[Federal Register Volume 78, Number 222 (Monday, November 18, 2013)]
[Notices]
[Pages 69088-69090]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-27176]
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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: ``Collection of Information for Agency for Healthcare Research
and Quality's (AHRQ) Consumer Assessment of Healthcare Providers and
Systems (CAHPS) Health Plan 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 August 14th, 2013 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 December 18, 2013.
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
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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
Collection of Information for Agency for Healthcare Research and
Quality's (AHRQ) Consumer Assessment of Healthcare Providers and
Systems (CAHPS) Health Plan Survey Comparative Database
Request for information collection approval. The Agency for
Healthcare Research and Quality (AHRQ) requests that the Office of
Management and Budget (OMB) reapprove, under the Paperwork Reduction
Act of 1995, AHRQ's collection of information for the AHRQ Consumer
Assessment of Healthcare Providers and Systems (CARPS) Database for
Health Plans: OMB Control number 0935-0165, expiration July 31, 2013.
The CAHPS Health Plan Database consists of data from the AHRQ CAHPS
Health Plan Survey. Health plans in the U.S. are asked to voluntarily
submit data from the survey to AHRQ, through its contractor, Westat.
The CAHPS Database was developed by AHRQ in 1998 in response to
requests from health plans, purchasers, and the Centers for Medicare &
Medicaid Services (CMS) to provide comparative data to support public
reporting of health plan ratings, health plan accreditation and quality
improvement.
Background on the CAHPS Health Plan Survey. The CAHPS Health Plan
Survey is a tool for collecting standardized information on enrollees'
experiences with health plans and their services. The development of
the CAHPS Health Plan Survey began in 1995, when AHRQ awarded the first
set of CAHPS grants to Harvard, RTI, and RAND. In 1997 the CAHPS 1.0
survey was released by the CAHPS Consortium. The CAHPS Consortium
refers to the research organizations involved in the development,
dissemination, and support of CAHPS products. The current Consortium
includes AHRQ, CMS, RAND, Yale School of Public Health, and Westat.
Since that time, the Consortium has clarified and updated the
survey instrument to reflect field test results; feedback from industry
experts; reports from health plan participants, data collection
vendors, and other users; and evidence from cognitive testing and focus
groups. In November 2006, the CAHPS Consortium released the latest
version of the instrument: The CAHPS Health Plan Survey 4.0. The
development of this update to the Health Plan Survey has been part of
the ``Ambulatory CAHPS (A-CAHPS) Initiative,'' which arose as a result
of extensive research conducted with users. AHRQ released the CAHPS
Health Plan Survey 4.0, along with guidance on how to customize and
administer it. The National Quality Forum endorsed the 4.0 version of
the Health Plan Survey in July 2007.
Rationale for the information collection. The CAHPS Health Plan
Database uses data from AHRQ's standardized CAHPS Health plan survey to
provide comparative results to health care purchasers, consumers,
regulators and policy makers across the country. The Database also
provides data for AHRQ's annual National Healthcare Quality and
National Healthcare Disparities Reports. Voluntary participants include
public and private employers, State Medicaid agencies, State Children's
Health Insurance Programs (SCHIP), the Centers for Medicare & Medicaid
Services (CMS), and individual health plans.
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 database development. 42 U.S.C.
299a(a)(1), (2), and (a)(8).
Method of Collection
Each year State Medicaid agencies, and individual health plans
decide whether to participate in the database and prepare their
materials and dataset for submission to the CARPS Health Plan Database.
Participating organizations are typically State Medicaid agencies with
multiple health plans. However, individual health plans are also
encouraged to submit their data to the CARPS Database. The number of
data submissions per registrant varies from participant to participant
and year to year because some participants submit data for multiple
health plans, while others may only submit survey data for one plan.
Each organization that decides to participate in the database must
have their point-of-contact (POC) complete a registration form
providing their contact information for access to the on-line data
submission system, sign and submit a DUA, and provide health plan
characteristics such as health plan name, product type, type of
population surveyed, health plan state, and plan name to appear in the
reporting of their results.
Each vendor that submits files on behalf of a Medicaid agency or
individual health plan must also complete the registration form in
order to obtain access to the on-line submission system. The vendor, on
behalf of their client, may also complete additional information about
survey administration (CAHPS survey version used, mode of survey
administration, total enrollment count, description of how the sample
was selected), submit a copy of the questionnaire used, and submit one
data file per health plan. Commercial health plan data is received
directly from NCQA. Medicare health plan data is received from CMS.
