83 FR 50094 - Agency Information Collection Activities: Proposed Collection; Comment Request

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality

Federal Register Volume 83, Issue 193 (October 4, 2018)

Page Range		50094-50096
FR Document		2018-21618
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 information collection project ``Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician and Group Survey Database.'' This proposed information collection was previously published in the Federal Register on July 16th, 2018 and allowed 60 days for public comment. AHRQ did not receive any substantive comments. The purpose of this notice is to allow an additional 30 days for public comment.
Federal Register, Volume 83 Issue 193 (Thursday, October 4, 2018)
[Federal Register Volume 83, Number 193 (Thursday, October 4, 2018)]
[Notices]
[Pages 50094-50096]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2018-21618]


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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 information collection 
project ``Consumer Assessment of Healthcare Providers and Systems 
(CAHPS) Clinician and Group Survey Database.'' This proposed 
information collection was previously published in the Federal Register 
on July 16th, 2018 and allowed 60 days for public comment. AHRQ did not 
receive any substantive comments. The purpose of this notice is to 
allow an additional 30 days for public comment.

DATES: Comments on this notice must be received by November 5, 2018.

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

Renewal of the Consumer Assessment of Healthcare Providers and Systems 
(CAHPS) Clinician and Group Survey 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. The CAHPS Database is a repository for data from selected 
CAHPS surveys. The primary purpose of the CAHPS Database is to 
facilitate comparisons of CAHPS survey results by survey users. This 
voluntary compilation of survey results from a large pool of data into 
a single database enables survey users to compare their own results to 
relevant Database results. The CAHPS Database also offers an important 
source of primary data for research related to consumer assessments of 
quality as measured by CAHPS surveys.
    The CAHPS Clinician & Group Survey (CG-CAHPS) Database is the 
newest component of the CAHPS Database. It was developed in response to 
the growing demand for Database results for the various versions of the 
CG-CAHPS Survey, including the 12-month and Visit versions. In May 
2011, the first set of Database results for both the 12-month and Visit 
versions was released through the CAHPS Database Online Reporting 
System.
    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 survey data to support public reporting of 
health plan ratings, health plan accreditation and quality improvement 
(OMB Control Number 0935-0165, expiration 5/31/2020). Demand for survey 
results from the CG Survey has grown as well, and therefore AHRQ 
developed a dedicated Clinician and Group Database to support 
benchmarking, quality improvement, and research (OMB Control Number 
0935-0197, expiration 02/28/2019).
    The CAHPS Database contains data from AHRQ's standardized CAHPS 
Surveys which provide survey measures of quality to health care 
purchasers, consumers, regulators, and policy makers. The Health Plan 
Database also provides data for AHRQ's annual National Healthcare 
Quality and Disparities Reports. The goal of this project is to renew 
the CAHPS CG Survey Database. This database will continue to update the 
CAHPS CG Database with the latest results of the CAHPS CG Survey. These 
results consist of 31 items that measure 5 areas or composites of 
patients' experiences with physicians and staff in outpatient medical 
practices. This database can be used to do the following:
    (1) Improve care provided by individual providers, sites of care, 
medical groups, or provider networks.
    (2) Offer several products and services, including providing survey 
results presented through an Online Reporting System, summary 
chartbooks, custom analyses, private reports in Excel format, and data 
for research purposes.
    (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
Providers' Use of Information to Coordinate Patient Care
Patients' Rating of the Provider

    This study is being conducted by AHRQ through its contractor, 
Westat, pursuant to AHRQ's statutory authority to conduct and support 
research on health care and on systems for the delivery of such care, 
including activities with respect to the quality, effectiveness, 
efficiency, appropriateness and value of health care services and with 
respect to 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 submit their CAHPS CG survey 
data voluntarily to the CAHPS CG Survey 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 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 the Data Use Agreement (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 DUA states 
how data submitted by participating organizations will be used and 
provides confidentiality assurances. 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 is either a health system, a

[[Page 50095]]

medical group or practice or a survey vendor who contracts with the 
medical group or practice to collect data on their behalf. After the 
POC has completed the Registration Form and the DUA, they will submit 
patient-level data collected from the CAHPS CG survey to the CAHPS CG 
Survey Database. Data on organizational characteristics such as 
ownership, number of patient visits per week, provider 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, (2) a Practice File 
containing the practice ownership and affiliation (i.e., commercial, 
hospital or health system, university or academic medical center, 
community health center, military or county), number of providers 
working each week, sampling information, number of patient visits per 
week, contact information and (3) a Sample File that contains one 
record for each patient surveyed, the date of visit, survey disposition 
code, information about survey completion, and survey responses.
    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 website; (2) individual participant 
reports (in Excel format), used for comparing a participating 
organization's CAHPS survey results to the database averages, 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 file in PDF format; and (4) a de-identified 
dataset that is made available to researchers for additional analyses.
    Information for the CAHPS CG Database has been collected by AHRQ on 
an annual basis since 2010. Participating organizations are asked to 
submit their data voluntarily to the database each year. The data are 
cleaned with standardized programs, then aggregated and used to produce 
summarized results. In addition, reports in Excel format are produced 
that compare the participating organizations' results to the overall 
database results. These reports are sent via a secured FTP site upon 
the participating organization's request.
    Database results and individual participant reports can serve a 
variety of purposes:

