Federal Register / Vol. 76, No. 144 / Wednesday, July 27, 2011 / Notices 44929 

EXHIBIT 3—ESTIMATED TOTAL AND ANNUALIZED COST—Continued 

Cost component Total cost Annualized 

cost 

Project Management ................................................................................................................................................ 164,552 41,138 

Total Costs ....................................................................................................................................................... 439,552 109,888 

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 healthcare 

research and healthcare 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: July 13, 2011. 

Carolyn M. Clancy, 

Director. 

[FR Doc. 2011–18789 Filed 7–26–11; 8:45 am] 

BILLING CODE 4160–90–M 

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: 

‘‘Evaluation of ARRA Comparative 

Effectiveness Research Dissemination 

Contractor Efforts.’’ In accordance with 

the Paperwork Reduction Act, 44 U.S.C. 

3501–3521, AHRQ invites the public to 

comment on this proposed information 

collection. 

DATES: Comments on this notice must be 

received by September 26, 2011. 

ADDRESSES: Written comments should 

be submitted to: Doris Lefkowitz, 

Reports Clearance Officer, AHRQ, by email at doris.lefkowitz@AHRQ.hhs.gov. 

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 

e-mail at 

doris.lefkowitz@AHRQ.hhs.gov. 

SUPPLEMENTARY INFORMATION: 

Proposed Project 

Evaluation of ARRA Comparative 

Effectiveness Research Dissemination 

Contractor Efforts 

Today, both patients and their health 

care providers have many options when 

deciding on a treatment plan. 

Information available to patients and 

their health care providers offers great 

opportunities for informed decision 

making. However, the volume of 

information that needs to be reviewed 

and synthesized can be daunting. To 

complicate matters, studies may offer 

conflicting information or have a 

conflict of interest (e.g., research 

sponsored by pharmaceutical 

companies that make drugs). Sorting 

through conflicting information requires 

a background in research that most 

patients do not have, and physicians 

have limited time to conduct these 

reviews. Having a neutral third party 

review research, draw conclusions, and 

disseminate findings is necessary to 

ensure effective health care delivery and 

consumption of quality care. 

AHRQ recognizes the need to fill this 

gap and has taken a lead role in 

developing mechanisms for reviewing 

and disseminating Comparative 

Effectiveness Research (CER) and 

findings to clinicians, health care 

decision makers, purchasers/business 

decision makers, and consumers 

through its Effective Healthcare Program 

(EHCP). CER directly compares the 

benefits, potential risks, and costs of 

two or more health care interventions. 

These direct comparisons allow 

assessments of how well a health care 

treatment or intervention works under 

real-world conditions. AHRQ has paid 

careful attention not only to how studies 

are conducted but also to how results 

are communicated to its audiences. 

To augment AHRQ’s existing CER 

dissemination efforts performed by the 

Eisenberg Center and other initiatives, 

AHRQ is conducting four one-time 

projects to test other ways to 

disseminate CER results. These four 

related projects will test new 

approaches to CER dissemination and 

promote awareness of the EHCP. 

Collectively, dissemination efforts will 

reach AHRQ’s priority audiences of: 

clinical decision makers, health care 

system decision makers, purchasers/ 

business decision makers, public policy 

decision makers, and consumers/ 

patients. 

Through these four projects AHRQ 

aims to: (1) Educate professional and 

consumer audiences about CER; (2) 

inform professional and consumer 

audiences about AHRQ’s EHCP; (3) and 

inform a wide range of audiences about 

new EHCP research findings. 

This project will evaluate the 

effectiveness of these four new 

dissemination efforts. The evaluation 

has four main goals: 

1. Assess the effectiveness of the four 

dissemination strategies in creating 

awareness of CER, specific CER topics, 

and the EHCP. 

2. Assess the effectiveness of the four 

dissemination strategies in fostering 

knowledge and understanding of CER 

finding, specific CER topics, and the 

EHCP. 

3. Assess the effectiveness of the four 

dissemination strategies in promoting 

utilization, including use of the EHCP 

materials by consumers and by 

clinicians in patient care and if usage by 

clinicians is increasing across time. 

4. Assess the effectiveness of the four 

dissemination strategies in supporting 

the benefits of using CER, and specific 

CER topics, for both patients and health 

care providers. 

