[Federal Register Volume 89, Number 77 (Friday, April 19, 2024)]
[Notices]
[Pages 28784-28787]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-08431]


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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 a revision of the currently 
approved information collection project: ``Medical Expenditures Panel 
Survey--Household and Medical Provider Components.'' In accordance with 
the Paperwork Reduction Act of 1995, AHRQ invites the public to comment 
on this proposed information collection.

DATES: Comments on this notice must be received by June 18, 2024.

ADDRESSES: Written comments should be submitted to: Doris Lefkowitz, 
Reports Clearance Officer, AHRQ, by email at 
[email protected].

FOR FURTHER INFORMATION CONTACT: Doris Lefkowitz, AHRQ Reports 
Clearance Officer, (301) 427-1477, or by email at 
[email protected].

SUPPLEMENTARY INFORMATION:

Proposed Project

Medical Expenditures Panel Survey--Household and Medical Provider 
Components

    AHRQ requests that OMB approve a revision to AHRQ's collection of 
information for the Medical Expenditures Panel Survey--Household and 
Medical Provider Components: OMB Control number 0935-0118, expiration 
November 30, 2025. Requested changes are for the Household Component 
(MEPS-HC) only.
    The MEPS was initiated in 1996. Each year a new panel of sample 
households is selected. Recent annual MEPS-HC sample sizes average 
about 13,500 households. Data can be analyzed at either the person, 
family, or event level. The panel design of the survey, which includes 
5 rounds of interviews covering 2 full calendar years, provides data 
for examining person level changes in selected variables such as 
expenditures, health insurance coverage, and health status.

This Research Has the Following Goals

    (1) To produce nationally representative estimates of health care 
use, expenditures, sources of payment, and health insurance coverage 
for the U.S. civilian noninstitutionalized population.
    (2) To produce nationally representative estimates of respondents' 
health status, demographic and socio-economic characteristics, 
employment, access to care, and satisfaction with health care.

Proposed Changes for the 2025 MEPS-HC

     Core MEPS Interview and Adult SAQ--The Core interview and 
the Adult Self-Administered Questionnaire (SAQ) include four questions 
from the Consumer Assessment of Healthcare Providers and Systems 5.0 
(CAHPS 5.0). These questions will have wording changes to update them 
to CAHPS 5.1. These wording changes will help identify telehealth 
utilization and access, as well as maintain consistency between CAHPS 
and MEPS-HC questionnaire items. Below are the four

[[Page 28785]]

questions, both the current version and the proposed version:
    Current: In the last 12 months, did {you/{PERSON{time} {time}  have 
an illness, injury or condition that needed care right away in a 
clinic, emergency room, or doctor's office?
    Proposed: In the last 12 months, did {you/{PERSON{time} {time}  
have an illness, injury, or condition that needed care right away?
    Current: In the last 12 months, did you make any appointments for a 
check-up or routine care for {yourself/{PERSON{time} {time}  at a 
doctor's office or clinic?
    Proposed: In the last 12 months, did you make any in-person, phone, 
or video appointments for a check-up or routine care for {yourself/
{PERSON{time} {time} ?
    Current: Looking at card CS-2, in the last 12 months, how often did 
you get an appointment for a check-up or routine care for {yourself/
{PERSON{time} {time}  at a doctor's office or clinic as soon as {you/
he/she{time}  needed?
    Proposed: Looking at card CS-2, in the last 12 months, how often 
did you get an appointment for a check-up or routine care for 
{yourself/{PERSON{time} {time}  as soon as {you/he/she{time}  needed?
    Current: Looking at card CS-3, in the last 12 months, not counting 
times {you/{PERSON{time} {time}  went to an emergency room, how many 
times did {you/he/she{time}  go to a doctor's office or clinic to get 
health care?
    Proposed: Looking at card CS-3, in the last 12 months, not counting 
the times {you/{PERSON{time} {time}  went to an emergency room, how 
many times did {you/he/she{time}  get health care in person, by phone, 
or by video?
     Burdens and Economic Impacts of Medical Care Self-
Administered Questionnaire (ESAQ)--The Office of the Secretary--Patient 
Centered Outcomes Research Trust Fund is funding this SAQ to expand the 
collection of economic outcomes data for patient-centered outcomes 
research (PCOR) via the Medical Expenditure Panel Survey (MEPS).
    The ESAQ will be completed during Round 3, Panel 30 and Round 5, 
Panel 29 (Spring 2025) by adult household members (aged 18 and over). 
The ESAQ will be administered in a mixed-mode of paper and online. 
Respondents will be offered a $20.00 monetary incentive to complete the 
ESAQ. This is a one-time data collection and the ESAQ will be removed 
from the MEPS after the 2025 fielding. The goal of the ESAQ is to 
enhance the MEPS data by adding new domains related to the economic 
burdens of seeking and receiving health care, to study economic 
outcomes in patient-centered outcomes research.
    There is no other survey that is now or has been recently conducted 
that will meet the objectives of the ESAQ. The ESAQ will supplement 
MEPS data on direct care expenditures with data on major indirect 
costs, including time costs of getting care and administrative hassles; 
lost work productivity due to presenteeism, lost productivity in non-
market activities, and time costs of informal care. With this new data, 
researchers will be able to better examine health care economic burdens 
and equity in health care access, utilization, and outcomes, for 
example to aggregate social costs of health care and poor health, 
examine indirect costs associated with common conditions, and analyze 
disparities and equity in indirect costs.
    In developing the ESAQ, AHRQ consulted with several experts in the 
area and used their expertise to identify priority topics and questions 
that have already been tested and widely accepted. Nearly all items are 
either from Federal surveys, federally funded surveys, or adapted from 
instruments that have been carefully validated. Two questions related 
to affordability and access are from Kaiser Family Foundation surveys. 
One question about informal care was cognitively tested in a prior 
question development project. One question on the high-priority topic 
of administrative hassles of health insurance was developed from 
phrases from the carefully tested and widely accepted Consumer 
Assessment of Health Plans and Systems.
     Cancer Self-Administered Questionnaire (CSAQ)--The CSAQ 
will be removed from the 2025 MEPS-HC.
    This study is being conducted by AHRQ through its contractor, 
Westat, pursuant to AHRQ's statutory authority to conduct and support 
research on healthcare and on systems for the delivery of such care, 
including activities with respect to the cost and use of health care 
services and with respect to health statistics and surveys. 42 U.S.C. 
299a(a)(3) and (8); 42 U.S.C. 299b-2.