 Identifying areas for quality improvement at multiple levels, 
including medical group, practice site, and individual practitioner.
 Briefing senior leadership on patients' views of the health 
care they receive
 Supporting public reporting of patients' assessments of care
 Combining with other quality measures to examine health care 
outcomes

    The CAHPS CG Database supports research by providing a de-
identified analytic database. Much like the CAHPS Health Plan Database 
developed in 1998 (OMB Control Number 0935-0165, Expiration Date 5/31/
2020), researchers can use the CAHPS CG Survey Database to examine:

 Disparities in CAHPS satisfaction scores by racial and ethnic 
characteristics of patients
 Comparisons of adult and child CAHPS survey results
 Analysis of case-mix factors affecting CAHPS scores, such as 
patient age, education, and self-reported health status

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated burden hours for the participating in 
the CG database. The 11 POCs in exhibit 1 are the number of estimated 
vendors. Survey vendors assist the Health/Medical entities with 
submitting data submission materials. Survey vendors generally submit 
all required survey data and other materials other than the DUA. The 86 
POCs in exhibit 1 are the number of estimated participating Health/
Medical entities based on 2017 submission.
    Each vendor will register online for submission. The online 
Registration Form will require about 5 minutes to complete. The DUA 
will be completed by the 86 participating Health/Medical entities. 
Vendors do not sign DUAs. The DUA process requires about 15 minutes to 
sign and return by fax, mail or to upload directly to the submission 
system and includes an accompanying practice site excel file that is 
uploaded to 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 Database. The average number of 
data submissions per vendor is estimated to be 10. 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 133 hours annually.

                                  Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                     Number of       Number of
                    Form name                      respondents/    responses for     Hours per     Total burden
                                                       POCs          each POC        response          hours
----------------------------------------------------------------------------------------------------------------
Registration Form...............................              11               1            5/60               1
Data Use Agreement..............................              86               1           15/60              22
Data Submission.................................              11              10               1             110
                                                 ---------------------------------------------------------------
    Total.......................................             108              NA              NA             133
----------------------------------------------------------------------------------------------------------------

    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 $6,602 annually.

[[Page 50096]]



                                   Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
                                           Number of
               Form name                 respondents/    Total burden   Average hourly wage rate    Total cost
                                             POCs            hours                  *                 burden
----------------------------------------------------------------------------------------------------------------
Registration Form.....................              11               1  \a\ 40.95...............             $41
Data Use Agreement....................              86              22  \b\ 93.44...............           2,056
Data Files Submission.................              11             110  \c\ 40.95...............           4,505
 
    Total.............................             108             133  NA......................           6,602
----------------------------------------------------------------------------------------------------------------
* National Compensation Survey: Occupational wages in the United States May 2016, ``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). https://www.bls.gov/oes/current/oes_nat.htm.

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'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.

Francis D. Chesley, Jr.,
Acting Deputy Director.
[FR Doc. 2018-21618 Filed 10-3-18; 8:45 am]
 BILLING CODE 4160-90-P
Federal Register / Vol. 83, No. 193 / Thursday, October 4, 2018 / Notices 50095

