[Federal Register Volume 80, Number 222 (Wednesday, November 18, 2015)]
[Notices]
[Pages 72063-72066]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-29440]


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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

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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.
    This proposed information collection was previously published in 
the Federal Register on August 11, 2015 and allowed 60 days for public 
comment. AHRQ received one substantive comment from the public.
    The purpose of this notice is to allow an additional 30 days for 
public comment.

DATES: Comments on this notice must be received by December 18, 2015.

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).

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, enabling 
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. AHRQ 
works closely with a consortium of public and private research 
organizations to develop and maintain surveys and tools to advance 
patient-centered care. CAHPS[supreg] is a registered trademark of AHRQ. 
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, whose Consumer Assessment Survey established a 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
 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

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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--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 Data Use Agreement (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
----------------------------------------------------------------------------------------------------------------
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.

                                   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
----------------------------------------------------------------------------------------------------------------
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 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. 2015-29440 Filed 11-17-15; 8:45 am]
 BILLING CODE 4160-90-P