[Federal Register Volume 86, Number 102 (Friday, May 28, 2021)]
[Notices]
[Pages 28837-28838]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-11318]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[30-Day-21-0234]


Agency Forms Undergoing Paperwork Reduction Act Review

    In accordance with the Paperwork Reduction Act of 1995, the Centers 
for Disease Control and Prevention (CDC) has submitted the information 
collection request titled The National Ambulatory Medical Care Survey 
(NAMCS) to the Office of Management and Budget (OMB) for review and 
approval. CDC previously published a ``Proposed Data Collection 
Submitted for Public Comment and Recommendations'' notice on January 
28, 2021 to obtain comments from the public and affected agencies. CDC 
received no comments related to the previous notice. This notice serves 
to allow an additional 30 days for public and affected agency comments.
    CDC will accept all comments for this proposed information 
collection project. The Office of Management and Budget is particularly 
interested in comments that:
    (a) Evaluate whether the proposed collection of information is 
necessary for the proper performance of the functions of the agency, 
including whether the information will have practical utility;
    (b) Evaluate the accuracy of the agencies estimate of the burden of 
the proposed collection of information, including the validity of the 
methodology and assumptions used;
    (c) Enhance the quality, utility, and clarity of the information to 
be collected;
    (d) Minimize the burden of the collection of information on those 
who are to respond, including, through the use of appropriate 
automated, electronic, mechanical, or other technological collection 
techniques or other forms of information technology, e.g., permitting 
electronic submission of responses; and
    (e) Assess information collection costs.
    To request additional information on the proposed project or to 
obtain a copy of the information collection plan and instruments, call 
(404) 639-7118. Comments and recommendations for the proposed 
information collection should be sent within 30 days of publication of 
this notice to www.reginfo.gov/public/do/PRAMain. Find this particular 
information collection by selecting ``Currently under 30-day Review--
Open for Public Comments'' or by using the search function. Direct 
written comments and/or suggestions regarding the items contained in 
this notice to the Attention: CDC Desk Officer, Office of Management 
and Budget, 725 17th Street NW, Washington, DC 20503 or by fax to (202) 
395-5806. Provide written comments within 30 days of notice 
publication.

Proposed Project

    National Ambulatory Medical Care Survey (NAMCS) (OMB Control No. 
0920-0234, Exp. 05/31/2022)--Revision--National Center for Health 
Statistics (NCHS), Centers for Disease Control and Prevention (CDC).

Background and Brief Description

    The National Ambulatory Medical Care Survey (NAMCS) was conducted 
intermittently from 1973 through 1985, and annually since 1989. The 
survey is conducted under authority of Section 306 of the Public Health 
Service Act (42 U.S.C. 242k). NAMCS is part of the ambulatory care 
component of the National Health Care Surveys (NHCS), a family of 
provider-based surveys that capture health care utilization from a 
variety of settings, including hospital inpatient and long-term care 
facilities. NCHS surveys of health care providers include NAMCS, the 
National Hospital Ambulatory Medical Care Survey (NHAMCS) (OMB Control 
No. 0920-

[[Page 28838]]

