Inpatient Severe Maternal Morbidity Measure Technical Specifications, 6525-6526 [2024-02021]
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Federal Register / Vol. 89, No. 22 / Thursday, February 1, 2024 / Notices
November 27, 2023. No comments were
received.
Obtaining Copies of Proposals:
Requesters may obtain a copy of the
information collection documents from
the GSA Regulatory Secretariat Division,
by calling 202–501–4755 or emailing
GSARegSec@gsa.gov. Please cite
‘‘Information Collection 3090–0322’’, in
all correspondence.
Jeffrey Koses,
Senior Procurement Executive, Office of
Acquisition Policy, Office of Governmentwide Policy.
[FR Doc. 2024–02040 Filed 1–31–24; 8:45 am]
BILLING CODE P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Agency for Healthcare Research and
Quality
Inpatient Severe Maternal Morbidity
Measure Technical Specifications
Agency for Healthcare Research
and Quality, U.S. Department of Health
and Human Services.
ACTION: Notice of Request for
Information.
AGENCY:
The Agency for Healthcare
Research and Quality (AHRQ) Center for
Quality Improvement and Patient Safety
(CQuIPS) Division of Quality
Measurement and Improvement (QMI)
invites public comment in response to
this Request for Information (RFI). The
AHRQ Quality Indicators (QI) program
maintains inpatient quality indicators
(https://qualityindicators.ahrq.gov/
measures/IQI_TechSpecTechSpec) and
patient safety indicators (https://
qualityindicators.ahrq.gov/measures/
PSI_TechSpec), several of which are
relevant to maternal health care.
Specifically, the QI program maintains
measures of obstetric trauma, birth
trauma, and cesarean delivery
calculated at the hospital level using
administrative data. However, severe
maternal morbidity during an inpatient
stay may result from a host of
complications, such as sepsis, cardiac
failure, stroke, respiratory distress, and
renal failure. While state-level rates of
severe maternal morbidity are available
from AHRQ (https://datatools.ahrq.gov/
hcup-fast-stats/?tab=specialemphasis&dash=92), experts have noted
some shortcomings of this measure.
This RFI seeks comments on the
usability, feasibility, and likely uptake
of a measure of severe maternal
morbidity to be validated, refined, and
maintained by the QI program, with the
goal of providing data for maternal
ddrumheller on DSK120RN23PROD with NOTICES1
SUMMARY:
VerDate Sep<11>2014
17:12 Jan 31, 2024
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health service improvements. While a
measure of severe maternal morbidity is
currently available from AHRQ and the
Health Resources and Service
Administration (HRSA), several experts
have suggested that this algorithm could
benefit from refinements.
DATES: Comments on this notice must be
received at the address provided below
within 30 days of publication of this
notice, no later than March 4, 2024.
ADDRESSES: Interested parties may
submit comments electronically to
askahrq@ahrq.hhs.gov. When
submitting comments or requesting
information, please include the
document identifier number and project
title ‘‘Inpatient Severe Maternal
Morbidity Measure Technical
Specifications’’ for reference.
FOR FURTHER INFORMATION CONTACT:
Questions may be addressed to Judy
George, Program Lead for the AHRQ
Quality Indicators, Judy.george@
ahrq.hhs.gov.
SUPPLEMENTARY INFORMATION: Maternal
health, including maternal behavioral
health, is a national priority in the
United States. Strengthening data
collection and evaluation is part of the
first goal of the White House Blueprint
for Addressing the Maternal Health
Crisis (https://www.whitehouse.gov/wpcontent/uploads/2022/06/MaternalHealth-Blueprint.pdf), which is to
increase access to and coverage of
comprehensive high-quality maternal
health services, including behavioral
health services. Unexpected
complications and outcomes around
labor and delivery may lead to short- or
long-term consequences to women’s
health (https://
pubmed.ncbi.nlm.nih.gov/27560600/),
which have been defined as severe
maternal morbidity (https://
www.cdc.gov/reproductivehealth/
maternalinfanthealth/
severematernalmorbidity.htmlhtml).
