[Federal Register Volume 71, Number 94 (Tuesday, May 16, 2006)]
[Notices]
[Pages 28345-28346]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 06-4574]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality
AHRQ Quality indicators Workgroup on Risk Adjustment Approaches
to Administrative Data
AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS.
ACTION: Notice of request for nominations.
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SUMMARY: The Agency for Healthcare Research and Quality (AHRQ) is
seeking nominations for members of an AHRQ-convened Workgroup on risk
adjustment specifically aimed at the AHRQ Quality Indicators (QIS).
This Workgroup is being formed as part of a structured approach for
evaluating risk-adjustment and the appropriateness of hierarchical
modeling methodology for the AHRQ Quality Indicators at the area and/or
provider levels. The Workgroup will evaluate appropriate technical and
methodological approaches currently available, and will also discuss
and suggest strategies as to what risk adjustment approach(s), if any,
would best fit AHRQ QI user needs. As part of this effort and using the
AHRQ QIs, the Workgroup member will be addressing several key issues
for the development of a risk adjustment methodology, including but not
limited to:
Statistical and methodological issues related to the
development and validation of risk adjusted models that predict patient
outcomes using administrative data, and are suitable for assessing
quality at different levels (individual hospital, State, region).
Methods for comparing the performance of hierarchical
methods with previously employed methods based on administrative data
to improve predictive and discriminant ability, and overall fit.
Appropriate use of sub-sampling techniques for model
validation.
Computation of confidence intervals for assessing
provider-specific and State-level performance in comparison to national
summary statistics (means or percentiles).
For additional information about the AHRQ QIs, please visit the
AHRQ Web site at http://www.qualityindicators.ahrq.gov.
Specifically, the AHRQ QIs Risk Adjustment Workgroup will consist
of up to 9 individuals who are familiar with different risk adjustment
methodologies including hierarchical modeling approaches. The Workgroup
will have a series of conference calls to discuss the technical and
policy issues surrounding risk adjustment for the AHRQ QIs and will
then assist AHRQ in developing a report that will aim to summarize the
discussions and suggestions of the workgroup, which will be made
available for public comment.
DATES: Please submit nominations on or before June 15, 2006. Self-
nominations are welcome. Third-party nominations must indicate that the
individual has been contacted and is willing to serve on the workgroup.
Notification of selected candidates will be contacted by AHRQ no later
than June 29, 2006.
ADDRESSES: Nominations can be sent in the form of a letter or e-mail,
preferably as an electronic file with an e-mail attachment and should
specifically address the submission criteria as noted below. electronic
submissions are strongly encouraged. Responses should be submitted to:
ATTN: Project Officer, AHRQ Quality Indicators Project, Agency for
Healthcare Research and Quality, Center for Delivery, Organization and
Markets, 540 Gaither Road, Room 5121, Rockville, MD 20850, E-mail:
projectofficer@qualityindicators. ahrq.gov.
Submission Criteria
To be considered for membership on the AHRQ QI Workgroup, please
send the following information for each nominee:
1. A brief nomination letter highlighting experience/knowledge
relevant in the development and use of risk adjustment methodology
including hierarchical modeling approaches and familiarity with the
AHRQ QIs and health care administrative data. (See selection criteria
below.) Please include full contact information of nominee: name,
title, organization, mailing address, telephone and fax numbers, and e-
mail address.
2. Curriculum vita (with citations to any pertinent publications).
Nominee Selection Criteria
Nominees should have technical expertise in health care quality
measurement development, and a familiarity with statistical methods in
the area of risk adjustment as well as hierarchical modeling,.
More specifically, each candidate will be evaluated using the
following criteria:
Knowledge of recent risk-adjustment and hierarchical
modeling approaches published in the literature;
Peer-reviewed publications relevant to the development and
use of risk-adjustment, hierarchical modeling; performance measures and
reporting;
Expertise in statistical methods relevant to the
evaluation of alternative approaches to risk-adjustment and
hierarchical modeling;
Experience with development of measures based on
administrative data and its uses;
Expertise in hospital quality improvement and patient
safety;
Familiarity with the AHRQ Quality Indicators and their
application; and,
Availability to participate in conference calls and
provide written comments starting from late June through September
2006.
Time Commitment
In an effort to provide for expert input and for recommendations on
how to improve on the existing risk adjustment approach to
administrative data, we are initiating a review process that will
require participation in approximately
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four to five conference calls with some pre and post evaluation time
(approximately 13 hours). Results from this process will influence the
development of risk-adjustment and hierarchical modeling approaches for
the AHRQ Quality Indicators. Beginning in late June through September,
selected nominees will be asked to participate in the following
activities:
Workgroup Activities
1. Provide evaluative comments on current methodology for risk-
adjustment and hierarchical modeling (2.0 hours) and participate in
subsequent Workgroup call (1.0 hour);
2. Participate in second Workgroup conference call to discuss
suggested changes to the current modeling methodology, including the
adoption of hierarchical methods (1.5 hour);
3. Provide evaluative comments on AHRQ's new draft or revised
methodology (1.5 hour);
4. Participate in third Workgroup call to respond to each others'
comments and questions or provide additional clarifications regarding
draft methodology (1.5 hours);
5. Review draft summary document (1.5 hour);
6. Participate in fourth Workgroup call. Provide suggestions for
summary document for public comment (2.0 hours); and,
7. Participate in final Workgroup call. Discuss and respond to
public comments (2.0 hours).
Please note that should additional conference calls be necessary,
Workgroup members are expected to make every effort to participate. The
Workgroup will conduct business by telephone, e-mail, or other
electronic means as needed.
FOR FURTHER INFORMATION CONTACT: Mamatha Pancholi, Center for Delivery,
Organization, and Markets, Agency for Healthcare Research and Quality,
540 Gaither Road, Rockville, MD 20850; Phone: (301) 427-1470; Fax:
(301) 427-1430; E-mail: [email protected]
Marybeth Farquhar, Center for Delivery, Organization, and Markets,
Agency for Healthcare Research and Quality, 540 Gaither Road,
Rockville, MD 20850; Phone: (301) 427-1317; Fax: (301) 427-1430; E-
mail: [email protected].
SUPPLEMENTARY INFORMATION:
Background
The AHRQ Quality Indicators (AHRQ QIs) are a unique set of measures
of health care quality that make use of readily available hospital
inpatient administrative data. The QIs have been used for various
purposes. Some of these include tracking, hospital self-assessment,
reporting of hospital-specific quality or pay for performance. The AHRQ
QIs are provider- and area-level quality indicators and currently
consist of four modules: the Prevention Quality Indicators (PQI), the
Inpatient Quality Indicators, the Patient Safety Indicators (PSI), and
the Pediatric Quality Indicators (PedQIs). In response to feedback from
the AHRQ QI user community, AHRQ is committed to developing risk
adjustment approaches in an effort to provide an overall view of
quality that is complete, useful and easily understandable to consumers
and others with the health care field.
Dated: May 8, 2006.
Carolyn M. Clancy,
Director.
[FR Doc. 06-4574 Filed 5-15-06; 8:45am]
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