Notice2023-27462
Agency Information Collection Activities: Proposed Collection; Comment Request
Primary source
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Published
December 14, 2023
Issuing agencies
Health and Human Services DepartmentAgency for Healthcare Research and Quality
Abstract
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 updates to the currently approved information collection project: "Medical Expenditures Panel Survey--Household and Medical Provider Components." This proposed information collection was previously published in the Federal Register on September 29, 2023 and allowed 60 days for public comment. AHRQ received two substantive comments from members of the public. The purpose of this notice is to allow an additional 30 days for public comment.
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<title>Federal Register, Volume 88 Issue 239 (Thursday, December 14, 2023)</title>
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[Federal Register Volume 88, Number 239 (Thursday, December 14, 2023)]
[Notices]
[Pages 86650-86652]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2023-27462]
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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 updates to the
currently approved information collection project: ``Medical
Expenditures Panel Survey--Household and Medical Provider Components.''
This proposed information collection was previously published in the
Federal Register on September 29, 2023 and allowed 60 days for public
comment. AHRQ received two substantive comments from members of 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 January 16, 2024.
ADDRESSES: Written comments and recommendations for the proposed
information collection should be sent within 30 days of publication of
this notice to <a href="http://www.reginfo.gov/public/do/PRAMain">www.reginfo.gov/public/do/PRAMain</a>. Find this particular
information collection by selecting ``Currently under 30-day Review--
Open for Public Comments'' or by using the search function.
Copies of the proposed collection plans, data collection
instruments, and specific details on the estimated burden can be
obtained from the AHRQ Reports Clearance Officer.
FOR FURTHER INFORMATION CONTACT: Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427-1477, or by email at
<a href="/cdn-cgi/l/email-protection#92f6fde0fbe1bcfef7f4f9fde5fbe6e8d2d3dac0c3bcfafae1bcf5fde4"><span class="__cf_email__" data-cfemail="01656e7368722f6d64676a6e7668757b41404953502f6969722f666e77">[email protected]</span></a>.
SUPPLEMENTARY INFORMATION:
Proposed Project
Medical Expenditures Panel Survey--Household and Medical Provider
Components
AHRQ requests that OMB approve a change 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 Fall 2024 MEPS-HC:
<bullet> Core MEPS Interview--Seven economic burden questions will
be added to the Core interview. Five of these questions come from the
Preventive Care Services Self-Administered Questionnaire (PSAQ), and
two are new to the MEPS. The specific topics of the five questions
moving from the PSAQ are partial and late payments for bills, having
been contacted by debt collection agencies, and ability to pay for
unexpected expenses. The questions were modified to be asked at the
household level. These topics are important for understanding the
context families face in paying for health care. The new questions
asking about medical debt are modified versions of questions used in
the Survey of Income and Program Participation (SIPP). The SIPP asks
the question at a person level; AHRQ has modified it to be asked at the
household level. Collecting medical debt amounts will enable analyses
of how medical debt is related to health care access, use, health
outcomes, and financial status. In addition, the wording for eight food
security questions has been slightly modified to allow for proxy
responses; thus, all households will be asked these questions.
<bullet> Preventive Care Services Self-Administered Questionnaire
(PSAQ)--The PSAQ will have the following changes for Fall 2024:
<bullet> Removing five economic burden questions, which will be
added to the Core interview;
<bullet> Combining the Male and Female PSAQ questionnaires into a
single questionnaire and revising the sex-specific questions
accordingly;
<bullet> Adding Sexual Orientation and Gender Identity (SOGI)
questions to the end of the questionnaire;
<bullet> Changing the age-specific skips to reflect new
recommendations for specific preventive health screening procedures;
<bullet> Creating a web-based mode of completion as an alternative
option to the traditional pen-and-paper-based survey.
The incorporation of SOGI questions into the PSAQ aligns with the
objectives outlined in Executive Order 14075, titled ``Advancing
Equality for Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex
Individuals.'' The inclusion of these questions necessitated further
adjustments to the questionnaires, including the consolidation of the
traditionally segregated male and female questionnaires into a unified
form. Optimally incorporating sex-specific preventive care questions
(e.g., prostate cancer screening) in surveys in a manner that respects
all gender identities requires balancing multiple competing factors.
AHRQ consulted with federal agencies fielding surveys with SOGI and
preventive care questions, and they have not yet modified their
preventive care questions to account for gender minorities. For this
initial attempt in the MEPS, AHRQ balanced the following
considerations: respect for gender minority respondents, cognitive
burden among cisgender respondents, minimizing skip patterns to
maintain consistency between pen-and-paper and web-based modes of the
PSAQ, and the strong expectation that the number of gender minority
respondents in the relevant age ranges will be too small to support
estimates of receipt of sex-specific preventive services in this
population. AHRQ will continue to monitor best practices and empirical
studies by consulting with NCHS and the National Cancer Institute (NCI)
to revise the PSAQ when it is fielded again in the future.
<bullet> Cancer Self-Administered Questionnaire (Cancer SAQ)--The
NCI has collaborated in previous years with AHRQ to create the MEPS
Experiences with Cancer Supplement, which oversampled households with
cancer survivors from the prior year National Health Interview Survey
(NHIS) and fielded a special survey about economic burden and access to
care in cancer survivors. Due to a change in the NHIS sample design,
MEPS will not be able to oversample cancer survivors in the 2024 data
collection. The current effort will field an updated version of the
MEPS Experiences with Cancer Survey in the
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Fall 2024 MEPS-HC. The new version of the survey will include most of
the same questions as the earlier survey to allow comparisons of trends
and will replace some survey items that are now less critical or
available from other data sources with new questions on employment
impacts and workplace accommodations; survivorship care; social
determinants of health; and social isolation and support.
