5458 Federal Register / Vol. 78, No. 17 / Friday, January 25, 2013 / Notices 

1 42 CFR 418.3 Accessed November 19, 2012 

http://www.gpo.gov/fdsys/pkg/CFR-2011-title42- 

vol3/xml/CFR-2011-title42-vol3-part418.xml#

seqnum418.3. 

2Hospice Foundation of America, accessed 

November 2, 2012 http://www.hospicefoundation.

org/whatishospice. 

3Caring Connections, accessed November 1, 2012 

http://www.caringinfo.org/i4a/pages/index.cfm?

pageid=3356. 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–4172–NC] 

Medicare Program; Request for 

Information To Aid in the Design and 

Development of a Survey Regarding 

Patient and Family Member/Friend 

Experiences With Hospice Care 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Request for information. 

SUMMARY: This document is a request for 

information regarding patient and 

family member or close friend 

experiences with hospice care. 

DATES: The information solicited in this 

notice must be received at the address 

provided below by March 26, 2013. 

ADDRESSES: In responding to this 

solicitation please reply via email to 

HospiceSurvey@cms.hhs.gov or by 

postal mail at Centers for Medicare and 

Medicaid Services, Attention: Debra 

Dean-Whittaker, Mailstop C1–25–05, 

7500 Security Boulevard, Baltimore, MD 

21244–1850. 

FOR FURTHER INFORMATION CONTACT: 

Debra Dean-Whittaker, 410–786–0848 

SUPPLEMENTARY INFORMATION: 

I. Background 

In accordance with section 3011 of 

the Affordable Care Act, the Department 

of Health and Human Services (HHS) 

developed the National Quality Strategy 

to create national aims and priorities to 

guide local, state, and national efforts to 

improve the quality of health care. The 

National Quality Strategy established 

three aims supported by six priorities. 

The three aims are as follows: 

• Better Care: Improve the overall 

quality, by making health care more 

patient-centered, reliable, accessible, 

and safe. 

• Healthy People/Healthy 

Communities: Improve the health of the 

U.S. population by supporting proven 

interventions to address behavioral, 

social, and environmental determinants 

of health in addition to delivering 

higher-quality care. 

• Affordable Care: Reduce the cost of 

quality health care for individuals, 

families, employers, and government. 

The six priorities are: ‘‘(1) Making 

care safer by reducing harm caused by 

the delivery of care; (2) ensuring that 

each person and family are engaged as 

partners in their care; (3) promoting 

effective communication and 

coordination of care; (4) promoting the 

most effective prevention and treatment 

practices for the leading causes of 

mortality, starting with cardiovascular 

disease; (5) working with communities 

to promote wide use of best practices to 

enable healthy living; and (6) making 

quality care more affordable for 

individuals, families, employers, and 

governments by developing and 

spreading new health care delivery 

models.’’ 

The survey, now under development, 

hereinafter referred to as the ‘‘Hospice 

Survey’’ supports the National Quality 

Strategy goal of Better Care and the 

priorities of— 

• Ensuring that each person and 

family are engaged as partners in their 

care (priority #2); and 

• Promoting effective communication 

and coordination of care (priority #3). 

The Centers for Medicare & Medicaid 

Services (CMS) has previously 

implemented national surveys called 

Consumer Assessment of Healthcare 

Providers and Systems (CAHPS®) 

surveys in both in-patient and outpatient settings and for different 

services. Specifically, CMS has 

implemented CAHPS® surveys for 

Medicare health and drug plans, 

inpatient hospitals, and home health 

agencies. CMS and the Agency for 

Healthcare Research and Quality 

(AHRQ) have also developed CAHPS®

surveys for in-center hemodialysis 

facilities, nursing homes, and clinician 

and group practices. None of these 

CAHPS® surveys address experiences 

with hospice services. 

Hospice focuses on caring for patients 

at the end of their lives and on helping 

their families. In the Federal Register 

we have defined hospice and hospice 

care as follows: 

Hospice means a public agency or 

private organization or subdivision of 

either of these that is primarily engaged 

in providing hospice care as defined in 

this section. 