Survey data from the CAHPS Health Plan Database is used to produce
four types of products: (1) An annual chartbook available to the public
on the CAHPS Database Web site (https://www.cahpsdatabase.ahrq.gov/CAHPSIDB/Public/Chartbook.aspx); (2) individual participant comparative
reports that are confidential and customized for each participating
organization (e.g., health plan, Medicaid agency) that submits their
data; (3) a research database available to researchers wanting to
conduct additional analyses; and (4) data tables provided to AHRQ for
inclusion in the National Healthcare Quality and National Healthcare
Disparities Reports.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated burden hours for the respondent to
participate in the database. The burden hours pertain only to the
collection of Medicaid data from State Medicaid agencies and individual
Medicaid health plans because those are the only entities that submit
data through the data submission process (other data are obtained
directly from NCQA and CMS as noted earlier in Section 2). The 80 POCs
in exhibit 1 are a combination of an estimated 60 State Medicaid
agencies and individual health plans, and 20 estimated vendors.
Each State Medicaid agency, health plan or vendor will register
online for submission. The online Registration form will require about
5 minutes to complete. Each submitter will also
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complete a Health Plan information form of information about each
Health Plan such as the name of the plan, the product type (e.g., HMO,
PPO), the population surveyed (e.g., adult Medicaid or child Medicaid),
the health plan State, total enrollment at the time the sample frame
was generated, mode of survey administration (mail, telephone, IVR) and
how the sample was selected. The online Health Plan Information form
takes on average 30 minutes to complete per health plan with each POC
completing the form for 4 plans on average. The data use agreement will
be completed by the 60 participating State Medicaid agencies or
individual health plans. Vendors do not sign or submit DUAs. The DUA
requires about 3 minutes to sign and return by fax or mail. Each
submitter will provide a copy of their questionnaire and the survey
data file in the required file format. Survey data files must conform
to the data file layout specifications provide by the CAHPS Database.
Since the unit of analysis is at the health plan level, submitters will
upload one data file per health plan. Once a data file is uploaded the
file will be automatically checked to ensure it conforms to the
specifications and a data file status report will be produced and made
available to the submitter. Submitters will review each report and will
be expected to fix any errors in their data file and resubmit if
necessary. It will take about one hour to submit the data for each
plan, and each POC will submit data for 4 plans on average. The total
burden is estimated to be 490 hours annually.
Exhibit 2 shows the estimated annualized cost burden based on the
respondents' time to complete one submission process. The cost burden
is estimated to be $20,202 annually.
Exhibit 1--Estimated Annualized Burden Hours
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Number of Number of
Form name respondents/ responses per Hours per Total burden
POCs POC response hours
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Registration Form............................... 80 1 5/60 7
Health Plan Information Form.................... 80 4 30/60 160
Data Use Agreement.............................. 60 1 3/60 3
Data Files Submission........................... 80 4 1 320
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Total....................................... 300 NA NA 490
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Exhibit 2--Estimated Annualized Cost Burden
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Number of
Form name respondents/ Total burden Average hourly Total cost
POCs hours wage rate* burden
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Registration Form............................... 80 7 47.34\a\ $331
Health Plan Information Form.................... 80 160 47.34\a\ 7,574
Data Use Agreement.............................. 60 3 85.02\b\ 255
Data Files Submission........................... 80 320 37.63\c\ 12,042
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Total....................................... 300 490 NA 20,202
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*National Compensation Survey: Occupational wages in the United States May 2012, ``U.S. Department of Labor,
Bureau of Labor Statistics.''
(a) Based on the mean hourly wage for Medical and Health Services Managers (11-9111).
(b) Based on the mean hourly wage for Chief Executives (11-1011).
(c) Based on the mean hourly wages for Computer Programmer (15-1131).
Request for Comments
In accordance with the Paperwork Reduction Act, comments on AHRQ's
information collection are requested with regard to any of the
following: (a) Whether the proposed collection of information is
necessary for the proper performance of AHRQ health care research and
health care information dissemination functions, including whether the
information will have practical utility; (b) the accuracy of AHRQ's
estimate of burden (including hours and costs) of the proposed
collection(s) of information; (c) ways to enhance the quality, utility,
and clarity of the information to be collected; and (d) ways to
minimize the burden of the collection of information upon the
respondents, including the use of automated collection techniques or
other forms of information technology.
Comments submitted in response to this notice will be summarized
and included in the Agency's subsequent request for OMB approval of the
proposed information collection. All comments will become a matter of
public record.
Dated: October 31, 2013.
Richard Kronick,
Director.
[FR Doc. 2013-27176 Filed 11-15-13; 8:45 am]
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