[Federal Register Volume 80, Number 154 (Tuesday, August 11, 2015)]
[Notices]
[Pages 48110-48112]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-19657]


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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 changes to the 
currently approved information collection project: ``Consumer 
Assessment of Healthcare Providers and Systems (CAHPS) Clinician and 
Group 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 13, 2015.

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

Consumer Assessment of Healthcare Providers and Systems (CAHPS) 
Clinician and Group Survey Comparative Database

    The CAHPS Clinician and Group Survey (``the CAHPS CG Survey'') is a 
tool for collecting standardized information on patients' experiences 
with physicians and staff in outpatient medical practices. The results, 
enable clinicians and administrators to assess and improve patients' 
experiences with medical care. The CAHPS CG Survey is a product of the 
CAHPS[supreg] program, which is funded and administered by AHRQ, and 
CAHPS[supreg] is a registered trademark of AHRQ. AHRQ works closely 
with a consortium of public and private research organizations to 
develop and maintain surveys and tools to advance patient-centered 
care. In 1999, the CAHPS Consortium began work on a survey that would 
assess patients' experiences with medical groups and clinicians. The 
CAHPS Consortium developed a preliminary instrument known as the CAHPS 
Group Practices Survey (G-CAHPS), with input from the Pacific Business 
Group on Health, which developed a Consumer Assessment Survey that is 
the precedent for this type of instrument.
    In August 2004, AHRQ issued a notice in the Federal Register 
inviting organizations to test the CAHPS CG Survey. These field-test 
organizations were crucial partners in the evolution and development of 
the instrument, and provided critical data illuminating key aspects of 
survey design and administration. In July 2007 the CAHPS CG Survey was 
endorsed by the National Quality Forum (NQF), an organization 
established to standardize health care quality measurement and 
reporting. The endorsement represents the consensus of many health care 
providers, consumer groups, professional associations, purchasers, 
federal agencies, and research and quality organizations. The CAHPS CG 
Survey and related toolkit materials are available on the CAHPS Web 
site at https://cahps.ahrq.gov/surveys-guidance/cg/instructions/index.html. Since its release, the survey has been used by thousands of 
physicians and medical practices across the U.S.
    The current CAHPS Consortium includes AHRQ, the Centers for 
Medicare & Medicaid Services (CMS), RAND, Yale School of Public Health, 
and Westat.
    AHRQ developed the database for CAHPS CG Survey data following the 
CAHPS Health Plan Database as a model. The CAHPS Health Plan Database 
was developed in 1998 in response to requests from health plans, 
purchasers, and CMS for comparative data to support public reporting of 
health plan ratings, health plan accreditation and quality improvement 
(OMB Control Number 0935-0165, expiration 5/31/2017). Demand for 
comparative results from the CG Survey has grown as well, and therefore 
AHRQ developed a dedicated CAHPS Clinician and Group Database to 
support benchmarking, quality improvement, and research (OMB Control 
Number 0935-0197, expiration 06/30/2015).
    The CAHPS Database contains data from AHRQ's standardized CAHPS 
Surveys which provide comparative measures of quality to health care 
purchasers, consumers, regulators, and policy makers. The CAHPS 
Database also provides data for AHRQ's annual National Healthcare 
Quality and Disparities Report.
    Health systems, medical groups and practices that administer the 
CAHPS Clinician & Group Survey according to CAHPS specifications can 
participate in this project. A health system is a complex of 
facilities, organizations, and providers of health care in a specified 
geographic area. A medical group is defined as a medical group, 
Accountable Care Organization (ACO), state organization or some other 
grouping of medical practices. A practice is an outpatient facility in 
a specific location whose physicians and other providers share 
administrative and clinical support staff. Each practice located in a 
building containing multiple medical offices is considered a separate 
practice.
    The goal of this project is to renew the CAHPS CG Database. This 
database will continue to update the CAHPS CG Database with the latest 
results of the CAHPS CG Survey. These results consist of 34 items that 
measure 5 areas or composites of patients' experiences with physicians 
and staff in outpatient medical practices. This database:

    (1) Allows participating organizations to compare their survey 
results with those of other outpatient medical groups;
    (2) Provides data to medical groups and practices to facilitate 
internal assessment and learning in the quality improvement process; 
and
    (3) Provides information to help identify strengths and areas 
with potential for improvement in patient care. The five composite 
measures are:

Getting Timely Appointments, Care, and Information
How Well Providers Communicate With Patients

[[Page 48111]]

Helpful, Courteous, and Respectful Office Staff
Care Coordination
Patients' Rating of the Provider

    The collection of information for the CAHPS CG Database for 
Clinicians and Groups is being conducted pursuant to AHRQ's statutory 
authority to conduct and support research on health care and systems 
for the delivery of such care, including activities with respect to the 
quality, effectiveness, efficiency, appropriateness and value of health 
care services; quality measurement and improvement; and health surveys 
and database development 42 U.S.C. 299a(a)(1), (2) and (8).

