Evaluation and Development of Outcome Measures for Quality Assessment in Medicare Advantage and Special Needs Plans

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10451 Amended CAHPS Survey	Form and Instruction	New	Repair queued
Form CMS-10451 Abstracting Information from Medical Records	Form and Instruction	New	Available
CMS-10451.Supporting Statement Part B & Instruments.pdf	Supporting Statement B	Uploaded 2013-03-04	Available
CMS-10451.Matrix Response to Comments.docx	Supplementary Document	Uploaded 2013-03-04	Available
CMS-10451.Supporting Statement Part A.pdf	Supporting Statement A	Uploaded 2013-03-04	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
206084	Amended CAHPS Survey	Form and Instruction	New
206083	Abstracting Information from Medical Records	Form and Instruction	New

ICR Details

OMB Control No: 0938-1200	ICR Reference No: 201303-0938-007
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No: 19062
Title: Evaluation and Development of Outcome Measures for Quality Assessment in Medicare Advantage and Special Needs Plans
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: 06/10/2013
	Date Received in OIRA: 03/08/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2016	36 Months From Approved
Responses	2,720	0	0
Time Burden (Hours)	1,540	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Quality improvement is a major initiative for the Centers for Medicare and Medicaid Services (CMS). With the passing of the Patient Protection and Affordable Care Act in March 2010, there is a focused interest in providing quality and value-based healthcare for Medicare beneficiaries. It is critical to develop criteria not only for quality improvement but also as a means for beneficiaries to compare healthcare plans to make the choice that is right for them. Process of care measures are needed that focus on the care needs of Medicare beneficiaries, such as factors affecting continuity of care and transitions. CMS seeks also to expand its quality improvement efforts from collection of structure and process measures to outcome measures. The development and subsequent implementation of outcome measures appropriate for programs serving older and/or disabled patients is especially important for ensuring that these beneficiaries obtain high quality healthcare. This request is for data collection to test the use of new tools available to CMS to measure care pertinent to vulnerable beneficiaries where quality of care provided by Medicare Advantage Organizations (MAOs) should be closely monitored. The measures to be evaluated and developed upon approval of this request relate to (1) continuity of information and care from hospital discharge to the outpatient setting, (2) continuity between mental health provider and primary care provider (PCP), and (3) items that may be added to the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey addressing language centered care, cultural competence, physical activity, healthy eating, and caregiver strain.

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Authorizing Statute(s): US Code: 42 USC 1395w-22 Name of Law: Benefits and Beneficiary Protections
  

Citations for New Statutory Requirements: US Code: 42 USC 1395w-22 Name of Law: Benefits and Beneficiary Protections

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 65391	10/26/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 13058	02/26/2013
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Abstracting Information from Medical Records	CMS-10451	Instruments
Amended CAHPS Survey	CMS-10451	Instruments

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ICR Summary of Burden

table that charts list 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	2,720	0	2,720	0	0	0
Annual Time Burden (Hours)	1,540	0	1,540	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: This is a new information collection request.

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Annual Cost to Federal Government: $109,492

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

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Common Form ICR:  No

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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: 03/08/2013

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