[Federal Register Volume 78, Number 157 (Wednesday, August 14, 2013)]
[Notices]
[Pages 49516-49518]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-19724]


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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: ``Evaluation of the Children's Health Insurance Program 
Reauthorization Act of 2009 (CHIPRA) Quality Demonstration Grant 
Program: Survey Data Collection.'' In accordance with the Paperwork 
Reduction Act, 44 U.S.C. 3501-3521, AHRQ invites the public to comment 
on this proposed information collection.
    This proposed information collection was previously published in 
the Federal Register on May 31st, 2013 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 September 13, 2013.

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 
email 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 email at 
[email protected].

SUPPLEMENTARY INFORMATION:

Proposed Project

Evaluation of the Children's Health Insurance Program Reauthorization 
Act of 2009 (CHIPRA) Quality Demonstration Grant Program: Survey Data 
Collection

    The Children's Health Insurance Program Reauthorization Act of 2009 
(CHIPRA), Public Law 111-3, included funding for five-year grants so 
that States could experiment with and evaluate several promising ideas 
related to improving the quality of children's health care in Medicaid 
and CHIP. In February 2010, the Centers for Medicare & Medicaid 
Services (CMS) announced the award of 10 demonstration grants to States 
that convincingly articulated an achievable vision of what they could 
accomplish by the end of the five-year grant period, described 
strategies they would use to achieve the objectives, and explained how 
the strategies would achieve the objectives. Applicants were encouraged 
by CMS to address multiple grant categories (described below) and to 
partner with other States in designing and implementing their projects.
    Of the 10 grantee States selected, six are partnering with other 
States, for a total of 18 demonstration States. The demonstration 
States are: Colorado (partnering with New Mexico); Florida (with 
Illinois); Maine (with Vermont); Maryland (with Wyoming and Georgia); 
Massachusetts; North Carolina; Oregon

[[Page 49517]]

(with Alaska and West Virginia); Pennsylvania; South Carolina; and Utah 
(with Idaho).
    These demonstration States are implementing 51 distinct projects in 
at least one of five possible grant categories, A to E. Category A 
grantees are experimenting with and/or evaluating the use of pediatric 
quality measures, including those in the initial core set of children's 
health care quality measures (a group of measures developed for state 
Medicaid and CHIP agencies to report in a standardized fashion to CMS). 
Category B grantees are promoting health information technologies for 
improved care delivery and patient outcomes. Category C grantees are 
implementing person-centered medical homes or other provider-based 
levels of service delivery. Category D grantees will evaluate the 
impact of a model pediatric electronic health record. Category E 
grantees are testing other State-designed approaches to quality 
improvement in Medicaid and CHIP.
    AHRQ's goal in supporting an evaluation of the CHIPRA Quality 
Demonstration Grant Program is to provide insight into how best to 
implement quality improvement programs as well as information on how 
successful programs can be replicated to improve children's health care 
quality in Medicaid and CHIP. The specific goals of this project are as 
follows:

    1. Identify CHIPRA State activities that measurably improve the 
nation's health care, especially as it pertains to children.
    2. Develop a deep, systematic understanding of how CHIPRA 
demonstration States carried out their grant-funded projects.
    3. Understand why the CHIPRA demonstration States pursued 
certain strategies.
    4. Understand whether and how the CHIPRA demonstration States' 
efforts affected outcomes related to knowledge and behavior change 
in targeted providers and/or consumers of health care.

    This study is being conducted by AHRQ through its contractor, 
Mathematica Policy Research Inc., and their subcontractors, the Urban 
Institute and AcademyHealth, pursuant to AHRQ's statutory authority to 
conduct and support research on health care and on systems for the 
delivery of such care, including activities with respect to the 
quality, effectiveness, efficiency, appropriateness and value of 
healthcare services and with respect to quality measurement and 
improvement. 42 U.S.C. 299a(a)(1) and (2).

Method of Collection

    To meet these goals AHRQ has designed a comprehensive evaluation 
that will make the best use of qualitative and quantitative research 
methods. The evaluation will include a survey of pediatricians and 
family physicians. This survey will include a random sample of 
physicians in Massachusetts, North Carolina, Ohio, and Pennsylvania. 
The questionnaire includes questions that support an analysis of (1) 
Physician attitudes towards specific strategies and resources aimed at 
improving the quality of care provided to pediatric patients; (2) the 
extent to which physicians' practices have attempted to implement 
changes in order to improve the quality of care provided to pediatric 
patients; (3) physician attitudes towards the utility of receiving 
performance feedback on nine of measures in the core quality measure 
set that are most relevant to primary care; (4) perceived usefulness of 
quality-of-care reports received by physician practices; (5) current 
practices and attitudes towards pay-for-performance financial incentive 
systems based on quality measure outcomes; (6) physicians' uses of and 
attitudes towards electronic health records (EHR) in quality 
measurement and improvement; (7) current and expected medical home 
accreditation processes; and (8) physician and practice demographic 
information. These data will be analyzed in conjunction with CMS claims 
data to gain insight on physician perspectives on quality measures and 
quality reporting and foster understanding of the strategies and 
resources that seemed to contribute most (or least) to those outcomes.
    A separate information collection request will be submitted for 
interviews and focus groups that are part of this evaluation. 
Administrative and survey data will be analyzed with descriptive and 
inferential techniques appropriate to answering questions about 
outcomes and impacts.

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated annualized burden hours for the 
respondents' time to participate in this evaluation. The survey will be 
completed by 1,200 pediatricians and family physicians working in 
primary care settings in four States (300 per State) and takes 15 
minutes to complete. The total burden is estimated to be 300 hours.

                                  Exhibit 1--Estimated Annualized Burden Hours
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                                                                     Number of
                    Form name                        Number of     responses per     Hours per     Total burden
                                                    respondents     respondent       response          hours
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Pediatrician and Family Physician Survey........           1,200               1           15/60             300
                                                 ---------------------------------------------------------------
    Total.......................................           1,200             n/a             n/a             300
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    Exhibit 2 shows the estimated annualized cost burden associated 
with the respondents' time to participate in this evaluation. The total 
cost burden is estimated to be $25,578.

                                   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
----------------------------------------------------------------------------------------------------------------
Pediatrician and Family Physician Survey........           1,200             300          $85.26         $25,578
                                                 ---------------------------------------------------------------

[[Page 49518]]

 
    Total.......................................           1,200             300             n/a          25,578
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* Based upon the higher of the two means of the hourly wages for general and family practitioners and general
  pediatricians, National Compensation Survey: ``May 2011 National Occupational Employment and Wage Estimates,
  United States.'' U.S. Department of Labor, Bureau of Labor Statistics.

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 2, 2013.
Carolyn M. Clancy,
AHRQ Director.
[FR Doc. 2013-19724 Filed 8-13-13; 8:45 am]
BILLING CODE 4160-90-P