[Federal Register Volume 87, Number 189 (Friday, September 30, 2022)]
[Notices]
[Pages 59427-59429]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-21218]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[30Day-22-0234]


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 March 18, 
2022, to obtain comments from the public and affected agencies. One 
non-substantive public comment was received 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) 639-7570. 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. 07/31/2024)--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. 0920-0278), the National Hospital Care Survey (OMB Control No. 
0920-0212), and the National Post-acute and Long-term Care Study (OMB 
Control No. 0920-0943).
    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 collect, analyze, and disseminate timely, relevant, and accurate 
health data and statistics. 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

[[Page 59428]]

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), the increasing role of advanced practice providers 
delivering clinical care, and growth in the number of alternative sites 
of care. Ambulatory services are rendered in a wide variety of 
settings, including physician/provider 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) play an 
important role in the health care community by providing care to people 
who might not be able to afford it otherwise. HCs are local, non-
profit, community-owned health care settings, which serve approximately 
29 million individuals throughout the United States. NAMCS collects and 
provides data on HCs via the NAMCS HC Component. In addition to the HC 
component NAMCS includes a Provider Interview Component and a Provider 
Electronic Component. The Provider Interview Component samples 
ambulatory care providers to collect information on their 
characteristics and the characteristics of their practice. The Provider 
Electronic Component gathers information on a sample of electronic data 
providers including characteristics of the provider, as well as a full 
year of electronic patient visit data. Lastly, the HC Component samples 
HCs and collects characteristics of the center as well as a full year 
of electronic patient visit data.
    This revision seeks approval to continue previously approved survey 
activities for the completion of the 2022 HC Component's data and to 
conduct the full 2023, 2024, and 2025 data years. CDC plans to 
implement changes to all three components of NAMCS. HC Component and 
Provider Interview Component sample sizes will be adjusted. In 2022, 
the goal is to target 100 HCs overall, while the Provider Interview 
Component is paused for redesign. In 2023, the goal for NAMCS is to 
sample 5,000 physicians, 5,000 advanced practice providers, and up to 
150 HCs overall. In 2024, we plan to sample up to 10,000 physicians, 
20,000 advanced practice providers, and up to 200 HCs overall (if funds 
allow). Lastly, in 2025 CDC will sample up to 20,000 physicians, 40,000 
advanced practice providers, and up to 250 HCs overall.
    For 2023-2025, there will be an additional 3,000 physicians sampled 
yearly for the Provider Electronic Component. The Provider Electronic 
Component is modifying its Provider Facility Interview questionnaire 
and there are plans to implement a set-up fee in the future. Also, for 
the Provider Electronic Component we plan to conduct research on 
supplementing electronic visit data with electronic data obtained from 
third-party sources. Questions on the Health Center Facility Interview 
questionnaire will be modified, and a Set-up Fee Questionnaire will be 
implemented. In 2023, the Physician Induction Interview will shift to a 
redesigned Ambulatory Care Provider Interview. Also beginning in 2023, 
a Tracing Questionnaire will be utilized for the Provider Interview 
Component, to increase response rates. Visit data collection via 
abstraction will be placed on hold to evaluate improved methods for 
collection of these data, and the reinterview study will be 
discontinued. The provider incentive experiment will also no longer be 
taking place, as we will begin to conduct other methodological work to 
improve upon the survey.
    CDC requests OMB approval for an estimated 37,744 burden hours. 
There are no costs to respondents other than their time to participate.

                                        Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                                     Number of    Average burden
          Type of respondents                   Form name            Number of     responses per   per response
                                                                    respondents     respondent       (in hrs.)
----------------------------------------------------------------------------------------------------------------
HC Staff..............................  HC Facility Interview                 73               1           45/60
                                         questionnaire (Survey
                                         year: 2022).
                                        Prepare and transmit EHR              33               4           60/60
                                         for Visit Data
                                         (quarterly) (Survey
                                         year: 2022).
                                        Set-up Fee Questionnaire              33               1           15/60
                                         (Survey year: 2022).
Physician or Staff....................  ACPI (Survey year: 2023-          11,667               1           30/60
                                         2025).
                                        Contact Tracing (Survey           11,667               1           10/60
                                         year: 2023-2025).
Advanced Practice Provider or Staff...  ACPI (Survey year: 2023-          21,667               1           30/60
                                         2025).                           21,667               1           10/60
                                        Contact Tracing (Survey
                                         year: 2023-2025).
Ambulatory Care Provider or Group or    PFI Survey year: 2023-             3,000               1           45/60
 Conglomerate Staff.                     2025).                            3,000               4           60/60
                                        Prepare and transmit
                                         Electronic Visit Data
                                         (quarterly) (Survey
                                         year: 2023-2025).
HC Staff..............................  HC Facility Interview                300               1           45/60
                                         questionnaire (Survey
                                         year: 2023-2025).
                                        Prepare and transmit EHR             200               4           60/60
                                         for Visit Data
                                         (quarterly) (Survey
                                         year: 2023-2025).
                                        Set-up Fee Questionnaire             200               1           15/60
                                         (Survey year: 2023-
                                         2025).
----------------------------------------------------------------------------------------------------------------



[[Page 59429]]

Jeffrey M. Zirger,
Lead, Information Collection Review Office, Office of Scientific 
Integrity, Office of Science, Centers for Disease Control and 
Prevention.
[FR Doc. 2022-21218 Filed 9-29-22; 8:45 am]
BILLING CODE 4163-18-P