[Federal Register Volume 75, Number 220 (Tuesday, November 16, 2010)]
[Notices]
[Pages 70009-70010]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-28788]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
Development of Health Risk Assessment Guidance
AGENCY: Centers for Disease Control and Prevention (CDC), Department of
Health and Human Services (HHS).
ACTION: Request for Information.
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SUMMARY: The Centers for Disease Control and Prevention (CDC) located
within the Department of Health and Human Services (HHS) is seeking
public comment on the development of guidance concerning Health Risk
Assessment (HRAs). Section 4103 of the Affordable Care Act (ACA) (Pub.
L. 111-148) requires that a health risk assessment be included in the
annual wellness visit benefit authorized for Medicare beneficiaries
under the ACA. CDC is collaborating with the Centers for Medicare and
Medicaid Services (CMS), also located within HHS, in the development of
guidance for this type of assessment. This guidance is also intended to
be useful for HRAs conducted in other patient populations such as
privately insured populations, including those persons covered by
employer healthcare plans. Comments received from this request for
information will be used to inform the HRA guidance development
process.
DATES: Written comments must be received on or before January 3, 2011.
Comments received after January 3, 2011 will be considered to the
extent possible.
ADDRESSES: You may submit written comments to the following address:
Office of Prevention through Healthcare, Office of the Associate
Director for Policy, Centers for Disease Control and Prevention, 1600
Clifton Road, NE., Mailstop D-28, Atlanta, Georgia, 30333, ATTN: Health
Risk Assessment Guidance.
You may also submit written comments via e-mail to: [email protected].
Please use ``Health Risk Assessment Guidance'' for the subject line.
Submitted comments will be available for public review from Monday
through Friday, except for legal holidays, from 9 a.m. until 5 p.m.
Eastern Standard Time, at 1600 Clifton Road NE., Atlanta, Georgia
30333. Please call ahead to 1-404-639-0210 and ask for a representative
in the Office of Prevention through Healthcare to schedule your visit.
Comments will also be available for viewing at the following Internet
address: http://www.cdc.gov/policy/opth/.
CDC will make all comments it receives available to the public
without change, including personal information you may provide, which
includes the name of the person submitting the comment or signing the
comment on behalf of an organization, business, or any such entity. If
anyone does not wish to have this information published, then that
information should not be included when submitting the comment.
FOR FURTHER INFORMATION CONTACT: Paula Staley, Office of Prevention
through Healthcare, Associate Director for Policy, Centers for Disease
Control and Prevention, 1600 Clifton Road, NE., Mailstop D-28, Atlanta,
Georgia, 30333, telephone: (404) 639-0210.
SUPPLEMENTARY INFORMATION:
Section 4103 of the Affordable Care Act (ACA) requires that a
health risk assessment be included in the annual wellness visit benefit
authorized for Medicare beneficiaries under the ACA. CDC is
collaborating with CMS to develop guidance for this type of assessment.
This guidance is also intended to be useful for HRAs conducted in other
patient populations such as privately insured populations, including
those persons covered by employer healthcare plans.
Currently there is considerable variation in available HRAs, with
the majority of assessments created to support employer-based health
and wellness programs. Several instruments have been created for use in
research and are not available in the marketplace; and the scientific
rigor of HRA tools is not always evident. Therefore, the development of
HRA guidance is essential for effective implementation of this part of
the Medicare wellness visit and to support broader HRA use within
primary care.
Although comments on any aspect of the guidance development process
will be accepted, comments are especially solicited about these areas
of emphasis:
Content and Design
Risk assessment domains--What are generic elements of any
HRA and what elements must be tailored to specific populations,
particularly those stratified by age?
How should literacy and other cultural appropriateness
factors be factored into the design?
How should the HRA instrument support shared decision-
making by provider and patient?
Mode of Administration
How will individuals access the HRA (e.g., via kiosk or
some other means in the physician's office, Internet, mail-in paper
form, other non-traditional healthcare locations, such as, kiosk in a
pharmacy)?
What are the cultural appropriateness factors in patient
HRA access?
Primary Care Office Capacity
What primary care office capacity (personnel, Information
Technology (IT), etc) is required to utilize HRA data effectively in
support of personalized prevention planning?
Are training and technical assistance necessary for
effective practice utilization of an HRA? What entity should provide
this technical assistance?
What are potential or demonstrated community care
transition linkages--follow-up outside the office by other providers--
that help patients and providers manage priority risks identified by
the HRA?
What is the current practice of HRA in medical practices
of various sizes, particularly those with five or fewer physicians?
[[Page 70010]]
Consumer/Patient Perspective
How could HRA data be shared with the patients for their
feedback and follow up in the primary care practice?
What role, if any, do incentives play in motivating
patients to take the HRA and/or participate in follow-up interventions?
Data
With respect to Information Technology (IT), how could HRA
data entered in any form populate electronic health records, and what
special challenges and solutions occur if the data are entered in a
non-electronic form?
Are there standardized and certified tools available to
support this data migration from multiple data entry sources?
Certification
What certification tools and processes should complement
the HRA guidance and how should they be made available to support
primary care office selection of an HRA instrument?
Evaluation and Quality Assurance
How should the HRA guidance be evaluated and updated with
respect to individual and population-level (practice-based panel
management) health outcomes?
Public Forum: CDC plans to convene a public forum in early February
2011 to highlight some of the key challenges, barriers, opportunities
and innovations related to HRA standardization. The public forum will
consist of panel presentations followed by public comment. CDC will
publish a separate notice in the Federal Register announcing additional
information for the Public Forum.
Dated: November 8, 2010.
Tanja Popovic,
Deputy Associate Director for Science, Centers for Disease Control and
Prevention.
[FR Doc. 2010-28788 Filed 11-15-10; 8:45 am]
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