[Federal Register Volume 72, Number 36 (Friday, February 23, 2007)]
[Notices]
[Pages 8165-8166]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-3099]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[30Day-07-0242X]


Agency Forms Undergoing Paperwork Reduction Act Review

    The Centers for Disease Control and Prevention (CDC) publishes a 
list of information collection requests under review by the Office of 
Management and Budget (OMB) in compliance with the Paperwork Reduction 
Act (44 U.S.C. Chapter 35). To request a copy of these requests, call 
the CDC Reports Clearance Officer at (404) 639-5960 or send an e-mail 
to [email protected]. Send written comments to CDC Desk Officer, Office of 
Management and Budget, Washington, DC or by fax to (202) 395-6974. 
Written comments should be received within 30 days of this notice.

Proposed Project

    Estimating the Cost of Sigmoidoscopy and Colonoscopy for Colorectal 
Cancer Screening in U.S. Healthcare Facilities (SECOST) --New--National 
Center for Chronic Disease and Public Health Promotion (NCDDPHP), 
Centers for Disease Control and Prevention (CDC).

Background and Brief Description

    Colorectal cancer (CRC) is the second leading cause of cancer-
related deaths in the United States. In 2005, it was estimated that 
approximately 56,300 Americans died from CRC and about 145,300 new 
cases were diagnosed. The risk of developing CRC increases with 
advancing age. More than 90% of newly diagnosed CRCs occur in persons 
50 years of age and older. Several scientific studies have demonstrated 
that regular screening for CRC reduces the incidence and mortality from 
this disease. Other studies have shown that regular screening for CRC 
is also cost-effective in terms of years of life saved.
    Despite strong scientific evidence and evidence-based clinical 
guidelines recommending screening, current screening rates remain low. 
A recent CDC study reported that more than 40 million Americans who are 
50 years of age or older and at average risk for CRC have not been 
screened in accordance with current guidelines. The study also reported 
that screening this population with current endoscopic (i.e., flexible 
sigmoidoscopy and colonoscopy) capacity in the health care system could 
require as much as ten years to complete. An effective national effort 
to promote CRC screening could increase the demand for endoscopic 
procedures.
    It has been reported that reimbursements for endoscopic procedures 
in publicly-funded programs may not be adequate to cover the costs of 
performing these procedures. This may be a disincentive for providers 
to perform endoscopy procedures. Currently, there is little information 
available about the resources required or the cost of providing these 
procedures in different types of healthcare facilities in the United 
States.
    The purpose of this project is to conduct a survey of a nationally 
representative sample of healthcare facilities in order to estimate the 
average variable costs of providing colonoscopy and flexible 
sigmoidoscopy for CRC screening and follow-up services. Over time, 
payments need to cover fixed costs in addition to variable costs. If 
some facilities have the ability to provide more procedures without 
additional investment in space or equipment, then recovering fixed 
costs is not necessary at least in the short run. The estimated average 
variable cost by procedure will be compared to the reimbursement rates 
for both screening procedures in order to determine whether the 
payments to facilities exceed this minimum threshold. Otherwise, 
facilities will find reimbursement a potential barrier to expansion of 
CRC screening to

[[Page 8166]]

uninsured or underinsured populations even if there is underutilized 
capacity. The study will also determine whether there are factors that 
affect average variable costs across facilities such as the number of 
procedures performed, specialization in types of procedures or other 
characteristics of the facility. Results of this study will be used to 
better understand the economics of colorectal cancer screening.
    Respondents include medical facility receptionists, hospital 
operators, and office/business managers. The total estimated cost to 
respondents is approximately $72,800 assuming an hourly wage of $37 for 
office/business managers and an hourly wage of $11 for others during 
the study period. There are no costs to the respondents other than 
their time. The total estimated annualized burden hours are 2072.
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    \1\ We expect that we will have to make 4,160 screening 
telephone calls to identify a sample of 1,250 HOPDs and 906 ASCs 
that are eligible for inclusion in the study.

                                        Estimated Annualized Burden Hours
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                                                                                         Number of     Average
                                                                            Number of    responses    burden per
            Type of respondent                        Form name            respondents      per        response
                                                                                         respondent   (in hours)
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Receptionist..............................  Telephone screening survey...    \1\ 4,160            1         5/60
OPHD nurse manager........................  SECOST mail survey...........        1,000            1            1
ASC nurse manager.........................  SECOST mail survey...........          725            1            1
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    Dated: February 16, 2007.
Joan F. Karr,
Acting Reports Clearance Officer, Centers for Disease Control and 
Prevention.
[FR Doc. E7-3099 Filed 2-22-07; 8:45 am]
BILLING CODE 4163-18-P