[Federal Register Volume 75, Number 250 (Thursday, December 30, 2010)]
[Notices]
[Pages 82400-82402]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-32963]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
Development of Health Risk Assessment Guidance; Public Forum
AGENCY: Centers for Disease Control and Prevention (CDC), Department of
Health and Human Services (HHS).
ACTION: Notice of Public Meeting.
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SUMMARY: On November 16, 2010, the Centers for Disease Control and
Prevention (CDC), located within the Department of Health and Human
Services (HHS), published a notice in the Federal Register (75 FR
70009) requesting public comment to assist development of guidance for
Health Risk Assessments (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
[[Page 82401]]
conducted in other patient populations, including those persons covered
by employer healthcare plans. In the November 16, 2010 notice, CDC also
announced that it would hold a public forum in early February 2011 to
obtain additional public comment. Today's notice announces the public
forum.
DATES: The public forum will be held on:
Tuesday, February 1, 2011, from 9 a.m. to 5 p.m. EST and Wednesday,
February 2, 2011, from 9 a.m. to 5 p.m. EST.
ADDRESSES: The Public Forum will be held at the Centers for Disease
Control and Prevention, Roybal Campus, Tom Harkin Global Communications
Center, Building 19, Auditorium A, 1600 Clifton Road, NE., Atlanta,
Georgia 30333.
Upon entering the campus visitors must stop at the CDC Visitor's
Center parking guard station. Visitors will be asked for identification
and the purpose of the visit. Please be aware that your vehicle is
subject to search before being allowed to enter the facility. A
government-issued photo ID is required for entry for all adults over
the age of 16. Acceptable forms of identification include a valid
driver's license, a passport or a state-issued photo identification
card. Parking spaces for visitors are available in the parking lot
adjacent to the CDC Visitor's Center (Building 19). Once inside the CDC
Visitor's Center, visitors will be asked to show their picture ID again
and a visitor's badge will be issued. Those who have registered in
advance will have a visitor's badge waiting and entry will be
expedited. Non-U.S. citizens (including permanent residents) must
register in advance. Please note, this is a working Federal Facility.
Please follow the guards' directions. Backpacks, suitcases or large
containers are prohibited and photography is restricted.
Please visit our Web site for additional information on security
and for directions to the facility (http://www.cdc.gov/museum/security.htm).
CDC will make every effort to accommodate persons with physical
disabilities or special needs. If you require special accommodations
due to a disability, please contact Paula Staley at (404) 639-0210 at
least 7 days in advance of the meeting.
Registration: Participants are encouraged to pre-register for the
Public Forum. On-line registration and a draft agenda is available at:
http://www.cdc.gov/policy. As space is limited, registration by January
7, 2011 is strongly encouraged.
FOR FURTHER INFORMATION CONTACT: Paula Staley, Office of Prevention
through Healthcare, Office of the Associate Director for Policy,
Centers for Disease Control and Prevention, 1600 Clifton Road, NE.,
Atlanta, Georgia 30333; phone: (404) 639-0210.
SUPPLEMENTARY INFORMATION: Section 4103 of the Affordable Care Act
(ACA) requires that a Health Risk Assessment (HRA) 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) 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. Currently there is considerable variation in available HRAs,
with the majority 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.
Agenda: The meeting will open with presentations related to
background information on the elderly population, HRAs and the HRA
guidance development. The meeting will consist of panel presentations
for each of the areas of emphasis which are listed in this notice as
well as in the November 16, 2010 Federal Register notice. Participants
attending the public forum will be invited to provide comment at the
end of each half day of the meeting. The final agenda and panelists'
presentations will be made available to the public no later than two
business days before the meeting. If CDC is unable to post the
presentations on its Web site prior to the meeting, the material will
be made publicly available at the location of the meeting. The final
agenda and panelists' presentations will be available at http://www.cdc.gov/policy. The agenda is subject to change without notice.
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?
Should the HRA instrument support shared decision-making
by provider and patient? If so, how?
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?
Is 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?
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 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 standards and how should they be made available to support
primary care office selection of an HRA instrument?
[[Page 82402]]
Evaluation and Quality Assurance
How should the HRA standards be evaluated and updated with
respect to individual and population-level (practice-based panel
management) health outcomes?
Procedure: Interested persons may present data, information, or
views orally or in writing, on topics listed in this Federal Register
notice. Written submissions for the public comment period may be made
to the contact person on or before January 18, 2011. Oral presentations
from the public will be scheduled during 30-minute public comment
periods at the end of each half day of proceedings, i.e., from 11:30
a.m. to 12 noon and 4:30 p.m. to 5 p.m. on Tuesday, February 1, 2011
and Wednesday, February 2, 2011. Those individuals interested in making
formal oral comments should notify the contact person and submit a
brief statement of the general nature of the comments they wish to
present and the names and addresses of proposed participants on or
before January 11, 2011. Each commenter will be limited to 3-5 minutes.
The CDC is not responsible for providing access to electrical outlets.
Individuals who have not submitted comments ahead of time will have
the opportunity to sign up to comment during registration on the day of
the forum. However, if time does not allow for all interested parties
to comment, individuals who have submitted their comments ahead of time
will be given preference. If the number of participants requesting to
comment is greater than can be reasonably accommodated, the CDC may
conduct a lottery to determine the speakers for the scheduled open
public comment sessions. The contact person will notify interested
persons regarding their request to comment by January 18, 2011.
Public forum participants not receiving an opportunity to comment
during the open public comment period may submit their comments to OPTH
mailbox at: http://www.cdc.gov/policy. 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.
Dated: December 21, 2010.
Tanja Popovic,
Deputy Associate Director for Science, Centers for Disease Control and
Prevention.
[FR Doc. 2010-32963 Filed 12-29-10; 8:45 am]
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