National and state rates of severe
maternal morbidity are currently
available on AHRQ’s Healthcare Cost
and Utilization Project (HCUP) Fast
Stats dashboard (https://
datatools.ahrq.gov/hcup-fast-stats/
?tab=special-emphasis&dash=92).
However, there are measurement
concerns for some of indicators
included in this measure (eclampsia,
disseminated intravascular coagulation,
and blood transfusions) and additional
validation and refinement may be
warranted.
In collaboration with federal partners
from the Department of Health and
Human Services, AHRQ is exploring
potential refinements to this measure of
severe maternal morbidity for use at an
PO 00000
Frm 00027
Fmt 4703
Sfmt 4703
6525
area level (e.g., county, state) using
administrative data. AHRQ aims to
assess the validity and reliability of
potential refinements to this severe
maternal morbidity measure. In
addition, AHRQ is considering
incorporating a measure of severe
maternal morbidity into its measure
portfolio, including the production of
technical specifications and the
dissemination of software to calculate
this measure through the AHRQ QI
program.
Many users of quality measures, such
as state and local governments, largely
rely on administrative data that lack the
robust clinical information found in
electronic health records (EHRs). For
example, Centers for Medicaid and
Medicare Services (CMS) has developed
Electronic Clinical Quality Measures
(ECQMs) for severe obstetric
complications which relies upon EHR
data. AHRQ aims to provide
measurement resources that are broadly
accessible across organizations,
including for those lacking access to
extensive clinical data.
To support measurement resources
that are broadly accessible across
organizations, AHRQ requests public
comment on the usability, feasibility,
and likely uptake of an inpatient severe
maternal morbidity measure, produced
through the QI program using
administrative data, with the intent of
promoting maternal health service
improvements at an area level (e.g.,
county, state). AHRQ invites
stakeholders representing consumers,
state/regional/local health departments,
accountable care organizations,
community health centers, birthing
centers, providers/health systems,
critical access/rural hospitals,
professional associations, payers, rural
and community health groups,
community health workers, doulas,
maternal health advocacy groups,
researchers, and other members of the
public to comment.
Specific questions of interest include,
but are not limited to:
1. If you are currently measuring
severe maternal morbidity in your
organization, what measure(s) are you or
your organization using? How do you
use these measures? What data sources
are you using? Please specify
organization type in your answer.
2. If you or your organization are not
currently measuring severe maternal
morbidity, what quantitative data would
you need to make maternal health
service improvements? Please specify
organization type in your answer.
3. At what level—state, county, or
some other level—would information be
E:\FR\FM\01FEN1.SGM
01FEN1
6526
Federal Register / Vol. 89, No. 22 / Thursday, February 1, 2024 / Notices
ddrumheller on DSK120RN23PROD with NOTICES1
most helpful for improving maternal
health services? In what ways?
4. The measure currently used by
AHRQ for severe maternal morbidity
uses 21 indicators (https://www.cdc.gov/
reproductivehealth/
maternalinfanthealth/smm/severemorbidity-ICD.htm) identified with
ICD–10CM10CM/PCS codes in
administrative data. Considering these
indicators,
a. What codes might be missing? Are
there changes you would you
recommend?
b. In what ways would the changes
that you propose make a severe
maternal morbidity measure more
useful to your organization?
c. Would a measure with the
refinements you propose be useful for
surveillance? Population health
management? Clinical quality
improvement? Program evaluation?
Research? Public reporting or
accountability programs? In what ways?
5. What other measures of maternal
health and/or morbidity would your
organization find useful/effective for
improving maternal health services,
including any potential measures for
use in either the prenatal or postpartum
time periods?
AHRQ is interested in all of the
questions listed above, but respondents
are welcome to address as many or as
few as they choose and to address
additional areas of interest not listed. It
is helpful to identify the question to
which a particular answer corresponds.
