[Federal Register Volume 77, Number 21 (Wednesday, February 1, 2012)]
[Notices]
[Pages 5021-5023]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-2129]
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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.
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SUMMARY: This notice announces the intention of the Agency for
Healthcare Research and Quality (AHRQ) to request that the Office of
Management and Budget (OMB) approve the proposed information collection
project: ``Consumer Assessment of Healthcare Providers and Systems
(CAHPS) Clinician and Group Survey Comparative Database.'' In
accordance with the Paperwork Reduction Act, 44 U.S.C. 3501-3521, AHRQ
invites the public to comment on this proposed information collection.
This proposed information collection was previously published in
the Federal Register on November 28th, 2011 and allowed 60 days for
public comment. No substantive comments were received. The purpose of
this notice is to allow an additional 30 days for public comment.
DATES: Comments on this notice must be received by March 2, 2012.
ADDRESSES: Written comments should be submitted to: AHRQ's OMB Desk
Officer by fax at (202) 395-6974 (attention: AHRQ's desk officer) or by
email at [email protected] (attention: AHRQ's desk officer).
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
[email protected].
SUPPLEMENTARY INFORMATION:
Proposed Project
Consumer Assessment of Healthcare Providers and Systems (CAHPS)
Clinician and Group Survey Comparative Database
The Agency for Healthcare Research and Quality (AHRQ) requests that
the Office of Management and Budget (OMB) approve, under the Paperwork
Reduction Act of 1995, AHRQ's collection of information for the AHRQ
Consumer Assessment of Healthcare Providers and Systems (CAHPS)
Database for Clinicians and Groups. The CAHPS Clinician and Group
Database (CAHPS CG Database) consists of data from the AHRQ CAHPS
Clinician and Group Survey (CAHPS CG Survey). Health systems
administrators, medical groups and medical practitioners in the U.S.
are asked to voluntarily submit data from the CAHPS CG Survey to AHRQ
through its contractor.
Dating back to the first phase of the CAHPS program (1996-2000),
the CAHPS Consortium recognized the need for a standardized, evidence-
based instrument that would gather data on patients' experiences with
physicians and staff in outpatient medical practices, enabling
clinicians and administrators to assess and improve patients'
experiences with medical care. In 1999, the Consortium began work on a
survey that would assess patients' experiences with medical groups and
clinicians. Working in collaboration with the Pacific Business Group on
Health, whose Consumer Assessment Survey established a precedent for
this type of instrument; the CAHPS Consortium developed a preliminary
instrument known as the CAHPS Group Practices Survey (G-CAHPS).
In August 2004, AHRQ issued a notice in the Federal Register
inviting organizations to test this instrument. These field test
organizations were crucial partners in the evolution and development of
the instrument, and provided critical data illuminating key aspects of
survey design and administration. In July 2007 the CAHPS CG Survey was
endorsed by the National Quality Forum (NQF), an organization
established to standardize health care quality measurement and
reporting. The endorsement represents the consensus of many health care
providers, consumer groups, professional associations, purchasers,
federal agencies, and research and quality organizations. The CAHPS CG
Survey and related toolkit materials are available on the CAHPS web
site at http://www.cahps.AHRO.gov/cahpskit/CG/CGChooseQX.asp. Since its
release, the survey has been used by thousands
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of physicians and medical practices across the U.S.
The current CAHPS Consortium includes AHRQ, the Centers for
Medicare & Medicaid Services (CMS), RAND, Yale School of Public Health,
and Westat.
AHRQ has developed the database for CAHPS CG Survey data following
the CAHPS Health Plan Database as a model. The CAHPS Health Plan
Database was developed in 1998 in response to requests from health
plans, purchasers, and CMS for comparative data to support public
reporting of health plan ratings, health plan accreditation and quality
improvement (OMB Control Number 0935-0165, Expiration Date 7/31/2013).
Demand for comparative results from the CG Survey has grown as well,
and therefore AHRQ has developed a dedicated CG Database to support
benchmarking, quality improvement, and research.
The CAHPS CG Database contains data from AHRQ's standardized CAHPS
CG Survey, which provides comparative measures of quality to health
care purchasers, consumers, regulators, and policy makers. The Database
also provides data for AHRQ's annual National Healthcare Quality and
National Healthcare Disparities Reports.
Health systems, medical groups and practices that administer the
CAHPS CG Survey according to CAHPS specifications can participate in
this project. A health system is a complex of facilities,
organizations, and providers of health care in a specified geographic
area. A medical group is defined as a medical group, Accountable Care
Organization (ACO), state organization or some other grouping of
practices. A practice is an outpatient facility in a specific location
whose physicians and other providers share administrative and clinical
support staff. Each practice located in a building containing multiple
medical offices is considered a separate practice.
The goal of this project is to continue to update the CAHPS CG
Database, with the latest results of the CAHPS CG Survey. These results
consist of 37 items that measure 5 areas or composites of patients'
experiences with physicians and staff in outpatient medical practices.
This database will (1) allow participating organizations to compare
their survey results with those of other outpatient medical groups; (2)
facilitate internal assessment and learning in the quality improvement
process; and (3) provide information to help identify strengths and
areas with potential for improvement in patient care. The five
composite measures are:
Getting Timely Appointments, Care, and Information
How Well Doctors Communicate With Patients
Helpful, Courteous, and Respectful Office Staff Follow-up on Test
Results
Patients' Rating of the Doctor
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 quality, effectiveness,
efficiency, appropriateness and value of healthcare services; quality
measurement and improvement; and health surveys and database
development. 42 U.S.C. 299a(a)(1), (2), and (8).
