[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

[[Page 28346]]

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]
BILLING CODE 4160-90-M