Hospice care means a comprehensive set of 

services described in section 1861(dd)(1) of 

the Act, identified and coordinated by an 

interdisciplinary group to provide for the 

physical, psychosocial, spiritual, and 

emotional needs of a terminally ill patient 

and/or family members, as delineated in a 

specific patient plan of care.1

The Hospice Foundation of America 

is one of many private organizations 

that agree with the following statement: 

Hospice is a special concept of care 

designed to provide comfort and support to 

patients and their families when a lifelimiting illness no longer responds to cureoriented treatments.2

The National Hospice and Palliative 

Care Organization (NHPCO), a leading 

organization for hospice providers, 

describes hospice care as follows: 

The focus of hospice relies on the belief 

that each of us has the right to die pain-free 

and with dignity, and that our loved ones 

will receive the necessary support to allow us 

to do so.3

The planned CMS Hospice Survey 

differs from other CMS patient 

experience surveys because the target 

population for the Hospice Survey is 

bereaved family members or close 

friends of patients who died in hospice 

care. The reasons for focusing on family 

members/friends are that the patient is 

not the best source of information for 

the entire trajectory of hospice care, and 

that many hospice patients are very ill 

and unable to answer survey questions. 

Given the unique environment and 

patient population of hospice care, 

existing patient experience instruments 

designed for other settings are only 

partially relevant for capturing hospice 

care experiences. A rigorous, welldesigned Hospice Survey will allow us 

to understand: (1) Patient experiences 

throughout their hospice care, as 

reported by their family members/ 

friends; and (2) the perspectives of 

family members/friends with regard to 

their own experiences with hospice. 

This information will ultimately be used 

to help improve the quality of care 

patients and their families and friends 

receive in hospice. 

We are in the process of reviewing 

potential topic areas, as well as publicly 

available instruments and measures, for 

the purpose of developing a Hospice 

Survey that will enable objective 

comparisons of hospice experiences 

across the country. This survey will be 

used to help consumers make more 

informed decisions about providers, as 

well as provide information to drive 

improvements in the quality of hospice 

care. The principal focus of this effort is 

to develop a survey of family members 

or friends who are 18 years of age and 

older and who are knowledgeable about 

the care provided to the person enrolled 

in hospice. 

II. Solicitation of Information 

We are soliciting the submission of 

suggested topic areas (such as 

‘‘communication with providers,’’ ‘‘pain 

mstockstill on DSK4VPTVN1PROD with 

Federal Register / Vol. 78, No. 17 / Friday, January 25, 2013 / Notices 5459 

1Please see U.S. Department of Health and 

Human Services, Report to Congress, National 

Strategy for Quality Improvement in Health Care, 

(March 2011), available at http:// 

www.healthcare.gov/law/resources/reports/ 

nationalqualitystrategy032011.pdf. 

control’’ or ‘‘non-pain symptom 

management,’’ as well as publicly 

available instruments for capturing 

family members’ or friends’ experiences 

with hospice care. We are interested in 

instruments and items that can measure 

quality of care from the family member/ 

friend’s perspective, including all 

potential hospice settings (for example, 

home, nursing home, hospital, and freestanding hospice) and instruments that 

track changes over time. 

We are looking for suggested topic 

areas and publicly available instruments 

in which the information was identified 

by family members/friends as important 

to them in evaluating hospice care. 

Existing instruments are preferred if 

they have been tested, have a high 

degree of reliability and validity, and 

report evidence of wide use. 

The following information would be 

especially helpful in any comments 

responding to this request for 

information: 

• A brief cover letter summarizing the 

information requested for submitted 

instruments and topic areas, 

respectively, and how the submission 

will help fulfill the intent of the survey. 

• (Optional) Information about the 

person submitting the material for the 

purposes of follow up questions about 

the submission which includes the 

following: 

++ Name. 

++ Title. 

++ Organization. 

++ Mailing address. 

++ Telephone number. 

++ Email address. 

++ Indication that the instrument is 

publicly available. 

• When submitting topic areas, we 

encourage including to the extent 

available the following information: 

++ Detailed descriptions of the 

suggested topic area(s) and specific 

purpose(s). 

++ Relevant peer-reviewed journal 

articles or full citations. 

• When submitting publicly available 

instruments or survey questions, we 

encourage including to the extent 

available the following information: 

++ Name of the instrument. 

++ Copies of the full instrument in all 

available languages. 

