[Federal Register Volume 71, Number 185 (Monday, September 25, 2006)]
[Notices]
[Pages 55796-55797]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 06-8183]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Agency for Healthcare Research and Quality


Request for Measures of Consumers' Home Health Care Experiences

AGENCY: Agency for Healthcare Research and Quality (AHRQ), DHHS.

ACTION: Notice of request for measures.

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SUMMARY: The Agency for Healthcare Research and Quality (AHRQ) is 
soliciting the submission of instruments or items that measure 
perceptions of patients and their informal caregivers regarding the 
quality of home health care these patients received from home health 
providers, health plans, other health care providers, stakeholders, 
vendors, researchers who include home health care as part of their 
research, and other interested parties. This initiative is in response 
to the need to develop a new CAHPs[reg] home health care survey. The 
Centers for Medicare & Medicaid Services is interested in incorporating 
this survey as part of its Home Health Quality Initiative which is 
intended to empower consumers with quality of care information to make 
more informed decisions about their health care while also encouraging 
Medicare certified home health agencies to improve the quality of care 
they deliver to all patients regardless of payer source. The survey is 
likely to assess the quality of care and services provided by nurses, 
therapists, home heath aides, medical social workers, and home health 
agency administrative staff.
    Based on the agency's prior consumer assessment of health care 
work, there are several functional areas that this instrument could 
assess such as: Communication; courtesy and respect; information 
provided and shared decision making; coordination/integration of care; 
time related issues (e.g., arrived and departed according to schedule, 
amount of time spent, visit frequency); competence: influence/control 
over care giver activities; unmet need issues, and customer service.

DATES: Please submit instruments and supporting information on or 
before October 25, 2006. AHRQ will not respond individually to 
submitters, but will consider all submitted instruments and publicly 
report the results of the review of the submissions in aggregate.

ADDRESSES: Submissions should include a brief cover letter, a copy of 
the instrument or items for consideration and supporting information as 
specified under the Submission Criteria below. Submissions may be in 
the form of a letter or e-mail, preferably with an electronic file as 
an E-mail attachment. Responses to this request should be submitted to: 
Charles Darby, Center for Quality Improvement and Patient Safety, 
Agency for Healthcare Research and Quality, 540 Gaither Road, 
Rockville, MD 20850, Phone: (301) 427-1324, Fax: (301) 427-1341, E-
mail: [email protected].
    To facilitate handling of submissions, please include full 
information about the instrument developer and/or a designated contact: 
(a) Name, (b) title, (c) organization, (d) mailing address, (e) 
telephone number, (f) fax number, and (g) e-mail address. Also, please 
submit a copy of the instrument or items for consideration, and 
evidence that meets the criteria below. It is requested that citation 
of a peer-reviewed journal article pertaining to the instrument to 
include the title of the article, author(s), publication year, journal 
name, volume, issue, and page numbers where article appears, be 
included, but is not required. Submitters must also provide a statement 
of willingness to grant to AHRQ the right to use and authorize others 
to use submitted measures and their documentation as part of a 
CAHPS[reg]-trademarked instrument. This final CAHPS[reg] instrument for 
collecting patient perspectives on the quality of home health care and 
services will be made publicly available, free of charge. Electronic 
submissions are encouraged.

FOR FURTHER INFORMATION CONTACT: Charles Darby, at the address above.

Submission Criteria

    Instruments submitted should focus on home health care or closely 
related care areas (e.g., home care; personal assistant services/
community based care) and address areas of interest such as: 
communication, information provided and shared decision making, 
courtesy and respect, coordination/integration, time related issues 
(e.g., arrival an departed according to schedule, amount of time spent: 
visit frequency competence) influence/control over care giver 
activities, unmet need issues, and customer service.
    Measures submitted must meet these criteria to be considered: 
capture the patients' experience of home health care workers and agency 
administrative and demonstrate a high degree of reliability and 
validity. Submitters' willingness to grant to AHRQ the right to use and 
authorize others to the instrument or item means that the CAHPS[reg] 
trademark will be applied to a new instrument combining the best 
features of all the submissions as well as any ideas that may develop 
from reviewing them. This will ensure free access to the

[[Page 55797]]

instrument, and free access to the instrument's supportive/
administrative information. AHRQ, in collaboration with CAHPS grantees, 
and in consultation with CMS, will evaluate all submitted instruments 
or items. As the CAHPS instrument is constructed, one or more 
instruments may be selected, either in whole or in part, or items may 
be modified prior to testing them.
    Submitters will relinquish ownership of any items that appear in 
the final instrument. However, item ownership will be protected during 
testing of the survey.
    The final instruments(s) will bear the CAHPS[supreg] trademark and 
they will be made freely available for use by all interested parties. 
As a matter of quality control, there will be warnings that the 
CAHPS[supreg] identification may not be used if any changes are made to 
the instrument or the final measure set or the methodology or 
instructions, without review and permission of the agency.
    Each submission should include the following information: the name 
of the instrument, domains included, language(s) the instrument is 
available in, evidence of cultural/cross group comparability, if any, 
instrument reliability (internal consistency, test-retest, etc.), 
validity (content, construct, criterion-related), response rates, 
methods and results of cognitive testing and field-testing and 
description of sampling strategies (including payer type) and data 
collection protocols, including such elements as mode of 
administration, use of advance letters, timing and frequencies of 
contacts. In addition, a list of where the instrument has been fielded 
should also be included in the submission. Submission of copies of 
existing report formats developed to disclose findings to consumers and 
providers is desirable, but not required. Additionally, information 
about existing database(s) for collecting results gathered using the 
instrument(s) or items submitted is helpful, but not required for 
submission. Evidence of the criteria should be demonstrated through 
submission of peer-reviewed journal article(s) or through the best 
evidence available at the time of submission.

SUPPLEMENTARY INFORMATION:

Background

    The CAHPS program was initiated in 1995 to develop a survey and 
report on consumers' perspectives on the quality of their health plans. 
Since that time the CAHPS program, in partnership with CMS and others, 
has expanded its scope and developed surveys and reports regarding 
patient assessments of care received from individual clinicians, group 
practices, in-center hemodialysis services, nursing homes and 
hospitals. Now, CMS has asked the CAHPS team to develop a survey to 
obtain the consumer's perspective on home health care and services.
    One of the top priorities of the Centers for Medicare & Medicaid 
Services is to increase the transparency in healthcare by providing 
quality and cost information to the public. One of the critical 
components missing from the current measurement set for home health 
agencies is information from the consumer perspective on the quality of 
care provided. The proposed instrument described above will address 
this need for useful patient assessments.

    Dated: September 19, 2006.
Carolyn M. Clancy,
Director.
[FR Doc. 06-8183 Filed 9-22-06; 8:45 am]
BILLING CODE 4160-90-M