medical group or practice or a survey (4) a de-identified dataset that is made education, and self-reported health
vendor who contracts with the medical available to researchers for additional status
group or practice to collect data on their analyses.
Estimated Annual Respondent Burden
behalf. After the POC has completed the Information for the CAHPS CG
Registration Form and the DUA, they Database has been collected by AHRQ Exhibit 1 shows the estimated burden
will submit patient-level data collected on an annual basis since 2010. hours for the participating in the CG
from the CAHPS CG survey to the Participating organizations are asked to database. The 11 POCs in exhibit 1 are
CAHPS CG Survey Database. Data on submit their data voluntarily to the the number of estimated vendors.
organizational characteristics such as database each year. The data are cleaned Survey vendors assist the Health/
ownership, number of patient visits per with standardized programs, then Medical entities with submitting data
week, provider specialty, and aggregated and used to produce submission materials. Survey vendors
information related to survey summarized results. In addition, reports generally submit all required survey
administration such as mode, dates of in Excel format are produced that data and other materials other than the
survey administration, sample size, and compare the participating organizations’ DUA. The 86 POCs in exhibit 1 are the
response rate, which are collected as results to the overall database results. number of estimated participating
part of CAHPS CG survey operations are These reports are sent via a secured FTP Health/Medical entities based on 2017
also submitted. site upon the participating submission.
Each submission will consist of 3 data organization’s request. Each vendor will register online for
files: (1) A Group File that contains Database results and individual submission. The online Registration
information about the group ownership, participant reports can serve a variety of Form will require about 5 minutes to
(2) a Practice File containing the purposes: complete. The DUA will be completed
practice ownership and affiliation (i.e., • Identifying areas for quality by the 86 participating Health/Medical
commercial, hospital or health system, improvement at multiple levels, entities. Vendors do not sign DUAs. The
university or academic medical center, including medical group, practice DUA process requires about 15 minutes
community health center, military or site, and individual practitioner. to sign and return by fax, mail or to
county), number of providers working • Briefing senior leadership on patients’ upload directly to the submission
each week, sampling information, views of the health care they receive system and includes an accompanying
number of patient visits per week, • Supporting public reporting of practice site excel file that is uploaded
contact information and (3) a Sample patients’ assessments of care to the submission system. Each
File that contains one record for each • Combining with other quality submitter will provide a copy of their
patient surveyed, the date of visit, measures to examine health care questionnaire and the survey data file in
survey disposition code, information outcomes the required file format. Survey data
about survey completion, and survey files must conform to the data file layout
responses. The CAHPS CG Database supports specifications provided by the CAHPS
Survey data from the CAHPS CG research by providing a de-identified Database. The average number of data
Database is used to produce four types analytic database. Much like the CAHPS submissions per vendor is estimated to
of products: (1) An online reporting of Health Plan Database developed in 1998 be 10. Once a data file is uploaded, the
results available to the public on the (OMB Control Number 0935–0165, file will be automatically checked to
CAHPS Database website; (2) individual Expiration Date 5/31/2020), researchers ensure it conforms to the specifications
participant reports (in Excel format), can use the CAHPS CG Survey Database and a data file status report will be
used for comparing a participating to examine: produced and made available to the
organization’s CAHPS survey results to • Disparities in CAHPS satisfaction submitter. Submitters will review each
the database averages, that are scores by racial and ethnic report and will be expected to fix any
confidential and customized for each characteristics of patients errors in their data file and resubmit if
participating organization that submits • Comparisons of adult and child necessary. It will take about one hour to
their data, (3) an annual Chartbook that CAHPS survey results complete each file submission. The total
presents summary-level results in a • Analysis of case-mix factors affecting burden is estimated to be 133 hours
downloadable file in PDF format; and CAHPS scores, such as patient age, annually.

EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS
Number of Number of Hours per Total burden
Form name respondents/ responses for response hours
POCs each POC

Registration Form ............................................................................................ 11 1 5/60 1
Data Use Agreement ....................................................................................... 86 1 15/60 22
Data Submission .............................................................................................. 11 10 1 110

Total .......................................................................................................... 108 NA NA 133
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Exhibit 2 shows the estimated submission process. The cost burden is
annualized cost burden based on the estimated to be $6,602 annually.
respondents’ time to complete the

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50096 Federal Register / Vol. 83, No. 193 / Thursday, October 4, 2018 / Notices

EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN
Number of Total burden Average hourly Total cost
Form name respondents/ hours wage rate * burden
POCs

Registration Form ..................................................................................... 11 1 a 40.95 .................. $41
Data Use Agreement ................................................................................ 86 22 b 93.44 .................. 2,056
Data Files Submission .............................................................................. 11 110 c 40.95 .................. 4,505

Total ................................................................................................... 108 133 NA ........................ 6,602
* National Compensation Survey: Occupational wages in the United States May 2016, ‘‘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). https://www.bls.gov/oes/current/oes_nat.htm.

