[Federal Register Volume 78, Number 157 (Wednesday, August 14, 2013)]
[Notices]
[Pages 49518-49520]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-19712]


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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) Health Plan Survey Comparative Database.'' In 
accordance with the Paperwork Reduction Act, 44 U.S.C. 3501-3521, AHRQ 
invites the public to comment on this proposed information collection.

DATES: Comments on this notice must be received by October 15, 2013.

ADDRESSES: Written comments should be submitted to: Doris Lefkowitz, 
Reports Clearance Officer, AHRQ, by email at 
[email protected].
    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 email 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

    Request for information collection approval. The Agency for 
Healthcare Research and Quality (AHRQ) requests that the Office of 
Management and Budget (OMB) reapprove, 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: OMB Control number 0935-0165, expiration July 31, 2013. 
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.
    Background on the CAHPS Health Plan Survey. 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.
    Rationale for the information collection. 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

[[Page 49519]]

Programs (SCHIP), the Centers for Medicare & Medicaid Services (CMS), 
and individual health plans.
    This study is being conducted by AHRQ through its contractor, 
Westat, pursuant to AHRQ's statutory authority to conduct and support 
research on healthcare and on systems for the delivery of such care, 
including activities with respect to: The quality, effectiveness, 
efficiency, appropriateness and value of healthcare services; quality 
measurement and improvement; and database development. 42 U.S.C. 
299a(a)(1), (2), and (a)(8).

Method of Collection

    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 point-of-contact (POC) complete a registration form 
providing their contact information for access to the on-line data 
submission system, sign and submit a 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.
    Survey data from the CAHPS Health Plan Database is used to produce 
four types of products: (1) An annual chartbook available to the public 
on the CAHPS Database Web site (https://www.cahpsdatabase.ahrq.gov/CAHPSIDB/Public/Chartbook.aspx); (2) individual participant comparative 
reports that are confidential and customized for each participating 
organization (e.g., health plan, Medicaid agency) that submits their 
data; (3) a research database available to researchers wanting to 
conduct additional analyses; and (4) data tables provided to AHRQ for 
inclusion in the National Healthcare Quality and National Healthcare 
Disparities Reports.

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated burden hours for the respondent to 
participate in the database. The burden hours 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). The 80 POCs 
in exhibit 1 are a combination of an estimated 60 State Medicaid 
agencies and individual health plans, and 20 estimated vendors.
    Each State Medicaid agency, health plan or vendor will register 
online for submission. The online Registration form will require about 
5 minutes to complete. Each submitter will also complete a Health Plan 
information form of information about each Health Plan such as the name 
of the plan, the product type (e.g., HMO, PPO), the population surveyed 
(e.g., adult Medicaid or child Medicaid), the health plan State, total 
enrollment at the time the sample frame was generated, mode of survey 
administration (mail, telephone, IVR) and how the sample was selected. 
The online Health Plan Information form takes on average 30 minutes to 
complete per health plan with each POC completing the form for 4 plans 
on average. The data use agreement will be completed by the 60 
participating State Medicaid agencies or individual health plans. 
Vendors do not sign or submit DUAs. The DUA requires about 3 minutes to 
sign and return by fax or mail. Each submitter will provide a copy of 
their questionnaire and the survey data file in the required file 
format. Survey data files must conform to the data file layout 
specifications provide by the CAHPS Database. Since the unit of 
analysis is at the health plan level, submitters will upload one data 
file per health plan. Once a data file is uploaded the file will be 
automatically checked to ensure it conforms to the specifications and a 
data file status report will be produced and made available to the 
submitter. Submitters will review each report and will be expected to 
fix any errors in their data file and resubmit if necessary. It will 
take about one hour to submit the data for each plan, and each POC will 
submit data for 4 plans on average. The total burden is estimated to be 
490 hours annually.
    Exhibit 2 shows the estimated annualized cost burden based on the 
respondents' time to complete one submission process. The cost burden 
is estimated to be $20,202 annually.

                                  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...............................              80               1            5/60               7
Health Plan Information Form....................              80               4           30/60             160
Data Use Agreement..............................              60               1            3/60               3
Data Files Submission...........................              80               4               1             320
                                                 ---------------------------------------------------------------
    Total.......................................             300              NA              NA             490
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[[Page 49520]]


                                   Exhibit 2--Estimated Annualized Cost Burden
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                                                     Number of                        Average
                    Form name                      respondents/    Total burden     hourly wage     Total cost
                                                       POCs            hours         rate \*\         burden
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Registration Form...............................              80               7       \a\ 47.34            $331
Health Plan Information Form....................              80             160       \a\ 47.34           7,574
Data Use Agreement..............................              60               3       \b\ 85.02             255
Data Files Submission...........................              80             320       \c\ 37.63          12,042
                                                 ---------------------------------------------------------------
    Total.......................................             300             490              NA          20,202
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\*\ National Compensation Survey: Occupational wages in the United States May 2012, ``U.S. Department of Labor,
  Bureau of Labor Statistics.''
\a\ Based on the mean hourly wage for Medical and Health Services Managers (11-9111).
\b\ Based on the mean hourly wage for Chief Executives (11-1011).
\c\ Based on the mean hourly wages for Computer Programmer (15-1131).

Request for Comments

    In accordance with the Paperwork Reduction Act, 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 health care research and 
health care 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: August 8, 2013.
Carolyn M. Clancy,
AHRQ Director.
[FR Doc. 2013-19712 Filed 8-13-13; 8:45 am]
BILLING CODE 4160-90-P