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[Federal Register Volume 79, Number 227 (Tuesday, November 25, 2014)]
[Notices]
[Pages 70188-70189]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-27687]

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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 changes to the 
currently approved information collection project: ``Medical 
Expenditure Panel Survey (AMPS) Household Component'' In accordance 
with the Paperwork Reduction Act, 44 U.S.C. 3501-3521, AHRQ invites the 
public to comment on this proposed information collection.
    This proposed information collection was previously published in 
the Federal Register on August 29th, 2014 and allowed 60 days for 
public comment. One comment was received. The purpose of this notice is 
to allow an additional 30 days for public comment.

DATES: Comments on this notice must be received by December 26, 2014.

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 OIRA_submission@omb.eop.gov (attention: AHRQ's desk officer).
    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 
doris.lefkowitz@AHRQ.hhs.gov.

SUPPLEMENTARY INFORMATION: 

Proposed Project

Medical Expenditure Panel Survey (MEPS) Household Component

    For over thirty years, results from the MEPS and its predecessor 
surveys (the 1977 National Medical Care Expenditure Survey, the 1980 
National Medical Care Utilization and Expenditure Survey and the 1987 
National Medical Expenditure Survey) have been used by OMB, DHHS, 
Congress and a wide number of health services researchers to analyze 
health care use, expenses and health policy.
    Major changes continue to take place in the health care system. The 
MEPS is needed to provide information about the current state of the 
health care system as well as to track changes over time. The MEPS 
permits annual estimates of use of health care and expenditures and 
sources of payment for that health care. It also permits tracking 
individual change in employment, income, health insurance and health 
status over two years. The use of the National Health Interview Survey 
(NHIS) as a sampling frame expands the MEPS analytic capacity by 
providing another data point for comparisons over time.
    Households selected for participation in the MEPS-HC are 
interviewed in person five times. These rounds of interviewing are 
spaced about 5 months apart. The interview will take place with a 
family respondent who will report for him/herself and for other family 
members.
    The MEPS-HC has the following goal:
     To provide nationally representative estimates for the 
U.S. civilian noninstitutionalized population for health care use, 
expenditures, sources of payment and health insurance coverage.
    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 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

    To achieve the goals of the MEPS-HC the following data collections 
are implemented:
    1. Household Component Core Instrument. The core instrument 
collects data about persons in sample households. Topical areas asked 
in each round of interviewing include condition enumeration, health 
status, health care utilization including prescribed medicines, expense 
and payment, employment, and health insurance. Other topical areas that 
are asked only once a year include access to care, income, assets, 
satisfaction with health plans and providers, children's health, and 
adult preventive care. While many of the questions are asked about the 
entire reporting unit, which is typically a family, only one person 
normally provides this information.
    2. Adult Self Administered Questionnaire. A brief self-administered 
questionnaire (SAQ) will be used to collect self-reported (rather than 
through household proxy) information on health status, health opinions 
and satisfaction with health care for adults 18 and older. The items on 
satisfaction with health care are a subset from the Consumer Assessment 
of Healthcare Providers and Systems. The health status items are from 
the Short Form 12 Version 2, which has been widely used as a measure of 
self-reported health status in the United States, the Kessler Index of 
non-specific psychological distress, and the Patient Health 
Questionnaire.
    3. Diabetes Care SAQ. A brief self-administered, paper-and-pencil 
questionnaire on the quality of diabetes care is administered once a 
year, during rounds 3 and 5, to persons identified as having diabetes. 
Included are questions about the number of times the respondent 
reported having a hemoglobin A1c blood test, whether the respondent 
reported having his or her feet checked for sores or irritations, 
whether the respondent reported having an eye exam in which his or her 
pupils were dilated, the last time the respondent had his or her blood 
cholesterol checked and whether the diabetes has caused kidney or eye 
problems. Respondents are also asked if their diabetes is being treated 
with diet, oral medications or insulin.
    4. Permission forms for the MEPS-MPC Provider and Pharmacy Survey. 
As in previous panels of the MEPS, we will ask respondents for 
permission to obtain supplemental information from their medical 
providers (hospitals, physicians, home health agencies and 
institutions) and pharmacies.

[[Page 70189]]

    The MEPS-HC was last approved by OMB on December 20th, 2012 and 
will expire on December 31, 2015. The OMB control number for the MEPS-
HC is 0935-0118. All of the supporting documents for the current MEPS-
HC can be downloaded from OMB's Web site at. http://www.reginfo.gov/public/do/PRAViewDocument?ref_nbr=201209-0935-001.
    The MEPS is a multi-purpose survey. In addition to collecting data 
to yield annual estimates for a variety of measures related to health 
care use and expenditures, the MEPS also provides estimates of measures 
related to health status, consumer assessment of health care, health 
insurance coverage, demographic characteristics, employment and access 
to health care indicators. Estimates can be provided for individuals, 
families and population subgroups of interest. Data from the MEPS-HC 
are intended for a number of annual reports required to be produced by 
the Agency, including the National Health Care Quality Report and the 
National Health Care Disparities Report.
    AHRQ proposes to make the following changes to questions asked of 
respondents:

Additions

    Closing--questions pertaining to respondent email and 
administration status of the Preventive Care self-administered 
questionnaire;
    Re-enumeration--addition of questions pertaining to educational 
level attainment and the determination of institutional status;
    Provider Probes--determination if health care was received in an 
overnight facility; and
    Health Insurance--questions were added regarding interaction with 
the health insurance marketplace, enrollment through state health 
insurance exchanges, the extent of subsidized health insurance, monthly 
premiums, health insurance metal plan names, and medical debt.
    Preventive Care--a field test will be conducted to assess response 
lost through self-administration.

Deletions

    Questions were removed from the following sections: Access to Care, 
Medical Conditions, Charge Payment, Child Preventive Health, Disability 
Days, Emergency Room, Employment, Health Status, Health Insurance, 
Hospital Stay, Income, Medical Provider Visits, Outpatient Departments, 
and Satisfaction with Health Plan.
    Questions were removed to reduce burden and redundancy, and 
additional questions were removed due to difficulty in respondent 
interpretation, low frequency in response or minimal variation, and 
limited ability of respondent to respond accurately.

Estimated Annual Respondent Burden

    There are no changes to the current burden estimates.

Estimated Annual Costs to the Federal Government

    There are no changes to the current cost estimates.

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 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: November 13, 2014.
Richard Kronick,
Director.
[FR Doc. 2014-27687 Filed 11-24-14; 8:45 am]
BILLING CODE 4160-90-M
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