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.
The MEPS-HC Core Interview will be completed by 11,750 ``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.
The Adult SAQ is 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 5,688 adults and
requires an average of 7 minutes to complete. The PSAQ is 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 5,688 adults and requires an average of 7 minutes to
complete. The Diabetes Care Survey will be completed by 1,000 persons
each year and requires 3 minutes to complete. The Cancer SAQ will be
completed by 1,500 persons each year and requires 20 minutes to
complete. Authorization forms for the MEPS-MPC and Pharmacy Survey will
be completed by 11,750 respondents. Each respondent will complete an
average of 4.66 forms each year, with each form requiring an average of
3 minutes to complete. A validation interview will be conducted with
4,225 respondents each year and requires 5 minutes to complete. The
total burden hours for the respondents' time to participate in the
MEPS-HC is estimated to be 47,387 hours.
The MEPS-MPC Contact Guide/Screening Call will be conducted with
54,758 providers and pharmacies each year and requires 5 minutes to
complete. The Home Care Providers Event Form will be completed by 886
providers, with each provider completing an average of 5.8 forms and
each form requiring 3 minutes to complete. The Office-based Providers
Event Form will be completed by 14,950 providers. Each provider will
complete an average of 4.3 forms and each form requires 3 minutes to
complete. The Separately Billing Doctors Event Form will be completed
by 12,690 providers, with each provider completing 1.4 forms on
average, and each form requiring 3 minutes to complete. The Hospital
Event Form will be completed by 8,302 hospitals or HMOs. Each hospital
or HMO will complete 7.5 forms on average, with each form requiring 3
minutes to complete. The Institutions (non-hospital) Event Form will be
completed by 118 institutions, with each institution completing 1.3
forms on average, and each form requiring 3 minutes to complete. The
Pharmacy Event Form will be completed by 9,079 pharmacies. Each
pharmacy will complete 37.6 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 29,111 hours. The
total annual burden hours for the MEPS-HC and MPC is estimated to be
76,498 hours.
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 $1,410,236;
the annual cost burden for the MEPS-MPC is estimated to be $569,200.
The total annual cost burden for the MEPS-HC and MPC is estimated to be
$1,979,436.
Exhibit 1--Estimated Annualized Burden Hours
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Number of
Form name Number of responses per Hours per Total burden
respondents respondent response hours
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MEPS-HC:
MEPS-HC Core Interview...................... 11,750 2.5 88/60 43,083
Adult SAQ *................................. 5,688 0.5 7/60 332
Preventive Care SAQ (PSAQ) **............... 5,688 0.5 7/60 332
Diabetes Care Survey (DCS).................. 1,000 1 3/60 50
Cancer SAQ.................................. 1,500 1 20/60 500
Authorization forms for the MEPS-MPC 11,750 4.66 3/60 2,738
Provider and Pharmacy Survey...............
MEPS Validation Interview................... 4,225 1 5/60 352
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Subtotal for the MEPS-HC................ 41,600 .............. .............. 47,387
MEPS-MPC:
MPC Contact Guide/Screening Call............ 54,758 1 5/60 4,563
Home Care Providers Event Form.............. 886 5.8 3/60 257
Office[dash]based Providers Event Form...... 14,950 4.3 3/60 3,214
Separately Billing Doctors Event Form....... 12,690 1.4 3/60 888
Hospitals & HMOs (Hospital Event Form)...... 8,302 7.5 3/60 3,113
Institutions (non-hospital) Event Form...... 118 1.3 3/60 8
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Pharmacies Event Form....................... 9,079 37.6 3/60 17,068
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Subtotal for the MEPS-MPC............... 100,783 .............. .............. 29,111
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Grand Total......................... 142,383 .............. .............. 76,498
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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--Estimated Annualized Cost Burden
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Average
Form name Number of Total burden hourly wage Total cost
respondents hours rate burden
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MEPS-HC:
MEPS-HC Core Interview...................... 11,750 43,083 $29.76 * $1,282,150
Adult SAQ................................... 5,688 332 29.76 * 9,880
Preventive Care SAQ (PSAQ).................. 5,688 332 29.76 * 9,880
Diabetes Care Survey (DCS).................. 1,000 50 29.76 * 1,488
Cancer SAQ.................................. 1,500 500 29.76 * 14,880
Authorization forms for the MEPS-MPC 11,750 2,738 29.76 * 81,483
Provider and Pharmacy Survey...............
MEPS Validation Interview................... 4,225 352 29.76 * 10,475
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Subtotal for the MEPS-HC................ 41,600 47,387 .............. 1,410,236
MEPS-MPC:
MPC Contact Guide/Screening Call............ 54,758 4,563 19.84 ** 90,530
Home care Providers Event Form.............. 886 257 19.84 ** 5,099
Office[dash]based Providers Event Form...... 14,950 3,214 19.84 ** 63,766
Separately Billing Doctors (SBD) Event Form. 12,690 888 19.84 ** 17,618
Hospitals & HMOs (Hospital Event Form....... 8,302 3,113 19.84 ** 61,762
Institutions (non-hospital) Event Form...... 118 8 19.84 ** 159
Pharmacies Event Form....................... 9,079 17,068 19.35 *** 330,266
---------------------------------------------------------------
Subtotal for the MEPS-MPC............... 100,783 29,111 .............. 569,200
---------------------------------------------------------------
Grand Total......................... 142,383 77,067 .............. 1,979,436
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* 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: December 11, 2023.
Marquita Cullom,
Associate Director.
[FR Doc. 2023-27462 Filed 12-13-23; 8:45 am]
BILLING CODE 4160-90-P
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