Method of Collection
To achieve the goal of this project, the following activities and
data collections will be implemented:
(1) Registration Form--The purpose of this form is to determine the
eligibility status and initiate the registration process for
participating organizations seeking to voluntarily submit their CAHPS
CG Survey data to the CAHPS CG Comparative Database. The point of
contact (POC) at the participating organization (or parent
organization) will complete the form. The POC is either a corporate-
level health care manager or a survey vendor who contracts with a
participating organization to collect the CAHPS CG Survey data.
(2) Data Use Agreement--The purpose of this form is to obtain
authorization from participating organizations to use their voluntarily
submitted CAHPS CG Survey data for analysis and reporting according to
the terms specified in the Data Use Agreement (DUA). The POC will
complete the form.
(3) Data Submission--After the POC has completed the Registration
Form and the Data Use Agreement, they will submit their patient-level
data from the CAHPS CG Survey to the CAHPS CG Comparative Database.
Data on the organizational characteristics such as ownership, number of
patient visits per year and medical specialty, and information related
to survey administration such as mode and dates of survey
administration, sample size, and response rate, which are collected as
part of CAHPS CG Survey operations, are also submitted. Each submission
will consist of 3 data files: (1) A Group File that contains 5
information about the group ownership and size of group, (2) a Practice
File containing type of practice, the practice ownership and
affiliation (i.e., commercial, hospital or integrated delivery system,
insurance company, university or medical school, community health
center, VA or military) and number of patient visits per year, and, (3)
a Sample File that contains one record for each patient surveyed, the
date of visit, survey disposition code and information about survey
completion.
Survey data from the CAHPS CG Database is used to produce three
types of products: (1) An online reporting of results available to the
public on the CAHPS User Network web site; (2) comparative reports that
are confidential and customized for each participating organization
(e.g., health system, medical group or practice) that submits data;
and, (3) a database available to researchers for additional analyses.
Information for the CAHPS CG Database is collected by AHRQ through
its contractor Westat. Participating organizations are asked to
voluntarily submit their data to the CAHPS Database. The data is
cleaned with standardized programs, then aggregated and used to produce
comparative results. In addition, reports are produced that compare the
participating organizations' results to the database in a password-
protected section of the CAHPS Database online reporting system. Trend
data will be available to participants when enough data is collected
across consecutive years.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated annualized burden hours for
participating organizations. The burden hours and costs below are based
on an estimated number of participants. It is estimated that about 30
health systems, medical groups and practices will participate in the
CAHPS CG Database. The number of data submissions per participating
organization will vary because some participants may submit data for
multiple practices, while others may only submit data for one.
The total burden for completing the registration, DUA and data
submission process is estimated to be 246 hours. The 30 participating
organizations that complete the registration form and submit
information to the CAHPS CG Database are a combination of an estimated
20 health systems, medical groups and practices and 10 estimated
vendors. Information about survey administration and the survey data
files are submitted together for each participating organization.
[[Page 5023]]
Exhibit 1--Estimated Annualized Burden Hours
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Number of Number of
Form name respondents responses per Hours per response Total burden
POCs POC hours
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Registration Form..................... 30 1 6/60.................... 3
Data Submission....................... 30 1 7 and 6/60.............. 213
Data Use Agreement.................... 30 1 1....................... 30
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Total............................. 30 NA 8 and 12/60............. 246
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Exhibit 2 shows the estimated annualized cost burden based on the respondents' time to complete the submission
process. The cost burden is estimated to be $10,485 annually.
Exhibit 2--Estimated Annualized Cost Burden
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Number of Total burden Average hourly Total cost
Form name respondents hours wage rate* burden
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Registration Form............................... 30 3 42.62 128
Data Submission................................. 30 213 42.62 9,078
Data Use Agreement.............................. 30 30 42.62 1,279
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Total....................................... 30 246 NA 10,485
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* Mean hourly wage rate of $42.62 for Medical and Health Services Managers (SOC code 19111) was obtained from
the May 2009 National Industry-Specific Occupational Employment and Wage Estimates, NAICS 621100--Offices of
Physicians located at http://www.bls.gov/oe5/2009/may/naic54_621100.htm.
Estimated Annual Cost to the Government
Exhibit 3 shows the estimated annualized cost to the government for
developing, maintaining and managing the CAHPS CG Database, analyzing
the data and reporting results. The cost is estimated to be $220,000
annually. Annualized costs for collecting and processing the CAHPS CG
Database are based upon 10 years of historical CAHPS Health Plan
Database project costs. AHRQ wishes to continue this data collection
indefinitely and requests OMB approval for 3 years.
Exhibit 3--Estimated Annualized Cost
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Annualized
Cost component Total cost cost
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Database Maintenance.................... $120,000 $40,000
Data Submission......................... 240,000 80,000
Data Analysis and Reporting............. 300,000 100,000
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Total............................... 660,000 220,000
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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: January 20, 2012.
Carolyn M. Clancy,
Director.
[FR Doc. 2012-2129 Filed 1-31-12; 8:45 am]
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