This study is being conducted by 

AHRQ through its contractor, IMPAQ 


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44930 Federal Register / Vol. 76, No. 144 / Wednesday, July 27, 2011 / Notices 

International, LLC and its subcontractor, 

Battelle Memorial Institute, 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 

quality, effectiveness, efficiency, 

appropriateness and value of healthcare 

services and with respect to clinical 

practice, including primary care and 

practice-oriented research. 42 U.S.C. 

299a(a)(1) and (4). 

Method of Collection 

To achieve project goals the following 

data collections will be implemented, 

each of which apply to all of the abovestated goals: 

1. Clinician Survey—Conduct three 

cross-sectional mail surveys with 

clinicians to measure awareness, 

understanding, use of the EHCP 

materials, and benefits of CER. 

Collecting survey data at multiple time 

points is critical to assess trends in the 

outcomes of interest among clinicians 

and the impact of ongoing and increased 

dissemination contractor activities. 

Three data points for the survey will 

allow us to test if the proportion of 

clinicians aware of CER and the 

Effective Healthcare Program is 

changing over time and if the rate of 

change is changing. The Survey will be 

administered at the end of years 1, 3 and 

4; the burden for the year 4 data 

collection is not included in the 

estimates in Exhibits 1 and 2 since it 

will be included in a second OMB 

clearance package to be submitted after 

year 3. 

2. Consumer/Patient Survey— 

Conduct two cross-sectional telephone 

surveys with consumers/patients to 

measure awareness, understanding, use 

of the EHCP materials, and benefits of 

CER. Collecting survey data at multiple 

time points is critical to assess trends in 

the outcomes of interest among 

consumers/patients and the impact of 

ongoing and increased dissemination 

contractor activities. Two data points for 

the survey will allow us to test if the 

proportion of consumers/patients aware 

of CER and the Effective Healthcare 

Program is changing over time. The 

Survey will be administered at the end 

of years 1 and 3. A short screener 

questionnaire will be used to identify 

eligible respondents. 

3. Health System Decision Maker 

Survey—Conduct one cross-sectional 

telephone survey with health care 

system decision makers to measure 

awareness, understanding, use of the 

EHCP materials, and benefits of CER. 

The questionnaire and respondent 

materials for this data collection are not 

included in this submission since it 

occurs in year 4 of the project and have 

not yet been developed. These materials 

will be submitted in another OMB 

clearance package in year 3 of this 

project. This data collection is 

mentioned here in order to provide an 

overview of the entire 5 years of the 

project; it is not included in the burden 

estimates in Exhibits 1 and 2. 

4. Clinician Focus Groups—Conduct 

six follow-up focus groups with 

clinicians after the first and third crosssectional surveys of this audience, The 

focus groups will be conducted with 

three clinician segments: (1) Those who 

report awareness of CER and have selfreported use of CER in their clinical 

practice; (2) those who report awareness 

of CER and have self-reported non-use 

of CER in their clinical practice; and (3) 

those who report no awareness of CER. 

One moderator guide will be used for 

each focus group. By asking the same 

questions to each clinician segment, 

who will have been targeted by all four 

dissemination contractors, differences 

among answers are more likely to be 

attributed to the segmentation criteria 

and eliminate bias through different 

questions. Two focus groups will be 

conducted for each of the three 

segments. The clinician focus groups 

will be conducted by telephone. The 

focus groups will be administered at the 

end of year 2 and during year 5; the 

burden for the year 5 data collection is 

not included in the estimates in Exhibits 

1 and 2 since it will be included in a 

second OMB clearance package to be 

submitted after year 3. 

5. Consumer/Patients Focus Groups— 

Conduct twelve follow-up focus groups 

with consumers/patients after the first 

cross-sectional survey of this audience, 

at the end of year 2 of the project. The 

focus groups will be conducted with 

three consumer/patient segments: (1) 

Those who report awareness of CER and 

have self-reported use of CER in medical 

decision making; (2) those who report 

awareness of CER and have self-reported 

non-use of CER in medical decision 

making; and (3) those who report no 

awareness of CER. Four focus groups 

will be conducted for each of the three 

segments. A single screening 

questionnaire will be used to recruit 

participants. The consumer/patient 

focus groups will be conducted by 

telephone. 

6. Health System Decision Maker 

Focus Groups—Conduct twelve followup focus groups with health care system 

decision makers, after the crosssectional survey of this audience. The 

focus groups will be conducted with 

three decision maker segments: (1) 

Those who reported awareness of CER 

and have self-reported use of CER in 

business decision making; (2) those who 

reported awareness of CER and have 

self-reported non-use of CER in business 

decision making; and (3) those who 

report no awareness of CER. Four focus 

groups will be conducted for each of the 

three segments. The focus groups will 

be conducted by telephone. The 

screener, moderator guides, and 

respondent materials for this data 

collection are not included in this 

submission since it occurs in year 5 of 

the project and have not yet been 

developed. These materials will be 

submitted in another OMB clearance 

package in year 3 of this project. This 

data collection is mentioned here in 

order to provide an overview of the 

entire 5 years of the project; it is not 

included in the burden estimates in 

Exhibits 1 and 2. 

7. Semi-structured Interviews— 

Conduct semi-structured interviews, in 

year 3 of the project, with 20 

individuals in each of the following 

groups: health care system decision 

makers, purchasers, and policymakers 

for a total of 60 interviews. In-depth 

interviews will be used to determine 

how people receive and interpret CERrelated materials and verbal 

information, and adopt new behaviors 

based on information they receive. 

AHRQ will use the survey, focus 

group, and in-depth interview data to 

assess trends and the effectiveness of 

the four complementary and different 

dissemination methods to inform 

current and future dissemination of the 

EHCP. Specific attention will be given 

to changes in audience awareness, 

understanding, behavior change/use, 

and benefits of CER. Collecting data at 

multiple times will enable AHRQ to 

determine whether increased 

dissemination contractors’ activities 

over time is associated with any change 

in CER awareness, knowledge, use, or 

benefit. Finally, collecting data from 

five audiences (i.e., clinicians, 

consumers/patients, health system 

decision makers, purchasers, and policy 

makers) will enable AHRQ to assess the 

effectiveness of its CER-related 

dissemination efforts among its target 

populations. 

Estimated Annual Respondent Burden 

Exhibit 1 shows the estimated 

annualized burden hours for the 

respondent’s time to participate in this 

evaluation. The total burden hours are 

estimated to be 3,760. 

Clinician Surveys: The design for the 

clinician survey consists of three cross 

sectional waves (only 2 of which are 

included in the estimates here, as 

explained in section 1), each wave 

having 1,926 respondents for a total of 


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Federal Register / Vol. 76, No. 144 / Wednesday, July 27, 2011 / Notices 44931 

3,852 across the two waves included in 

this information collection request. The 

survey will take no longer than 20 

minutes to complete. 

Consumer/Patient Surveys: The 

design for the consumer/patient survey 

consists of two cross-sectional waves, 

each wave having 1,000 respondents for 

a total of 2,000 across both waves. The 

screener will take no longer than 5 

minutes to complete. The survey will 

take no longer than 20 minutes to 

complete. 

Clinician Focus Groups: Six follow-up 

focus groups with clinicians will be 

conducted by telephone twice; once 

after the first and again after the third 

cross-sectional surveys of this audience 

(only one of which is included in the 

estimates here, as explained in section 

1). Focus group participants will have 

completed the survey and will have 

expressed interest in participating in a 

telephone focus group. For each of the 

two rounds of focus groups, twelve 

clinicians will be recruited for each of 

six focus groups. 

Focus groups will last one hour. 

Consumer/Patient Focus Groups: 

Twelve follow-up focus groups with 

consumer/patients will be conducted by 

telephone after the first cross-sectional 

survey of this audience. Focus group 

participants will have completed the 

survey and will have expressed interest 

in participating in a telephone focus 

group. Eight people will be in each 

focus group. The screener will take no 

longer than 5 minutes to complete. 

Focus group will last approximately 90 

minutes. 

In-Depth Interviews with Other Key 

Audiences: In-depth interviews will be 

conducted with up to 20 representatives 

in each of three key audiences: (1) 

Health care system decision makers, (2) 

purchasers, and (3) policy makers. 

Respondents located in the metropolitan 

Washington, DC/Baltimore area will be 

interviewed in person, and respondents 

located outside the local area will be 

interviewed by telephone. Participant 

recruitment should take no longer than 

five minutes. The interviews will last 

one hour. 

The estimated annualized cost burden 

associated with the respondent’s time to 

participate in this evaluation is shown 

in Exhibit 2. The total cost burden is 

estimated to be $144,266. 

EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS

Data Collection Activity Number of 

respondents 

Number of 

responses per 

respondent 

Hours per 

response 

Total burden 

hours 

Clinician Survey ............................................................................................... 3,852 1 20/60 1,284 

Consumer/Patient Survey Screener ................................................................ 2560 1 5/60 214 

Survey .............................................................................................................. 2000 1 20/60 667 

Clinician Focus Groups ................................................................................... 72 1 60/60 72 

Consumer/Patient Focus Groups Screener ..................................................... 120 1 5/60 10 

Focus Group .................................................................................................... 96 1 90/60 144 

Semi-structured Interviews with Health System Decision Makers .................. 20 1 60/60 20 

Semi-structured Interviews with Purchasers ................................................... 20 1 60/60 20 

Semi-structured Interviews with Policymakers ................................................ 20 1 60/60 20 

Total .......................................................................................................... 8,760 n/a n/a 2,451 

EXHIBIT 2: ESTIMATED ANNUALIZED COST BURDEN

Data Collection Activity Number of 

respondents 

Total burden 

hours 

Average 

hourly wage 

rate* 

Total cost 

burden 

Clinician Survey ............................................................................................... 3,852 1,284 $88.46 $113,583 

Consumer/Patient Survey Screener ................................................................ 2560 214 20.90 4,473 

Survey .............................................................................................................. 2000 667 20.90 13,940 

Clinician Focus Groups ................................................................................... 72 72 88.46 6,369 

Consumer/Patient Focus Groups Screener ..................................................... 120 10 20.90 209 

Focus Groups .................................................................................................. 96 144 20.90 3,010 

Semi-structured Interviews with Health System Decision Makers .................. 20 20 43.74 875 

Semi-structured Interviews with Purchasers ................................................... 20 20 46.59 932 

Semi-structured Interviews with Policymakers ................................................ 20 20 43.74 875 

Total .......................................................................................................... 8,760 2,451 n/a 144,266 

* Based upon the mean of the average wages, National Compensation Survey: Occupational wages in the United States May 2009, ‘‘U.S. Department of Labor, Bureau of Labor Statistics.’’ Hourly wage rates for clinicians were estimated using the mean wage for internists (occupation 

code 29–1063). Hourly wage rates for consumers/patients were estimated using the mean wage for all occupations (occupation code 00–0000) 

since participants in the consumer groups may have a wide range of jobs and occupations. Hourly wage rates for health system decision makers 

and policymakers were estimated using the mean wage for medical and health services managers (occupation code 11–9111). Hourly wage 

rates for purchasers were estimated using the mean wage for purchasing managers (occupation code 11–3061). These rates were obtained in 

January 2011 at the following Web site: http://www.bls.gov/oes/current/oes_nat.htm#b29–0000. 

Estimated Annual Costs to the Federal 

Government 

The total cost to the Government for 

this information collection is $2,719,272 

over the five years of the project. Exhibit 

3 provides a breakdown of these costs. 


sroberts on DSK5SPTVN1PROD with NOTICES
44932 Federal Register / Vol. 76, No. 144 / Wednesday, July 27, 2011 / Notices 

EXHIBIT 3—ESTIMATED TOTAL AND ANNUALIZED COST

Cost Component Total cost Annualized 

cost 

Project Development ....................................................................................................................................................... $420,055 $84,011 

Data Collection Activities ................................................................................................................................................. 1,452,290 290,458 

Data Processing and Analysis, and Reports to AHRQ ................................................................................................... 141,637 28,327 

Project Management ........................................................................................................................................................ 291,706 58,341 

Overhead ......................................................................................................................................................................... 413,584 82,717 

Total .......................................................................................................................................................................... 2,719,272 543,854 

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 healthcare 

research and healthcare 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: July 6, 2011. 

Carolyn M. Clancy, 

Director. 

[FR Doc. 2011–18790 Filed 7–26–11; 8:45 am] 

BILLING CODE 4160–90–M 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Meeting of the National Advisory 

Council Subcommittee Identifying 

Quality Measures for Medicaid Eligible 

Adults 

AGENCY: Agency for Healthcare Research 

and Quality (AHRQ). 

ACTION: Notice of public meeting. 

SUMMARY: This notice announces a 

meeting of a Subcommittee of the 

National Advisory Council for 

Healthcare Research and Quality. 

DATES: The meeting will be held on 

Tuesday, August 9th from 10 a.m. to 6 

p.m., and Wednesday, August 10th from 

9 a.m. to 3 p.m. 

ADDRESSES: The meeting will be held at 

the Westin Washington, DC City Center, 

1400 M Street, NW., Washington DC. 

FOR FURTHER INFORMATION CONTACT: 

Nancy Wilson, MD MPH, Coordinator of 

the National Advisory Council 

Subcommittee Identifying Quality 

Measures for Medicaid Eligible Adults 

at the Agency for Healthcare Research 

and Quality, 540 Gaither Road, 

Rockville, Maryland, 20850, (301) 427– 

1310. For press-related information, 

please contact Karen Migdail at (301) 

427–1855. 

If sign language interpretation or other 

reasonable accommodation for a 

disability is needed, please contact the 

Food and Drug Administration (FDA) 

Office of Equal Employment 

Opportunity and Diversity Management 

on (301) 827–4840, no later than August 

1, 2011. The agenda, roster, and meeting 

report will be available from Dr. Wilson. 

SUPPLEMENTARY INFORMATION: 

I. Purpose of the National Advisory 

Council Subcommittee Identifying 

Quality Measures for Medicaid Eligible 

Adults 

The purpose of the National Advisory 

Council Subcommittee Identifying 

Quality Measures for Medicaid Eligible 

Adults is to develop consensus on a 

core set of health quality measures for 

Medicaid-eligible adults. While a 

number of current efforts to assess, 

publicly report, and improve quality of 

care include Medicaid eligible adults, 

this core set of measures will reflect 

aspects of care particularly important to 

Medicaid recipients that are not 

currently assessed consistently and 

routinely. 

Section 2701 of the Affordable Care 

Act (ACA), which added Section 1139B 

to Title XI of the Social Security Act, 

requires the Secretary of Health and 

Human Services to identify and publish 

a recommended core set of health 

quality measures for Medicaid eligible 

adults. AHRQ and the Centers for 

Medicare and Medicaid Services (CMS) 

have entered into an interagency 

agreement to collaboratively identify 

these measures. Section 2701 also 

requires the Secretary, in consultation 

with States, to develop a standardized 

format for reporting information and to 

develop procedures that encourage 

voluntary reporting based on the initial 

core set of measures. The Secretary is 

also required to establish a Medicaid 

Quality Measurement Program that will 

fund the development, testing, and 

validation of emerging and innovative 

evidence-based measures and to 

subsequently publish recommended 

changes to the initial core measure set. 

Not later than September 30, 2014 and 

annually thereafter the Secretary is 

required to collect, analyze, and make 

publically available the information 

reported by the States. 

The National Advisory Council 

Subcommittee Identifying Quality 

Measures for Medicaid Eligible Adults 

met on October 18th and 19th 2010, and 

identified an initial core set of 

measures. These measures were 

subsequently posted in the Federal 

Register for a two month public 

comment period. This initial core set of 

measures must be finalized by January 

1, 2012. 

The purpose of the National Advisory 

Council Subcommittee Identifying 

Quality Measures for Medicaid Eligible 

Adults is to: (a) Review the public 

comment analysis, (b) determine and 

apply criteria by which the initial list is 

further refined, and (c) make 

recommendations to the National 

Advisory Council regarding finalizing 

the initial core set of measures. The 

National Advisory Council 

Subcommittee Identifying Quality 

Measures for Medicaid Eligible Adults 

membership will reflect expertise in 

healthcare quality measurement, 

healthcare disparities, and in the 

populations eligible for Medicaid. 

Elizabeth McGlynn, PhD, Director, 

Kaiser Permanente Center for 

Effectiveness & Safety Research, and 

Foster Gesten, M.D., Medical Director of 


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