0278, Exp. 09/30/2023), the National Hospital Care Survey (OMB Control 
No. 0920-0212, Exp. 03/31/2022), and National Post-acute and Long-term 
Care Study (OMB Control No. 0920-0943, Exp. 09/30/2023).
    An overarching purpose of NAMCS is to meet the needs and demands 
for statistical information about the provision of ambulatory medical 
care services in the United States; this fulfills one of NCHS missions, 
to monitor the nation's health. In addition, NAMCS provides ambulatory 
medical care data to study: (1) The performance of the U.S. health care 
system, (2) care for the rapidly aging population, (3) changes in 
services such as health insurance coverage change, (4) the introduction 
of new medical technologies, and (5) the use of electronic health 
records (EHRs). Ongoing societal changes have led to considerable 
diversification in the organization, financing, and technological 
delivery of ambulatory medical care. This diversification is evidenced 
by the proliferation of insurance and benefit alternatives for 
individuals, the development of new forms of physician group practices 
and practice arrangements (such as office-based practices owned by 
hospitals), and growth in the number of alternative sites of care.
    Ambulatory services are rendered in a wide variety of settings, 
including physician offices and hospital outpatient and emergency 
departments. Since more than 65% of ambulatory medical care visits 
occur in physician offices, NAMCS provides data on the majority of 
ambulatory medical care services. In addition to health care provided 
in physician offices and outpatient and emergency departments, health 
centers (HCs, formerly referred to as community health centers) play an 
important role in the health care community by providing care to 
medically underserved populations. HCs serve approximately 29 million 
individuals throughout the United States.
    This revision seeks approval to adjust the HC sample size. In 2021, 
the sample size will be reduced to 50 HCs, and in 2022 allocated funds 
will cover a sample size of 110 HCs. In 2023 the sample size will 
increase to 115 HCs. Additionally, in the 2021 survey year we will not 
include the supplemental sample of physicians from which visit data are 
collected through submission of EHRs, with the approved 2019 sample 
size. These physicians will be included in subsequent survey years when 
deemed necessary. The annualized 2021-2023 NAMCS sample size is 
projected to be 5,000 office-based physicians and 92 HCs. Questions on 
the traditional office-base physician survey will be modified for 
clarification and to keep current with medical practice and 
terminology. We are also seeking to include the potential for 
experiments involving physician incentives for some office-based 
physicians. Beginning in the 2021 survey year, data collection for HCs 
will transition from manual abstraction to be transmitted through EHRs. 
A set-up fee will be allotted to sampled HCs to offset the cost of this 
new data collection method. With this transition, a new HC facility 
interview will be implemented. The reinterview survey will also be 
discontinued for HC respondents. Personally identifiable information 
(PII) will be collected from both the HCs, and physicians who transmit 
EHR visit data. For both the traditional office-based physicians and 
HCs, we will continue COVID-19 questions in 2021 and for subsequent 
data years where information is pertinent. We will also begin to 
conduct methodological work to improve upon the survey.
    CDC requests approval for an estimated 6,819 annual burden hours. 
There is no cost to respondents other than their time to participate.

                                        Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                                                      Average
                                                                     Number of       Number of      burden per
          Type of respondents                   Form name           respondents    responses per   response  (in
                                                                                    respondent         hrs.)
----------------------------------------------------------------------------------------------------------------
Office-based Physicians or Staff        Physician Induction                  500               1           30/60
 (Abstraction).                          Interview (2020).
HC Executive/Medical Directors........  HC Facility Induction                 17               1           30/60
                                         Interview (2020).
HC Providers..........................  Provider Induction                    52               1           30/60
                                         Interview (2020).
HC Provider Staff.....................  Pulling, re-filing                    52              30            1/60
                                         medical record forms
                                         (FR abstracts) (2020).
Office-based Physicians (Abstraction)   Reinterview Study (2020)              33               1           15/60
 and HC Providers.
Office-based Physicians or Staff        Physician Induction                3,000               1           30/60
 (Abstraction).                          Interview (2021-2023).
                                        Pulling, re-filing                 2,000              30            1/60
                                         medical record forms
                                         (FR abstracts) (2021-
                                         2023).
Office-based Physician Staff (EHR       PFI (2021-2023).........           2,000               1           45/60
 Submission).
                                        Pulling, re-filing                 2,000               1           60/60
                                         medical record forms
                                         (EHR Onboarding) (2021-
                                         2023).
HC Staff..............................  HC Facility Interview                 92               1           45/60
                                         (2021-2023).
                                        Prepare and transmit EHR              92               4           60/60
                                         for Visit Data
                                         (quarterly) (2021-2023).
Office-based Physicians (Abstraction).  Reinterview Study (2021-             250               1           15/60
                                         2023).
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Jeffrey M. Zirger,
Lead, Information Collection Review Office, Office of Scientific 
Integrity, Office of Science, Centers for Disease Control and 
Prevention.
[FR Doc. 2021-11318 Filed 5-27-21; 8:45 am]
BILLING CODE 4163-18-P