Method of Collection

    To achieve the goal of this project, the following activities and 
data collections will be implemented:

    (1) Registration Form--The purpose of this form is to determine 
the eligibility status and initiate the registration process for 
participating organizations seeking to voluntarily submit their 
CAHPS CG Survey data to the CAHPS CG Database. The point of contact 
(POC) at the participating organization (or parent organization) 
will complete the form. The POC is either a corporate-level health 
care manager or a survey vendor who contracts with a participating 
organization to collect the CAHPS CG Survey data.
    (2) Data Use Agreement (DUA)--The purpose of this DUA is to 
obtain authorization from participating organizations to use their 
voluntarily submitted CAHPS CG Survey data for analysis and 
reporting according to the terms specified in the DUA. The POC at 
the organization will complete the form. Vendors do not sign the 
DUA.
    (3) Data Submission--The number of submissions to the database 
may vary each year because medical groups and practices may not 
administer the survey and submit data each year. Data submission is 
typically handled by one POC who either is a health system, medical 
group or practice or a survey vendor who contracts with the medical 
group or practice to collect their data. After the POC has completed 
the Registration Form and the Data Use Agreement, they will submit 
their patient-level data from the CAHPS CG Survey to the CAHPS CG 
Database. Data on the organizational characteristics such as 
ownership, number of patient visits per year, medical specialty, and 
information related to survey administration such as mode, dates of 
survey administration, sample size, and response rate, which are 
collected as part of CAHPS CG

    Survey operations are also submitted. Each submission will consist 
of 3 data files:

    (1) A Group File that contains information about the group 
ownership and size of group, (2) a Practice File containing type of 
practice, the practice ownership and affiliation (i.e., commercial, 
hospital or integrated delivery system, insurance company, 
university or medical school, community health center, VA or 
military) and number of patient visits per year, and 3) a Sample 
File that contains one record for each patient surveyed, the date of 
visit, survey disposition code and information about survey 
completion.

    Survey data from the CAHPS CG Database is used to produce four 
types of products:

    (1) An online reporting of results available to the public on 
the CAHPS Database Web site; (2) individual participant comparative 
reports that are confidential and customized for each participating 
organization that submits their data, (3) an annual Chartbook that 
presents summary-level results in a downloadable PDF file; and (4) a 
dataset available to researchers for additional analyses.

    Information for the CAHPS CG Database has been collected by AHRQ 
through its contractor Westat on an annual basis since 2010. 
Participating organizations are asked to voluntarily submit their data 
to the CAHPS CG Database each year. The data is cleaned with 
standardized programs, then aggregated and used to produce comparative 
results. In addition, reports are produced that compare the 
participating organizations' results to the database in a password-
protected section of the CAHPS CG Database online reporting system.

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated burden hours for the respondent to 
participate in the CAHPS CG Database. The 20 POCs in exhibit 1 are the 
number of estimated vendors. The 240 POCs in exhibit 1 are the number 
of estimated participating Health/Medical entities.
    Each vendor will register online for submission. The online 
Registration form will require about 5 minutes to complete. The data 
use agreement will be completed by the 240 participating Health/Medical 
entities. Vendors do not sign DUAs. The DUA requires about 3 minutes to 
sign and return by fax, mail or to upload directly in the submission 
system. 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 provided by the 
CAHPS CG Database. The number of data submissions per POC will vary 
because some may submit data for multiple practices, while others may 
submit data for only one. 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 complete each file submission. The total burden 
is estimated to be 454 hours annually.

                                  Exhibit 1--Estimated Annualized Burden Hours
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                                                     Number of       Number of
                    Form name                      respondents/   responses  for     Hours per     Total burden
                                                       POCs          each POC        response          hours
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Registration Form...............................              20               1            5/60               2
Data Use Agreement..............................             240               1            3/60              12
Data Files Submission...........................             440               1               1             440
                                                 ---------------------------------------------------------------
    Total.......................................             700              NA              NA             454
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    Exhibit 2 shows the estimated annualized cost burden based on the 
respondents' time to complete the submission process. The cost burden 
is estimated to be $18,613 annually.

[[Page 48112]]



                                   Exhibit 2--Estimated Annualized Cost Burden
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                                          Number of         Total burden     Average  hourly       Total cost
              Form name               respondents/ POCs        hours           wage  rate *          burden
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Registration Form...................                 20                  2          39.75 \a\                $80
Data Use Agreement..................                240                 12          86.88 \b\               1043
Data Files Submission...............                 20                440          39.75 \c\             17,490
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    Total...........................                280                454                 NA             18,613
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* National Compensation Survey: Occupational wages in the United States May 2014, ``U.S. Department of Labor,
  Bureau of Labor Statistics.'' (a) and (c) Based on the mean hourly wages for Computer Programmer (15-1131).
  (b) Based on the mean hourly wage for Chief Executives (11-1011). http://www.bls.gov/oes/current/oes_nat.htm#15-0000

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 
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.

Sharon B. Arnold,
Deputy Director.
[FR Doc. 2015-19657 Filed 8-10-15; 8:45 am]
 BILLING CODE 4160-90-P