This RFI is for planning purposes
only and should not be construed as a
policy, solicitation for applications, or
as an obligation on the part of the
Government to provide support for any
ideas in response to it. AHRQ will use
the information submitted in response
toto this RFI at its discretion and will
not provide comments to any
respondent’s submission. However,
responses to this RFI may be reflected
in future solicitation(s) or policies. The
information provided will be analyzed
and may appear in reports.
Dated: January 29, 2024.
Marquita Cullom,
Associate Director.
[FR Doc. 2024–02021 Filed 1–31–24; 8:45 am]
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17:12 Jan 31, 2024
Jkt 262001
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
Reorganization of the National Center
for Environmental Health
Centers for Disease Control and
Prevention (CDC), the Department of
Health and Human Services (HHS).
ACTION: Notice.
AGENCY:
CDC has modified its
structure. This notice announces the
reorganization of the National Center for
Environmental Health (NCEH). NCEH
retitled three branches and established
the Environmental Public Health
Tracking Branch.
DATES: This reorganization was
approved by the Director of CDC on
January 26, 2024 and became effective
January 26, 2024.
FOR FURTHER INFORMATION CONTACT:
D’Artonya Graham, Office of Strategic
Business Initiatives, Office of the Chief
Operating Officer, Office of the Director,
Centers for Disease Control and
Prevention, 1600 Clifton Road NE, MS
TW–2, Atlanta, GA 30329; Telephone
770–488–4401; Email: reorgs@cdc.gov.
SUPPLEMENTARY INFORMATION: Part C
(Centers for Disease Control and
Prevention) of the Statement of
Organization, Functions, and
Delegations of Authority of the
Department of Health and Human
Services (45 FR 67772–76, dated
October 14, 1980, and corrected at 45 FR
69296, October 20, 1980, as amended
most recently at 88 FR 69188–69190,
dated October 5, 2023) is amended to
reflect the reorganization of the National
Center for Environmental Health,
Centers for Disease Control and
Prevention. Specifically, the changes are
as follows:
I. Under Part C, Section C–B,
Organization and Functions, make the
following changes:
• Update the functional statements and
retitle all references to the Asthma
and Community Health Branch
(CNCC) to the Asthma and Air Quality
Branch (CNCC)
• Update the functional statements and
retitle all references to the Lead
Poisoning Prevention and
Environmental Health Tracking
Branch (CNCD) to the Lead Poisoning
Prevention and Surveillance Branch
(CNCD)
• Update the functional statements and
retitle the Emergency Management,
Radiation, and Chemical Branch
(CNCE) to the Emerging
SUMMARY:
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Frm 00028
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Environmental Hazards and Health
Effects Branch (CNCE)
II. Under Part C, Section C–B,
Organization and Functions, after the
Emerging Environmental Hazards and
Health Effects Branch insert the
following organizational unit:
• Environmental Public Health
Tracking Branch (CNCG)
III. Under Part C, Section C–B,
Organization and Functions, insert the
following:
Asthma and Air Quality Branch
(CNCC) (1) develops, implements, and
evaluates asthma programs and
strategies that are part of the National
Asthma Control Program to reduce
asthma morbidity and mortality; (2)
conducts epidemiologic research and
investigations of asthma morbidity and
mortality; (3) develops program,
conducts epidemiologic analysis and
supports other activities to address
social determinants of health related to
asthma disparities; (4) supports
surveillance activities for asthma, and
other respiratory diseases, as
appropriate, to quantify burden and
guide programs; (5) identifies the
evidence for, promotes, and tracks
interventions that reduce the burden of
asthma, focusing on populations with a
disproportionate burden of the disease;
(6) develops and disseminates training,
tools, communication products, and
other resources to strengthen and
sustain asthma control activities and
technical capacity among national, state,
tribal, local, territorial and other
program partners; (7) provides technical
consultation to state, local, private,
international, and other federal agencies
on asthma control, surveillance,
epidemiology, and evaluation
(including economic evaluation; (8)
disseminates and promotes information
from surveillance and health studies
related to asthma control; (9) conducts
epidemiologic research and
investigations of the potential health
effects of ambient air pollutants,
including wildfire smoke; (10) designs
and evaluates behavioral,
communication, policy, technological,
and community design interventions to
reduce exposures to air pollution and
improve health; (11) supports activities
to reduce indoor air pollution; (12)
develops and coordinates training and
decision support tools to strengthen and
sustain air pollution activities and
technical capacity among national, state,
tribal, local, and territorial program
partners; (13) provides technical
consultation to federal, state, tribal,
local, territorial, private, and
international agencies on environmental
issues related to air pollutants; (14)
E:\FR\FM\01FEN1.SGM
01FEN1
]]>Agencies
[Federal Register Volume 89, Number 22 (Thursday, February 1, 2024)]
[Notices]
[Pages 6525-6526]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-02021]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality
Inpatient Severe Maternal Morbidity Measure Technical
Specifications
AGENCY: Agency for Healthcare Research and Quality, U.S. Department of
Health and Human Services.