++ Topic areas included in the 

instrument. 

++ Measures derived from the 

instrument. 

++ Instrument reliability (internal 

consistency, test-retest, etc) and 

validity (content, construct, criterionrelated). 

++ Results of cognitive testing (one-onone testing with a small number of 

respondents to ensure that they 

understand the questionnaire.) 

++ Results of field testing. 

++ Current use of the instrument (who 

is using it, what it is being used for, 

what population it is being used with, 

how instrument findings are reported, 

and by whom the findings are used). 

++ Relevant peer-reviewed journal 

articles or full citations. 

++ CAHPS® trademark status. 

++ National Quality Forum (NQF) 

endorsement status. 

++ Survey administration instructions. 

++ Data analysis instructions. 

++ Guidelines for reporting survey data. 

CMS is developing this survey and 

plans to submit it to AHRQ for 

recognition as a Consumer Assessment 

of Healthcare Providers and Systems 

(CAHPS®) survey. The survey will be 

developed in accordance with CAHPS®

Survey Design Principles and 

implementation instructions will be 

based on those for CAHPS® instruments 

(https://www.cahps.AHRQ.gov/AboutCAHPS/Principles.aspx). 

(Catalog of Federal Domestic Assistance 

Program No. 93.773, Medicare—Hospital 

Insurance; and Program No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program) 

Dated: December 5, 2012. 

Marilyn Tavenner, 

Acting Administrator, Centers for Medicare 

& Medicaid Services. 

[FR Doc. 2013–01299 Filed 1–24–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–4171–NC] 

Medicare Program; Request for 

Information To Aid in the Design and 

Development of a Survey Regarding 

Patient Experiences With Hospital 

Outpatient Surgery Departments/ 

Ambulatory Surgery Centers and 

Patient-Reported Outcomes From 

Surgeries and Procedures Performed 

in These Settings 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Request for information. 

SUMMARY: This document is a request for 

information regarding hospital 

outpatient surgery departments (HOSDs) 

and ambulatory surgery centers (ASCs), 

as well as patient-reported outcomes 

from surgeries or other procedures 

performed in these settings. 

DATES: The information solicited in this 

notice must be received at the address 

provided below by March 26, 2013. 

ADDRESSES: In responding to this 

solicitation, please reply via email to 

AmbSurgSurvey@cms.hhs.gov or by 

postal mail at Centers for Medicare and 

Medicaid Services, Attention: Memuna 

Ifederah, Mailstop C1–25–05, 7500 

Security Boulevard, Baltimore, MD 

21244–1850. 

FOR FURTHER INFORMATION CONTACT: 

Memuna Ifederah, (410) 768–6849 or 

Caren Ginsberg (410) 786–0713. 

SUPPLEMENTARY INFORMATION: 

I. Background 

In accordance with section 3011 of 

the Affordable Care Act, the Department 

of Health and Human Services (HHS) 

developed the National Quality Strategy 

to create national aims and priorities to 

guide local, state, and national efforts to 

improve the quality of health care. The 

National Quality Strategy established 

three aims supported by six priorities. 

The 3 aims are as follows: 

• Better Care: Improve the overall 

quality, by making health care more 

patient-centered, reliable, accessible, 

and safe. 

• Healthy People/Healthy 

Communities: Improve the health of the 

U.S. population by supporting proven 

interventions to address behavioral, 

social, and environmental determinants 

of health in addition to delivering 

higher quality care. 

• Affordable Care: Reduce the cost of 

quality health care for individuals, 

families, employers, and government.1

The six priorities are: ‘‘(1) Making 

care safer by reducing harm caused by 

the delivery of care; (2) ensuring that 

each person and family are engaged as 

partners in their care; (3) promoting 

effective communication and 

coordination of care; (4) promoting the 

most effective prevention and treatment 

practices for the leading causes of 

mortality, starting with cardiovascular 

disease; (5) working with communities 

to promote wide use of best practices to 

enable health living; and (6) making 

quality care more affordable for 

individuals, families, employers and 

governments by developing and 

spreading new health care delivery 

models’’. 

Surveys focusing on the patient 

experience as well as the Hospital 

Outpatient Surgery Department/ 

mstockstill on DSK4VPTVN1PROD with