Health Literacy Item Set Supplemental to CAHPS Health Plan Survey - Pretest of Proposed Questions and Methodology

Forms and Documents

Document	Type	Status	Availability
Form Form #1 CAHPS Health Plan Health Literacy Module	Form and Instruction	New	Available
Supporting Statement Part B -CAHPS Health Plan Health Literacy Project03-14-2011.doc	Supporting Statement B	Uploaded 2011-09-20	Available
Attachment E -- Federal Register Notice.pdf	Supplementary Document	Uploaded 2011-09-20	Available
Attachment A -- Healthcare Research and Quality Act of 1999.pdf	Supplementary Document	Uploaded 2011-09-20	Available
Attachment D -- Pre-NotificationCoverLetters ReminderPCardLetterTelephone Script - English&Spanish.docx	Supplementary Document	Uploaded 2011-09-20	Available
Supporting Statement Part A -Health Lit Item Set Sup to CAHPS Health Plan Survey - Pretest 9-20-2011.doc	Supporting Statement A	Uploaded 2011-09-20	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
199359	CAHPS Health Plan Health Literacy Module	Form and Instruction	New

ICR Details

OMB Control No: 0935-0189	ICR Reference No: 201109-0935-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/AHRQ	Agency Tracking No:
Title: Health Literacy Item Set Supplemental to CAHPS Health Plan Survey - Pretest of Proposed Questions and Methodology
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/30/2011
	Date Received in OIRA: 09/21/2011
Terms of Clearance: AHRQ and OMB agree that when AHRQ is disseminating a tool or instrument to the public which it has pretested and determined to be reliable or useful, it will disseminate information informing potential users about the extent of the testing conducted and the results thereof. With respect to this ICR, AHRQ agrees to disseminate final reports from the contract describing the testing and results of that testing for the health literacy CAHPS supplement. In the future when planning the development of tools or instruments, AHRQ will include documentation and dissemination of the testing of that tool as a key activity and plan to disseminate such information to users.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2012	12 Months From Approved
Responses	1,000	0	0
Time Burden (Hours)	417	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The Consumer Assessment of Healthcare Providers and Systems (CAHPS?) program is a multi-year initiative. AHRQ first launched the program in October 1995 in response to concerns about the lack of good information about the quality of health plans from the enrollees' perspective. Over time, the program has expanded beyond its original focus on health plans to address a range of health care services and to meet the various needs of health care consumers, purchasers, health plans, providers, and policymakers. Based on a literature review and an assessment of currently available questionnaires, AHRQ identified the need to develop a health literacy module for the CAHPS? Health Plan Survey. The intent of the health literacy module is to examine health plan enrollees' perspectives on how well health information is communicated to them by health plans and by healthcare professionals in the health plan setting. The objective of the new module is to provide information to health plans, clinicians, group practices, and other interested parties regarding the quality of health information delivered to patients. The health literacy module will be pre-tested as a supplement to the CAHPS ? Health Plan Survey.

---

Authorizing Statute(s): US Code: 42 USC 299 Name of Law: Healthcare Research and Quality Act of 1999
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 39876	07/07/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 57046	09/15/2011
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
CAHPS Health Plan Health Literacy Module	Form #1, Form #2	CAHPS Health Plan Health Literacy Survey-- English ,   CAHPS Health Plan Health Literacy Survey -Spanish

---

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	1,000	0	0	1,000	0	0
Annual Time Burden (Hours)	417	0	0	417	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Submission of a new ICR.

---

Annual Cost to Federal Government: $299,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/21/2011

---