurate reporting.
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 11,750 ``family
level'' respondents. Since the MEPS-HC typically 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 88 minutes to administer.
The Adult SAQ is completed once during the 2-year panel, in rounds 2
and 4 during odd numbered years, making the annualized average 0.5
times per year. The Adult SAQ will be completed by 5,688 adults and
requires an average of 7 minutes to complete. The PSAQ is completed
once during the 2-year panel, in rounds 2 and 4 during even numbered
years, making the annualized average 0.5 times per year. The PSAQ will
be completed by 5,688 adults and requires an average of 7 minutes to
complete. The Diabetes Care Survey will be completed by 1,000 persons
each year and requires 3 minutes to complete. The Cancer SAQ will be
completed by 1,500 persons each year and requires 20 minutes to
complete. Authorization forms for the MEPS-MPC and Pharmacy Survey will
be completed by 11,750 respondents. Each respondent will complete an
average of 4.66 forms each year, with each form requiring an average of
3 minutes to complete. A validation interview will be conducted with
4,225 respondents each year and requires 5 minutes to complete. The
total burden hours for the respondents' time to participate in the
MEPS-HC is estimated to be 47,387 hours.
[[Page 67293]]
The MEPS-MPC Contact Guide/Screening Call will be conducted with
54,758 providers and pharmacies each year and requires 5 minutes to
complete. The Home Care Providers Event Form will be completed by 886
providers, with each provider completing an average of 5.8 forms and
each form requiring 3 minutes to complete. The Office-based Providers
Event Form will be completed by 14,950 providers. Each provider will
complete an average of 4.3 forms and each form requires 3 minutes to
complete. The Separately Billing Doctors Event Form will be completed
by 12,690 providers, with each provider completing 1.4 forms on
average, and each form requiring 3 minutes to complete. The Hospital
Event Form will be completed by 8,302 hospitals or HMOs. Each hospital
or HMO will complete 7.5 forms on average, with each form requiring 3
minutes to complete. The Institutions (non-hospital) Event Form will be
completed by 118 institutions, with each institution completing 1.3
forms on average, and each form requiring 3 minutes to complete. The
Pharmacy Event Form will be completed by 9,079 pharmacies. Each
pharmacy will complete 37.6 forms on average, with each form requiring
3 minutes to complete. The total burden hours for the respondent's time
to participate in the MEPS-MPC is estimated to be 29,111 hours. The
total annual burden hours for the MEPS-HC and MPC is estimated to be
76,498 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 $1,410,236;
the annual cost burden for the MEPS-MPC is estimated to be $569,200.
The total annual cost burden for the MEPS-HC and MPC is estimated to be
$1,979,436.
Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
Number of
Number of responses Hours per Total
Form name respondents per response burden
respondent hours
----------------------------------------------------------------------------------------------------------------
MEPS-HC
----------------------------------------------------------------------------------------------------------------
MEPS-HC Core Interview...................................... 11,750 2.5 88/60 43,083
Adult SAQ *................................................. 5,688 0.5 7/60 332
Preventive Care SAQ (PSAQ) **............................... 5,688 0.5 7/60 332
Diabetes Care Survey (DCS).................................. 1,000 1 3/60 50
Cancer SAQ.................................................. 1,500 1 20/60 500
Authorization forms for the MEPS-MPC........................ 11,750 4.66 3/60 2,738
Provider and Pharmacy Survey
MEPS Validation Interview................................... 4,225 1 5/60 352
----------------------------------------------------------------------------------------------------------------
Subtotal for the MEPS-HC................................ 41,600 ........... ........... 47,387
----------------------------------------------------------------------------------------------------------------
MEPS-MPC
----------------------------------------------------------------------------------------------------------------
MPC Contact Guide/Screening Call............................ 54,758 1 5/60 4,563
Home Care Providers Event Form.............................. 886 5.8 3/60 257
Office[dash]based Providers Event Form...................... 14,950 4.3 3/60 3,214
Separately Billing Doctors Event Form....................... 12,690 1.4 3/60 888
Hospitals & HMOs (Hospital Event Form)...................... 8,302 7.5 3/60 3,113
Institutions (non-hospital) Event Form...................... 118 1.3 3/60 8
Pharmacies Event Form....................................... 9,079 37.6 3/60 17,068
Subtotal for the MEPS-MPC................................... 100,783 ........... ........... 29,111
---------------------------------------------------
Grand Total............................................. 142,383 ........... ........... 76,498
----------------------------------------------------------------------------------------------------------------
* The Adult SAQ is completed once every two years, on the odd numbered years.
** The PSAQ is completed once every two years, on the even numbered years.
Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
Total Average
Form name Number of burden hourly wage Total cost
respondents hours rate burden
----------------------------------------------------------------------------------------------------------------
MEPS-HC
----------------------------------------------------------------------------------------------------------------
MEPS-HC Core Interview...................................... 11,750 43,083 * $29.76 $1,282,150
Adult SAQ................................................... 5,688 332 * 29.76 9,880
Preventive Care SAQ (PSAQ).................................. 5,688 332 * 29.76 9,880
Diabetes Care Survey (DCS).................................. 1,000 50 * 29.76 1,488
Cancer SAQ.................................................. 1,500 500 * 29.76 14,880
Authorization forms for the MEPS-MPC Provider and Pharmacy 11,750 2,738 * 29.76 81,483
Survey.....................................................
MEPS Validation Interview................................... 4,225 352 * 29.76 10,475
Subtotal for the MEPS-HC.................................... 41,600 47,387 ........... 1,410,236
----------------------------------------------------------------------------------------------------------------
MEPS-MPC
----------------------------------------------------------------------------------------------------------------
MPC Contact Guide/Screening Call............................ 54,758 4,563 ** 19.84 90,530
Home care Providers Event Form.............................. 886 257 ** 19.84 5,099
[[Page 67294]]
Office[dash]based Providers Event Form...................... 14,950 3,214 ** 19.84 63,766
Separately Billing Doctors (SBD) Event Form................. 12,690 888 ** 19.84 17,618
Hospitals & HMOs (Hospital Event Form....................... 8,302 3,113 ** 19.84 61,762
Institutions (non-hospital) Event Form...................... 118 8 ** 19.84 159
Pharmacies Event Form....................................... 9,079 17,068 *** 19.35 330,266
Subtotal for the MEPS-MPC................................... 100,783 29,111 ........... 569,200
---------------------------------------------------
Grand Total............................................. 142,383 77,067 ........... 1,979,436
----------------------------------------------------------------------------------------------------------------
* 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 2022 National Occupational Employment and Wage Estimates United States,
U.S. Department of Labor, Bureau of Labor Statistics.
Request for Comments
In accordance with the Paperwork Reduction Act, 44 U.S.C. 3501-
3520, 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's 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.
Dated: September 26, 2023.
Marquita Cullom,
Associate Director.
[FR Doc. 2023-21473 Filed 9-28-23; 8:45 am]
BILLING CODE 4160-90-P