ACTION: Notice of Request for Information.
-----------------------------------------------------------------------
SUMMARY: The Agency for Healthcare Research and Quality (AHRQ) Center
for Quality Improvement and Patient Safety (CQuIPS) Division of Quality
Measurement and Improvement (QMI) invites public comment in response to
this Request for Information (RFI). The AHRQ Quality Indicators (QI)
program maintains inpatient quality indicators (https://qualityindicators.ahrq.gov/measures/IQI_TechSpecTechSpec) and patient
safety indicators (https://qualityindicators.ahrq.gov/measures/PSI_TechSpec), several of which are relevant to maternal health care.
Specifically, the QI program maintains measures of obstetric trauma,
birth trauma, and cesarean delivery calculated at the hospital level
using administrative data. However, severe maternal morbidity during an
inpatient stay may result from a host of complications, such as sepsis,
cardiac failure, stroke, respiratory distress, and renal failure. While
state-level rates of severe maternal morbidity are available from AHRQ
(https://datatools.ahrq.gov/hcup-fast-stats/?tab=special-emphasis&dash=92), experts have noted some shortcomings of this
measure. This RFI seeks comments on the usability, feasibility, and
likely uptake of a measure of severe maternal morbidity to be
validated, refined, and maintained by the QI program, with the goal of
providing data for maternal health service improvements. While a
measure of severe maternal morbidity is currently available from AHRQ
and the Health Resources and Service Administration (HRSA), several
experts have suggested that this algorithm could benefit from
refinements.
DATES: Comments on this notice must be received at the address provided
below within 30 days of publication of this notice, no later than March
4, 2024.
ADDRESSES: Interested parties may submit comments electronically to
[email protected]. When submitting comments or requesting
information, please include the document identifier number and project
title ``Inpatient Severe Maternal Morbidity Measure Technical
Specifications'' for reference.
FOR FURTHER INFORMATION CONTACT: Questions may be addressed to Judy
George, Program Lead for the AHRQ Quality Indicators,
[email protected].
SUPPLEMENTARY INFORMATION: Maternal health, including maternal
behavioral health, is a national priority in the United States.
Strengthening data collection and evaluation is part of the first goal
of the White House Blueprint for Addressing the Maternal Health Crisis
(https://www.whitehouse.gov/wp-content/uploads/2022/06/Maternal-Health-Blueprint.pdf), which is to increase access to and coverage of
comprehensive high-quality maternal health services, including
behavioral health services. Unexpected complications and outcomes
around labor and delivery may lead to short- or long-term consequences
to women's health (https://pubmed.ncbi.nlm.nih.gov/27560600/), which
have been defined as severe maternal morbidity (https://www.cdc.gov/reproductivehealth/maternalinfanthealth/severematernalmorbidity.htmlhtml). National and state rates of severe
maternal morbidity are currently available on AHRQ's Healthcare Cost
and Utilization Project (HCUP) Fast Stats dashboard (https://datatools.ahrq.gov/hcup-fast-stats/?tab=special-emphasis&dash=92).
