[Federal Register Volume 86, Number 17 (Thursday, January 28, 2021)]
[Notices]
[Pages 7398-7399]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-01691]



[[Page 7398]]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[60Day-21-0234; Docket No. CDC-2020-0125]


Proposed Data Collection Submitted for Public Comment and 
Recommendations

AGENCY: Centers for Disease Control and Prevention (CDC), Department of 
Health and Human Services (HHS).

ACTION: Notice with comment period.

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SUMMARY: The Centers for Disease Control and Prevention (CDC), as part 
of its continuing effort to reduce public burden and maximize the 
utility of government information, invites the general public and other 
Federal agencies the opportunity to comment on a proposed and/or 
continuing information collection, as required by the Paperwork 
Reduction Act of 1995. This notice invites comment on a proposed 
information collection project titled the National Ambulatory Medical 
Care Survey (NAMCS). The goal of the project is to assess the health of 
the population through patient use of physician offices, community 
health centers (CHCs), and to monitor the characteristics of physician 
practices.

DATES: CDC must receive written comments on or before March 29, 2021.

ADDRESSES: You may submit comments, identified by Docket No. CDC-2020-
0125 by any of the following methods:
    <bullet> Federal eRulemaking Portal: Regulations.gov. Follow the 
instructions for submitting comments.
    <bullet> Mail: Jeffrey M. Zirger, Information Collection Review 
Office, Centers for Disease Control and Prevention, 1600 Clifton Road 
NE, MS-D74, Atlanta, Georgia 30329.
    Instructions: All submissions received must include the agency name 
and Docket Number. CDC will post, without change, all relevant comments 
to Regulations.gov.
    Please note: Submit all comments through the Federal eRulemaking 
portal (regulations.gov) or by U.S. mail to the address listed above.

FOR FURTHER INFORMATION CONTACT: To request more information on the 
proposed project or to obtain a copy of the information collection plan 
and instruments, contact Jeffrey M. Zirger, Information Collection 
Review Office, Centers for Disease Control and Prevention, 1600 Clifton 
Road NE, MS-D74, Atlanta, Georgia 30329; phone: 404-639-7570; Email: 
<a href="/cdn-cgi/l/email-protection#c3acaea183a0a7a0eda4acb5"><span class="__cf_email__" data-cfemail="a7c8cac5e7c4c3c489c0c8d1">[email protected]</span></a>.

SUPPLEMENTARY INFORMATION: Under the Paperwork Reduction Act of 1995 
(PRA) (44 U.S.C. 3501-3520), Federal agencies must obtain approval from 
the Office of Management and Budget (OMB) for each collection of 
information they conduct or sponsor. In addition, the PRA also requires 
Federal agencies to provide a 60-day notice in the Federal Register 
concerning each proposed collection of information, including each new 
proposed collection, each proposed extension of existing collection of 
information, and each reinstatement of previously approved information 
collection before submitting the collection to the OMB for approval. To 
comply with this requirement, we are publishing this notice of a 
proposed data collection as described below.
    The OMB is particularly interested in comments that will help:
    1. 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;
    2. Evaluate the accuracy of the agency's estimate of the burden of 
the proposed collection of information, including the validity of the 
methodology and assumptions used;
    3. Enhance the quality, utility, and clarity of the information to 
be collected; and
    4. 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 
submissions of responses.
    5. Assess information collection costs.

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 in-patient 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, 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, community health centers (CHCs) 
play an important role in the health care community by providing care 
to people who might not be able to afford it, otherwise. CHCs are 
local, non-profit, community-owned health care settings, which serve 
approximately 28 million individuals throughout the United States.
    This revision seeks approval to adjust the CHC sample size. In 
2021, the sample size will be reduced to 50 CHCs, and in 2022 allocated 
funds will cover a sample size of 110 CHCs. In 2023 the sample size 
will increase to 115 CHCs. There will be no modification to the office-
based physician sample. In the 2021 survey year we will include the 
supplemental sample of physicians from

[[Page 7399]]

which visit data are collected through submission of EHRs with the 
approved 2019 sample size, and for subsequent survey years when deemed 
necessary. The annualized 2021-2023 NAMCS sample size is projected to 
be 6,000 office-based physicians and 92 CHCs. Questions on the 
traditional office-base physician survey will be modified for 
clarification and to keep current with medical practice and 
terminology. In 2020 we are also seeking to include the potential for 
experiments involving physician incentives for some office-based 
physicians. In 2021, data collection for CHCs will transition from 
manual abstraction to be sent through EHRs. A set-up fee will be 
allotted to sampled CHCs to offset the cost of this new data collection 
method. With this transition, a new CHC facility interview will be 
implemented and personally identifiable information (PII) will be 
collected from both the CHCs, and physicians who submit EHR data. For 
both the traditional office-based physicians and CHCs, 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. Estimated annualized burden is 9,272 
hours.

                                        Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                                       Average
                                                        Number of       Number of     burden per   Total burden
      Type of respondents             Form name        respondents    responses per    response      (in hrs.)
                                                                       respondent     (in hrs.)
----------------------------------------------------------------------------------------------------------------
Office-based Physicians or       Physician                      500               1        30/60             250
 Staff (Abstraction).             Induction
                                  Interview (2020).
                                 Pulling, re-filing             500              30         1/60             250
                                  medical record
                                  forms (FR
                                  abstracts) (2020).
CHC Executive/Medical Directors  CHC Facility                    17               1        30/60               9
                                  Induction
                                  Interview (2020).
CHC Providers..................  Provider Induction              52               1        30/60              26
                                  Interview (2020).
CHC Provider Staff.............  Pulling, re-filing              52              30         1/60              26
                                  medical record
                                  forms (FR
                                  abstracts).
Office-based Physicians          Reinterview Study               33               1        15/60               8
 (Abstraction) and CHC            (2020).
 Providers.
Office-based Physicians or       Physician                    3,000               1        30/60           1,500
 Staff (Abstraction).             Induction
                                  Interview (2021-
                                  2023).
                                 Pulling, re-filing           3,000              30         1/60           1,500
                                  medical record
                                  forms (FR
                                  abstracts) (2021-
                                  2023).
Office-based Physician Staff     Physician Facility           3,000               1        45/60           2,250
 (EHR Submission).                Interview (PFI)
                                  (2021-2023).
                                 Pulling, re-filing           3,000               1        60/60           3,000
                                  medical record
                                  forms (EHR
                                  Onboarding) (2021-
                                  2023).
CHC Staff......................  CHC Facility                    92               1        15/60              23
                                  Interview (2021-
                                  2023).
                                 Prepare and                     92               4        60/60             368
                                  transmit EHR for
                                  Visit Data
                                  (quarterly) (2021-
                                  2023).
Office-based Physicians          Reinterview Study              250               1        15/60              63
 (Abstraction).                   (2021-2023).
                                                    ------------------------------------------------------------
    Total......................  ..................  ..............  ..............  ...........           9,272
----------------------------------------------------------------------------------------------------------------


Jeffrey M. Zirger,
Lead, Information Collection Review Office, Office of Scientific 
Integrity, Office of Science, Centers for Disease Control and 
Prevention.
[FR Doc. 2021-01691 Filed 1-27-21; 8:45 am]
BILLING CODE 4163-18-P


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