Method of Collection

    The MEPS-HC uses a combination of computer assisted personal 
interviewing (CAPI), computer assisted video interviewing (CAVI), and 
self-administered paper and web questionnaires, to collect information 
about each household member, and the survey builds on this information 
from interview to interview. CAVI is a new data collection technology 
and offers the best of both telephone and in-person interviewing, while 
offering opportunities for cost savings and more accurate reporting.

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated annualized burden hours for the 
respondents' time to participate in the MEPS-HC and the MEPS-MPC.

MEPS-HC

     MEPS-HC Core Interview--completed by 12,218 ``family 
level'' respondents. Since the MEPS-HC typically consists of 5 rounds 
of interviewing covering a full two years of data, the annual average 
number of responses per respondent is 2.5 responses per year. The MEPS-
HC core requires an average response time of 88 minutes to administer.
     Adult SAQ--completed once during the 2-year panel, in 
rounds 2 and 4 during odd numbered years, making the annualized average 
0.5 times per year. The Adult SAQ will be completed by 11,912 adults 
and requires an average of 7 minutes to complete.
     Preventive Care SAQ (PSAQ)--completed once during the 2-
year panel, in rounds 2 and 4 during even numbered years, making the 
annualized average 0.5 times per year. The PSAQ will be completed by 
11,912 adults and requires an average of 7 minutes to complete.
     Diabetes Care Survey (DCS)--completed by 1,195 persons 
each year and requires 3 minutes to complete.
     Burdens and Economic Impacts of Medical Care SAQ--
completed by 15,577 and is estimated to take 10 minutes to complete. 
This SAQ will be completed only once in 2025 and will be removed in 
2026; to annualize the burden hours the number of responses per 
respondent is 0.5 times per year.
     Authorization forms for the MEPS-MPC and Pharmacy Survey--
completed by 6,769 respondents. Each respondent will complete an 
average of 5.7 forms each year, with each form requiring an average of 
3 minutes to complete.
     Validation interview--conducted with approximately 1,759 
respondents each year and requires 5 minutes to complete. The total 
annual burden hours for the respondent's time to participate in the 
MEPS-HC is estimated to be 49,149 hours.

MEPS-MPC

     Contact Guide/Screening Call--conducted with 38,683 
providers and pharmacies each year and requires 5 minutes to complete.
     Home Care Providers Event Form--completed by 540 
providers, with each provider completing an average of 5

[[Page 28786]]

forms and each form requiring 3 minutes to complete.
     Office-based Providers Event Form--completed by 9,300 
providers. Each provider will complete an average of 2.8 forms and each 
form requires 3 minutes to complete.
     Separately Billing Doctors Event Form--will be completed 
by 4,676 providers, with each provider completing 1.2 forms on average, 
and each form requiring 3 minutes to complete.
     Hospital Event Form--completed by 3,935 hospitals or HMOs. 
Each hospital or HMO will complete 5.9 forms on average, with each form 
requiring 3 minutes to complete.
     Institutions (non-hospital) Event Form--completed by 86 
institutions, with each institution completing 1.3 forms on average, 
and each form requiring 3 minutes to complete.
     Pharmacy Event Form--completed by 6,112 pharmacies. Each 
pharmacy will complete 31.3 forms on average, with each form requiring 
3 minutes to complete.
    The total burden hours for the respondent's time to participate in 
the MEPS-MPC is estimated to be 15,674 hours. The total annual burden 
hours for the MEPS-HC and MPC is estimated to be 64,832 hours.

