86650 Federal Register / Vol. 88, No. 239 / Thursday, December 14, 2023 / Notices 

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. 

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 www.reginfo.gov/public/do/ 

PRAMain. 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 doris.lefkowitz@AHRQ.hhs.gov. 

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 socioeconomic characteristics, employment, 

access to care, and satisfaction with 

health care. 

Proposed Changes for the Fall 2024 

MEPS–HC: 

• Core MEPS Interview—Seven 

economic burden questions will be 

added to the Core interview. Five of 

these questions come from the 

Preventive Care Services SelfAdministered 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. 

• Preventive Care Services SelfAdministered Questionnaire (PSAQ)— 

The PSAQ will have the following 

changes for Fall 2024: 

• Removing five economic burden 

questions, which will be added to the 

Core interview; 

• Combining the Male and Female 

PSAQ questionnaires into a single 

questionnaire and revising the sexspecific questions accordingly; 

• Adding Sexual Orientation and 

Gender Identity (SOGI) questions to the 

end of the questionnaire; 

• Changing the age-specific skips to 

reflect new recommendations for 

specific preventive health screening 

procedures; 

• 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 penand-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. 

• 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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Federal Register / Vol. 88, No. 239 / Thursday, December 14, 2023 / Notices 86651 

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 selfadministered 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

Form name Number of 

respondents 

Number of 

responses per 

respondent 

Hours per 

response 

Total burden 

hours 

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 Provider and Pharmacy Survey ......................................................................................................... 11,750 4.66 3/60 2,738 

MEPS Validation Interview ....................................................................... 4,225 1 5/60 352 

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-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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86652 Federal Register / Vol. 88, No. 239 / Thursday, December 14, 2023 / Notices 

EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS—Continued 

Form name Number of 

respondents 

Number of 

responses per 

respondent 

Hours per 

response 

Total burden 

hours 

Pharmacies Event Form ........................................................................... 9,079 37.6 3/60 17,068 

Subtotal for the MEPS–MPC ............................................................. 100,783 ........................ ........................ 29,111 

Grand Total ................................................................................ 142,383 ........................ ........................ 76,498 

* 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

Form name Number of 

respondents 

Total burden 

hours 

Average 

hourly wage 

rate 

Total cost 

burden 

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 Provider and Pharmacy Survey ......................................................................................................... 11,750 2,738 29.76 * 81,483 

MEPS Validation Interview ....................................................................... 4,225 352 29.76 * 10,475 

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-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 

* 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 

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. 

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 

‘‘TeamSTEPPS® 3.0 Training 

Assessment.’’ This proposed 

information collection was previously 

published in the Federal Register on 


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