However, there are measurement concerns for some of indicators included
in this measure (eclampsia, disseminated intravascular coagulation, and
blood transfusions) and additional validation and refinement may be
warranted.
In collaboration with federal partners from the Department of
Health and Human Services, AHRQ is exploring potential refinements to
this measure of severe maternal morbidity for use at an area level
(e.g., county, state) using administrative data. AHRQ aims to assess
the validity and reliability of potential refinements to this severe
maternal morbidity measure. In addition, AHRQ is considering
incorporating a measure of severe maternal morbidity into its measure
portfolio, including the production of technical specifications and the
dissemination of software to calculate this measure through the AHRQ QI
program.
Many users of quality measures, such as state and local
governments, largely rely on administrative data that lack the robust
clinical information found in electronic health records (EHRs). For
example, Centers for Medicaid and Medicare Services (CMS) has developed
Electronic Clinical Quality Measures (ECQMs) for severe obstetric
complications which relies upon EHR data. AHRQ aims to provide
measurement resources that are broadly accessible across organizations,
including for those lacking access to extensive clinical data.
To support measurement resources that are broadly accessible across
organizations, AHRQ requests public comment on the usability,
feasibility, and likely uptake of an inpatient severe maternal
morbidity measure, produced through the QI program using administrative
data, with the intent of promoting maternal health service improvements
at an area level (e.g., county, state). AHRQ invites stakeholders
representing consumers, state/regional/local health departments,
accountable care organizations, community health centers, birthing
centers, providers/health systems, critical access/rural hospitals,
professional associations, payers, rural and community health groups,
community health workers, doulas, maternal health advocacy groups,
researchers, and other members of the public to comment.
Specific questions of interest include, but are not limited to:
1. If you are currently measuring severe maternal morbidity in your
organization, what measure(s) are you or your organization using? How
do you use these measures? What data sources are you using? Please
specify organization type in your answer.
2. If you or your organization are not currently measuring severe
maternal morbidity, what quantitative data would you need to make
maternal health service improvements? Please specify organization type
in your answer.
3. At what level--state, county, or some other level--would
information be
[[Page 6526]]
most helpful for improving maternal health services? In what ways?
4. The measure currently used by AHRQ for severe maternal morbidity
uses 21 indicators (https://www.cdc.gov/reproductivehealth/maternalinfanthealth/smm/severe-morbidity-ICD.htm) identified with ICD-
10CM10CM/PCS codes in administrative data. Considering these
indicators,
a. What codes might be missing? Are there changes you would you
recommend?
b. In what ways would the changes that you propose make a severe
maternal morbidity measure more useful to your organization?
c. Would a measure with the refinements you propose be useful for
surveillance? Population health management? Clinical quality
improvement? Program evaluation? Research? Public reporting or
accountability programs? In what ways?
5. What other measures of maternal health and/or morbidity would
your organization find useful/effective for improving maternal health
services, including any potential measures for use in either the
prenatal or postpartum time periods?
AHRQ is interested in all of the questions listed above, but
respondents are welcome to address as many or as few as they choose and
to address additional areas of interest not listed. It is helpful to
identify the question to which a particular answer corresponds.
This RFI is for planning purposes only and should not be construed
as a policy, solicitation for applications, or as an obligation on the
part of the Government to provide support for any ideas in response to
it. AHRQ will use the information submitted in response toto this RFI
at its discretion and will not provide comments to any respondent's
submission. However, responses to this RFI may be reflected in future
solicitation(s) or policies. The information provided will be analyzed
and may appear in reports.
Dated: January 29, 2024.
Marquita Cullom,
Associate Director.
[FR Doc. 2024-02021 Filed 1-31-24; 8:45 am]
BILLING CODE P