Request for Comments SUMMARY: The Centers for Disease SUPPLEMENTARY INFORMATION: Under the
Control and Prevention (CDC), as part of Paperwork Reduction Act of 1995 (PRA)
In accordance with the Paperwork
its continuing effort to reduce public (44 U.S.C. 3501–3520), Federal agencies
Reduction Act, comments on AHRQ’s
burden and maximize the utility of must obtain approval from the Office of
information collection are requested
government information, invites the Management and Budget (OMB) for each
with regard to any of the following: (a)
general public and other Federal collection of information they conduct
Whether the proposed collection of
agencies the opportunity to comment on or sponsor. In addition, the PRA also
information is necessary for the proper
a proposed and/or continuing requires Federal agencies to provide a
performance of AHRQ’s health care
information collection, as required by 60-day notice in the Federal Register
research and health care information
the Paperwork Reduction Act of 1995. concerning each proposed collection of
dissemination functions, including
This notice invites comment on a information, including each new
whether the information will have
proposed information collection project proposed collection, each proposed
practical utility; (b) the accuracy of
titled Laboratory Response Network to extension of existing collection of
AHRQ’s estimate of burden (including
maintain an integrated national and information, and each reinstatement of
hours and costs) of the proposed
international network of laboratories previously approved information
collection(s) of information; (c) ways to
that can respond to suspected acts of collection before submitting the
enhance the quality, utility and clarity
biological, chemical, or radiological collection to the OMB for approval. To
of the information to be collected; and
terrorism and other public health comply with this requirement, we are
(d) ways to minimize the burden of the
emergencies. publishing this notice of a proposed
collection of information upon the
data collection as described below.
respondents, including the use of DATES:CDC must receive written
automated collection techniques or comments on or before December 3, The OMB is particularly interested in
other forms of information technology. 2018. comments that will help:
Comments submitted in response to 1. Evaluate whether the proposed
ADDRESSES: You may submit comments, collection of information is necessary
this notice will be summarized and identified by Docket No. CDC–2018–
included in the Agency’s subsequent for the proper performance of the
0088 by any of the following methods: functions of the agency, including
request for OMB approval of the • Federal eRulemaking Portal:
proposed information collection. All whether the information will have
Regulations.gov. Follow the instructions practical utility;
comments will become a matter of for submitting comments.
public record. 2. Evaluate the accuracy of the
• Mail: Jeffrey M. Zirger, Information agency’s estimate of the burden of the
Francis D. Chesley, Jr., Collection Review Office, Centers for proposed collection of information,
Acting Deputy Director. Disease Control and Prevention, 1600 including the validity of the
[FR Doc. 2018–21618 Filed 10–3–18; 8:45 am] Clifton Road NE, MS–D74, Atlanta, methodology and assumptions used;
BILLING CODE 4160–90–P
Georgia 30329. 3. Enhance the quality, utility, and
Instructions: All submissions received clarity of the information to be
must include the agency name and collected; and
DEPARTMENT OF HEALTH AND Docket Number. CDC will post, without 4. Minimize the burden of the
HUMAN SERVICES change, all relevant comments to collection of information on those who
Regulations.gov. are to respond, including through the
Centers for Disease Control and Please note: Submit all comments use of appropriate automated,
Prevention through the Federal eRulemaking portal electronic, mechanical, or other
(regulations.gov) or by U.S. mail to the technological collection techniques or
[60Day–18–0850; Docket No. CDC–2018– address listed above. other forms of information technology,
0088] FOR FURTHER INFORMATION CONTACT: To e.g., permitting electronic submissions
request more information on the of responses.
Proposed Data Collection Submitted
proposed project or to obtain a copy of 5. Assess information collection costs.
daltland on DSKBBV9HB2PROD with NOTICES

for Public Comment and
the information collection plan and
Recommendations Proposed Project
instruments, contact Jeffrey M. Zirger,
AGENCY: Centers for Disease Control and Information Collection Review Office, Laboratory Response Network
Prevention (CDC), Department of Health Centers for Disease Control and Information Collection (OMB Control
and Human Services (HHS). Prevention, 1600 Clifton Road NE, MS– No. 0920–0850, Exp. Date: 4/30/2019)—
D74, Atlanta, Georgia 30329; phone: Extension—National Center for
ACTION: Notice with comment period.
404–639–7570; Email: omb@cdc.gov. Emerging and Zoonotic Infectious

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Document Created: 2018-10-04 02:02:49
Document Modified: 2018-10-04 02:02:49
Category		Regulatory Information
Collection		Federal Register
sudoc Class		AE 2.7: GS 4.107: AE 2.106:
Publisher		Office of the Federal Register, National Archives and Records Administration
Section		Notices
Action		Notice.
Dates		Comments on this notice must be received by November 5, 2018.
Contact		Doris Lefkowitz, AHRQ Reports Clearance Officer, (301) 427-1477, or by email at [email protected]
FR Citation		83 FR 50094
83 FR 50094 - Agency Information Collection Activities: Proposed Collection; Comment Request

DEPARTMENT OF HEALTH AND HUMAN SERVICESAgency for Healthcare Research and Quality

Federal Register Volume 83, Issue 193 (October 4, 2018)

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality
