Federal Register / Vol. 89, No. 239 / Thursday, December 12, 2024 / Notices 100497 

highest-level owner of the space, 

including any financing entity, and 

disclose whether that owner is a foreign 

person or entity, including the country 

associated with the ownership entity. 

This information collection covers 

GSA’s implementation of the Act 

through GSAR clause 552.270–33. As 

this information is still required, GSA 

seeks to have this information collection 

extended for three years. 

B. Annual Reporting Burden 

The annual reporting burden is 

estimated as follows: 

1. Initial Disclosure 

Baseline Representation 

Estimated annual responses: 542. 

Estimated hours per response: 2. 

Additional Representation 

Estimated annual responses: 54. 

Estimated hours per response: 10. 

Total Initial Response Burden Hours: 

1,624. 

2. Annual Updates 

Estimated annual responses: 542. 

Estimated hours per response: 0.50. 

Total Update Response Burden Hours: 

271. 

C. Public Comments 

A 60-day notice published in the 

Federal Register at 89 FR 78305 on 

September 25, 2024. No public 

comments were received. 

Jeffrey A. Koses, 

Senior Procurement Executive, Office of 

Acquisition Policy, Office of Governmentwide Policy. 

[FR Doc. 2024–29130 Filed 12–11–24; 8:45 am] 

BILLING CODE 6820–61–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Request for Information Regarding 

Diagnostic Excellence Measurement 

AGENCY: Agency for Healthcare Research 

and Quality, Department of Health and 

Human Services. 

ACTION: Notice of Request for 

Information (RFI) regarding diagnostic 

excellence measurement. 

SUMMARY: The Agency for Healthcare 

Research and Quality (AHRQ) invites 

public comment in response to this 

Request for Information (RFI) on the 

development of measures of diagnostic 

excellence that may be calculated using 

administrative data or electronic health 

record (EHR) data. The purpose of 

diagnostic excellence measurement is to 

identify potential opportunities to 

improve the diagnostic process at a 

health system or geographic level. 

AHRQ welcomes comments on the 

importance and usability of existing 

measures and those that may be under 

development. 

DATES: Comments on this notice must be 

received by February 13, 2025. 

ADDRESSES: Interested parties may 

submit comments electronically to 

qisupport@ahrq.hhs.gov with the 

subject line ‘‘Diagnostic Excellence 

Measurement.’’ 

FOR FURTHER INFORMATION CONTACT: 

Questions may be addressed to Judy 

George, judy.george@ahrq.hhs.gov, (301) 

427–1717. 

SUPPLEMENTARY INFORMATION: The 

COVID–19 pandemic led to disruptions 

in healthcare service delivery and 

reversed some of the gains made in 

patient safety over the previous two 

decades. In 2024, AHRQ on behalf of 

HHS, officially launched the National 

Action Alliance for Patient and 

Workforce Safety (https://

www.ahrq.gov/action-alliance/ 

index.html), a collaboration between 

public and private partners to recommit 

to patient and workforce safety and to 

eliminate preventable harm in 

healthcare. Diagnostic safety events are 

an important contributor to patient 

safety, with diagnostic errors potentially 

impacting millions of U.S. residents 

each year (https://

pmc.ncbi.nlm.nih.gov/articles/ 

PMC5502242/). Diagnostic error is ‘‘the 

failure to (a) establish an accurate and 

timely explanation of the patient’s 

health problem(s) or (b) communicate 

that explanation to the patient’’ (https:// 

doi.org/10.17226/21794). However, in 

order to improve patient safety, a focus 

on diagnostic error reduction alone is 

not sufficient. Efforts are needed to 

improve the diagnostic process as a 

whole, with an emphasis on diagnostic 

excellence. 

Diagnostic excellence may be defined 

as ‘‘an optimal process to attain an 

accurate and precise explanation about 

a patient’s condition’’ (https://

jamanetwork.com/journals/jama/articleabstract/2785845). This process should 

be ‘‘timely, cost-effective, convenient, 

and understandable to the patient.’’ 

Diagnostic excellence ‘‘embraces the six 

dimensions of quality enumerated by 

the Institute of Medicine in 2001: care 

that is safe, effective, patient-centered, 

timely, efficient, and equitable’’ (https:// 

jamanetwork.com/journals/jama/articleabstract/2785845). 

Several efforts have been underway to 

develop measures that provide 

information on the state of diagnostic 

excellence, including research funded 

by AHRQ and the Gordon and Betty 

Moore Foundation. The AHRQ Quality 

Indicators (QI) Program develops 

indicators of healthcare quality and 

patient safety in a variety of healthcare 

settings. The QI Program is actively 

engaged in collecting information on 

measures that can contribute to 

diagnostic excellence measurement. 

AHRQ is considering measures that rely 

on administrative claims data (for state 

and regional health departments with 

limited access to clinical data), as well 

as electronic health record data (for 

healthcare systems with full access to 

clinical data). AHRQ aims to address 

gaps in diagnostic excellence 

measurement with a population health 

lens and with the following goals: 

1. Develop a starter set of 

standardized measures to support 

population-level diagnostic excellence 

surveillance. 

2. Generate measures that are 

accessible and applicable across 

different types of users, especially those 

with limited access to clinical data 

sources. 

3. Produce national benchmarks for 

population-level surveillance of 

diagnostic excellence. 

4. Foster healthcare quality 

improvement in the area of diagnostic 

excellence. 

AHRQ requests information from the 

public on existing measures that may be 

used in diagnostic excellence 

measurement and others that may be 

under development. 

Criteria. Diagnostic excellence 

measures should be important, 

scientifically acceptable, feasible, and 

useful. These concepts are defined as 

follows: 

Important. (1) There is evidence 

linking the measure to important 

outcomes (including either process 

outcomes or clinical outcomes); (2) 

there is evidence of inequalities across 

groups or opportunity for improvement 

on that measure; or (3) the target 

population of the measure (e.g., 

patients) or users of the measure (e.g., 

researchers, providers) value the 

measurement and find it meaningful. 

Scientifically acceptable. A 

scientifically acceptable measure is both 

(1) valid (the measure accurately 

represents the concept it is trying to 

measure) and (2) reliable (the measure 

consistently produces the same result 

over time and in different contexts). 

Feasible. A measure is feasible if it is 

possible to implement with existing 

data systems and clinical processes. 


ddrumheller on DSK120RN23PROD with NOTICES1
100498 Federal Register / Vol. 89, No. 239 / Thursday, December 12, 2024 / Notices 

Useful. A measure is useful if it 

provides information useful for quality 

improvement programs, with the ability 

to capture variation in performance 

across reporting entities. 

Additional Considerations. In 

addition to the criteria listed above, 

AHRQ aims to consider the extent to 

which measures: 

• Identify an important gap in 

diagnostic performance; 

• Contribute to the solution of a 

diagnostic safety problem; 

• Are broadly applicable to a 

population-level diagnostic safety 

opportunity; 

• Could be used to lessen health 

disparities. 

AHRQ requests responses to the 

following questions: 

1. Are you currently working on any 

initiatives related to diagnostic 

excellence, diagnostic safety, or 

diagnostic quality? If so, please 

describe. If you are working on 

diagnostic excellence initiatives, which 

ones would benefit from publicly 

available measurement tools or 

resources? Are there specific resources 

that you would like to see from AHRQ? 

If so, please describe. 

2. If you are currently measuring 

diagnostic excellence in your 

organization, what measure(s) are you 

using? How do you use these measures 

(e.g., for quality improvement efforts, to 

track population health) and what 

motivated the use of such measures? 

What data sources are you using? What 

data model are you using to map data 

to standardized concepts (e.g., 

Observational Medical Outcomes 

Partnership (OMOP) Common Data 

Model, others)? Please specify your 

organization type (e.g., state/local health 

department, professional society, 

healthcare system, research 

organization, etc.) in your answer. 

3. If you or your organization are not 

currently measuring diagnostic 

excellence, what diagnostic excellence 

measures might be helpful to your 

organization? Please specify your 

organization type in your answer. 

4. If standardized measures with 

national benchmarks were made 

available through software by AHRQ, 

how likely would you be to use them? 

What characteristics (e.g., risk 

adjustment, frequency counts) or 

features (e.g., statistical programming 

languages, data model platforms, 

technology [web or cloud-based 

applications]) of such measures would 

facilitate their use and usefulness 

within your organization? 

5. AHRQ is considering the diagnostic 

excellence-related measures listed here: 

https://bit.ly/41mg3i6. We invite 

comments on: 

a. The extent to which these measures 

meet the ‘‘Criteria’’ listed above; and 

b. The extent to which these measures 

address the ‘‘Additional 

Considerations’’ listed above. 

6. AHRQ invites any additional 

comments related to potential AHRQ 

measures of diagnostic excellence. 

AHRQ is interested in all of the 

questions listed above, but respondents 

are welcome to address as many or as 

few as they choose and to address 

additional areas of interest not listed. It 

is helpful to identify the question to 

which a particular answer corresponds. 

This RFI is for planning purposes 

only and should not be construed as a 

policy, solicitation for applications, or 

as an obligation on the part of the 

Government to provide support for any 

ideas in response to it. AHRQ will use 

the information submitted in response 

toto this RFI at its discretion and will 

not provide comments to any 

respondent’s submission. However, 

responses to this RFI may be reflected 

in future solicitation(s) or policies. The 

information provided will be analyzed 

and may appear in reports. 

Dated: December 6, 2024. 

Marquita Cullom, 

Associate Director. 

[FR Doc. 2024–29134 Filed 12–11–24; 8:45 am] 

BILLING CODE P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–3461–FN] 

Medicare and Medicaid Programs; 

Approval of Application by the 

Accreditation Association for 

Ambulatory Healthcare for Continued 

CMS-Approval of Its Ambulatory 

Surgical Center Accreditation Program 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice. 

SUMMARY: This notice acknowledges the 

approval of an application by the 

Accreditation Association for 

Ambulatory Healthcare for continued 

recognition as a national accrediting 

organization for Ambulatory Surgical 

Centers that wish to participate in the 

Medicare or Medicaid programs. 

DATES: The decision announced in this 

notice is applicable November 20, 2024 

through November 20, 2029. 

FOR FURTHER INFORMATION CONTACT: 

Joy Webb, (410) 786–1667. 

Joann Fitzell, (410) 786–4280. 

SUPPLEMENTARY INFORMATION: 

I. Background 

Ambulatory Surgical Centers (ASCs) 

are distinct entities that operate 

exclusively for the purpose of 

furnishing outpatient surgical services 

to patients. Under the Medicare 

program, eligible beneficiaries may 

receive covered services from an ASC 

provided certain requirements are met. 

Section 1832(a)(2)(F)(i) of the Social 

Security Act (the Act) establishes 

distinct criteria for a facility seeking 

designation as an ASC. Regulations 

concerning provider agreements are at 

42 CFR part 489, and those pertaining 

to activities relating to the survey and 

certification of facilities are at 42 CFR 

part 488. The regulations at 42 CFR part 

416 specify the conditions that an ASC 

must meet in order to participate in the 

Medicare program, the scope of covered 

services, and the conditions for 

Medicare payment for ASCs. 

Generally, to enter into an agreement, 

an ASC must first be certified by a state 

survey agency (SA) as complying with 

the conditions or requirements set forth 

in part 416 of our Medicare regulations. 

Thereafter, the ASC is subject to regular 

surveys by an SA to determine whether 

it continues to meet these requirements. 

Section 1865(a)(1) of the Act provides 

that, if a provider entity demonstrates 

through accreditation by a Centers for 

Medicare & Medicaid Services (CMS) 

approved national accrediting 

organization (AO) that all applicable 

Medicare conditions are met or 

exceeded, we may deem that provider 

entity as having met the requirements. 

Accreditation by an AO is voluntary and 

is not required for Medicare 

participation. 

If an AO is recognized by the 

Secretary of the Department of Health 

and Human Services as having 

standards for accreditation that meet or 

exceed Medicare requirements, any 

provider entity accredited by the 

national accrediting body’s approved 

program may be deemed to meet the 

Medicare conditions. The AO applying 

for approval of its accreditation program 

under part 488, subpart A, must provide 

CMS with reasonable assurance that the 

AO requires the accredited provider 

entities to meet requirements that are at 

least as stringent as the Medicare 

conditions. Our regulations concerning 

the approval of AOs are set forth at 

§ 488.5. 

The Accreditation Association for 

Ambulatory Healthcare’s (AAAHC’s) 

current term of approval for its ASC 

program expires December 20, 2024. 


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