           Exhibit 1--MEPS-HC and MPC Estimated Annualized Respondents and Burden Hours, 2025 to 2027
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                                                                               Number of                  Total
                          Form name                             Number of    responses per    Hours per   burden
                                                               respondents     respondent     response    hours
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                                                     MEPS-HC
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MEPS-HC Core Interview......................................        12,218              2.5       88/60   44,799
Adult SAQ *.................................................        11,912              0.5        7/60      695
Preventive Care SAQ (PSAQ) **...............................        11,912              0.5        7/60      695
Diabetes Care Survey (DCS)..................................         1,195                1        3/60       60
Burdens and Economic Impacts of Medical Care SAQ............        15,577              0.5       10/60    1,298
Authorization forms for the MEPS-MPC Provider and Pharmacy           6,769              5.7        3/60    1,455
 Survey.....................................................
MEPS Validation Interview...................................         1,759                1        5/60      147
Subtotal for the MEPS-HC....................................        61,342  ...............  ..........   49,149
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                                                    MEPS-MPC
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Contact Guide/Screening Call................................        38,683                1        5/60    3,224
Home Care Providers Event Form..............................           540              5.0        3/60      135
Office-based Providers Event Form...........................         9,300              2.8        3/60    1,302
Separately Billing Doctors Event Form.......................         4,676              1.2        3/60      281
Hospitals & HMOs (Hospital Event Form)......................         3,935              5.9        3/60    1,161
Institutions (non-hospital) Event Form......................            86              1.3        3/60        6
Pharmacies Event Form.......................................         6,112             31.3        3/60    9,565
Subtotal for the MEPS-MPC...................................        63,332  ...............  ..........   15,674
                                                             ---------------------------------------------------
    Grand Total.............................................       124,674  ...............  ..........   64,832
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* The Adult SAQ is completed once every two years, on the odd numbered years.
** The PSAQ is completed once every two years, on the even numbered years.

    Exhibit 2 shows the estimated annual cost burden associated with 
the respondents' time to participate in this information collection. 
The annual cost burden for the MEPS-HC is estimated to be $1,462,674 
and the annual cost burden for the MEPS-MPC is estimated to be 
$306,285. The total annual cost burden for the MEPS-HC and MPC is 
estimated to be $1,768,959.

               Exhibit 2--Estimated Annualized Cost Burden
------------------------------------------------------------------------
                                  Total
           Form name              burden    Average hourly    Total cost
                                  hours        wage rate        burden
------------------------------------------------------------------------
                                 MEPS-HC
------------------------------------------------------------------------
MEPS-HC Core Interview........     44,799          * $29.76   $1,333,218
Adult SAQ.....................        695           * 29.76       20,683
Preventive Care SAQ (PSAQ)....        695           * 29.76       20,683
Diabetes Care Survey (DCS)....         60           * 29.76        1,786
Burdens and Economic Impacts        1,298           * 29.76       38,628
 of Medical Care SAQ..........
Authorization forms for the         1,455           * 29.76       43,301
 MEPS-MPC Provider and
 Pharmacy Survey..............
MEPS Validation Interview.....        147           * 29.76        4,375
Subtotal for the MEPS-HC......     49,149  ................    1,462,674
------------------------------------------------------------------------
                                MEPS-MPC
------------------------------------------------------------------------
MPC Contact Guide/Screening         3,224          ** 19.84       63,964
 Call.........................
Home care Providers Event Form        135          ** 19.84        2,678
Office-based Providers Event        1,302          ** 19.84       25,832
 Form.........................

[[Page 28787]]

 
Separately Billing Doctors            281          ** 19.84        5,575
 (SBD) Event Form.............
Hospitals & HMOs (Hospital          1,161          ** 19.84       23,034
 Event Form...................
Institutions (non-hospital)             6          ** 19.84          119
 Event Form...................
Pharmacies Event Form.........      9,565         *** 19.35      185,083
Subtotal for the MEPS-MPC.....     15,674  ................      306,285
------------------------------------------------------------------------
    Grand Total...............     64,832  ................    1,768,959
------------------------------------------------------------------------
* Mean hourly wage for All Occupations (00-0000)
** Mean hourly wage for Medical Secretaries (43-6013)
*** Mean hourly wage for Pharmacy Technicians (29-2052)
Occupational Employment Statistics, May 2022 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, 44 U.S.C. 3501-
3520, 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's 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: April 15, 2024.
Mamatha Pancholi,
Deputy Director.
[FR Doc. 2024-08431 Filed 4-18-24; 8:45 am]
BILLING CODE 4160-90-P