[Federal Register Volume 75, Number 61 (Wednesday, March 31, 2010)]
[Notices]
[Pages 16134-16136]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-6780]
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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[supreg]) Health Plan Survey Comparative Database.'' In
accordance with the Paperwork Reduction Act, 44 U.S.C. 3501-3520, AHRQ
invites the public to comment on this proposed information collection.
This proposed information collection was previously published in
the Federal Register on January 25th, 2010 and allowed 60 days for
public comment. No 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 April 30, 2010.
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
e-mail 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 e-mail 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
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 Health Plans. 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.
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.
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), CMS, and
individual health plans.
The collection of information for the CAHPS Database for Health
Plans is being conducted pursuant to AHRQ's statutory authority to
conduct and support research on health care and systems for the
delivery of such care, including activities with respect to the
quality, effectiveness, efficiency, appropriateness and value of health
care services. See 42 U.S.C. 299a(a)(1).
Method of Collection
Information for the CAHPS Health Plan Database has been collected
by AHRQ through its contractor Westat on an annual basis since 1998.
Health plans are asked to voluntarily submit their data to the
comparative database in June of each year. The data are cleaned with
standardized programs, then aggregated and used to produce comparative
results for commercial (adult and child), Medicaid (adult and child),
and Medicare (adult) populations for the two most recent years. In
addition, individual participant reports are produced that display the
participating organizations' own results compared to appropriate
comparisons derived from the National, regional and product-type
distributions on a password-protected section of the online reporting
system.
The CAHPS Health Plan Database receives the data from three
sources. First, commercial health plan data is purchased by the CAHPS
Health Plan Database directly from the National Committee for Quality
Assurance (NCQA). The data is collected by NCQA from those who
participate in its accreditation program. Second, Medicare data is
provided by CMS through an agency data use agreement. The Medicare data
is collected by CMS
[[Page 16135]]
and their contractor from beneficiaries who were enrolled in a managed
care health plan. Third, Medicaid data is collected by the CAHPS Health
Plan Database. Medicaid agencies and their vendors directly submit
their Medicaid health plan survey data to the CAHPS Health Plan
Database through an online data submission system. Data submitted by
Medicaid plans are compiled along with the data received from CMS and
NCQA to comprise the CAHPS Health Plan Survey comparative database.
Estimated Annual Respondent Burden
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 CAHPS 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 CAHPS 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 POC complete a registration form providing their contact
information for access to the on-line data submission system, sign and
submit a data use agreement (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.
The burden hours and costs below 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). In 2009, a total of
60 participants, representing 45 individual organizations and 15
vendors, submitted data for 244 health plans (an average of about 4
health plans per participant).
Exhibits 1 and 2 are based on the estimated number of individual
participants (participating organizations and/or vendors) who will
complete the database submission steps and forms in the coming years,
and is not based on the total number of health plans that are
submitted. The number of respondents and burden hours are based on an
estimated slight increase in the number of participants to 70 in 2010
and 2011.
In Exhibit 1, the 70 participants that will complete the
registration form and submit information to the CAHPS Health Plan
Database are a combination of an estimated 50 State Medicaid agencies
and individual health plans, and 20 estimated vendors. The 50 State
Medicaid agencies or individual health plans will sign and submit a
DUA. Vendors do not sign or submit DUAs. Health plan information and
data files are submitted for each health plan. Exhibit 1 shows an
estimated total of 280 health plans (70 estimated participants with 4
health plans per participant). The total burden hours for completing
the registration, DUA and data submission process are estimated to be
722 hours.
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 and Data Submission *......... 70 1 7.6 532
Data Use Agreement **........................... 50 1 1 50
Health Plan Information ***..................... 70 4 30/60 140
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Total....................................... 190 NA NA 722
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* The online Registration Form requires about 5 minutes to complete; however over 7 hours is required to plan/
prepare for the data submission. This includes the amount of time the participating organization, and others
(CEO, lawyer, vendor) typically spend deciding whether to participate in the database and preparing their
materials and dataset for submission to the CAHPS Health Plan Database and performing the submission.
** The Data Use Agreement requires about 3 minutes to complete; however about 57 minutes is required for the
participating organization to review the agreement prior to signing. This includes the review by the
organization's CEO or legal department.
*** A few health plans may submit their data directly, however most health plan data will be submitted by the
POC.
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 $31,046 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 and Data Submission *......... 70 532 $43.00 $22,876
Data Use Agreement.............................. 50 50 43.00 2,150
Health Plan Information......................... 70 140 43.00 6,020
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[[Page 16136]]
Total....................................... 190 722 NA 31,046
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\*\ Wage rates were calculated using the mean hourly wage based on occupational employment and wage estimates
from the Dept of Labor, Bureau of Labor Statistics' May 2008 National Industry-Specific Occupational
Employment and Wage Estimates NAICS 622000--located at http://www.bls.gov/oes/current/oes_nat.htm.
\**\ Wage rate of $43.00 is based on the mean hourly wages for Medical and Health Services Managers. Wage rate
of $42.67 is the weighted mean hourly wage for: Medical and Health Services Managers ($42.67 x 2.6 hours =
$110.95), Lawyers ($59.98 x .5 hours = $29.99), Chief Executives ($89.16 x .5 hours = $44.58), and Computer
programmer ($35.32 x 4 hours = $141.28) [Weighted mean = ($110.95 + 29.99 + 44.58 = 141.28)/7.6 hours =
$326.80/7.6 hours = $43.00/hour].
Estimated Annual Costs to the Federal Government
Exhibit 3 shows the estimated annualized cost to the government for
developing, maintaining and managing the Health Plan Database and
analyzing the data and reporting results. The cost is estimated to be
$260,000 annually. Annualized costs for collecting and processing the
CAHPS Health Plan Database are based upon 10 years of historical
project costs. Start-up costs were present in the early years of the
database only.
Exhibit 3--Estimated Annualized Cost
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Annualized
Cost component cost
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Database Maintenance.................................... $50,000
Data Submission......................................... 100,000
Data Analysis and Reporting............................. 110,000
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Total............................................... 260,000
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Request for Comments
In accordance with the above-cited Paperwork Reduction Act
legislation, 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: March 19, 2010.
Carolyn M. Clancy,
Director.
[FR Doc. 2010-6780 Filed 3-30-10; 8:45 am]
BILLING CODE 4160-90-M