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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0935-0118
ICR Reference No:
201808-0935-001
Status:
Historical Active
Previous ICR Reference No:
201802-0935-002
Agency/Subagency:
HHS/AHRQ
Agency Tracking No:
Title:
Medical Expenditure Panel Survey Household Component and Medical Provider Component (MEPS-HC and MEPS-MPC)
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
11/20/2018
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/14/2018
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
11/30/2021
36 Months From Approved
05/31/2019
Responses
311,519
0
339,044
Time Burden (Hours)
77,666
0
86,702
Cost Burden (Dollars)
0
0
0
Abstract:
Medical Expenditure Panel Survey (MEPS) Household Component (HC) The MEPS provides information about the current state of the health care system as well as to track changes over time. The MEPS permits annual estimates of use of health care and expenditures and sources of payment for that health care. It also permits tracking individual change in employment, income, health insurance and health status over two years. Households selected for participation in the MEPS-HC are interviewed five times in person. Medical Expenditure Panel Survey (MEPS) Medical Provider Component (MPC) For a sample of those who participate in the MEPS HC, the MEPS-MPC contacts medical providers (hospitals, physicians, home health agencies and institutions) identified by household respondents in the MEPS-HC as sources of medical care for the time period covered by the interview, and all pharmacies providing prescription drugs to household members during the covered time period.. Since the previous OMB Clearance request for the MEPS, the MEPS-HC has had a number of changes to the survey instrument itself and the survey administration in an effort to increase data quality, decrease respondent burden and to simplify instrument administration. The current request includes a burden reduction due to a reduction in sample size necessary to accommodate the new NHIS design while maintaining the precision level necessary for MEPS estimates.
Authorizing Statute(s):
US Code:
42 USC 299
Name of Law: Agency for 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:
83 FR 25671
06/04/2018
30-day Notice:
Federal Register Citation:
Citation Date:
83 FR 44877
09/04/2018
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
16
IC Title
Form No.
Form Name
Attachment 20 HC Adult SAQ Female
Attachment 20 , Attachment 19
Attachment 20 HC Adult SAQ Female
,
Attachment 19 HC Adult SAQ Male
3. Veteran SAQ
Attachment 21
Attachment 21 Veteran SAQ
Attachment 19 – HC Adult SAQ – Male
Attachment 19 , Attachment 18
Attachment 19 – HC Adult SAQ – Male
,
Attachment 18 HC Adult SAQ
Authorization form for the MEPS-MPC Pharmacy Survey
Attachment 24
Attachment 24 HC Authorization Form for the MEPS MPC Pharmacy
Authorization form for the MEPS-MPC Provider Survey
Attachment 25
Attachment 25 HC Authorization Form for the MEPS MPC Provider
Diabetes Care SAQ
Attachment 22, Attachment 23
Attachment 22 -- HC Diabetes SAQ - Proxy
,
Attachment 23 -- HC Diabetes SAQ - Self
Home care for health care providers questionnaire
Attachment 78
Attachment 78 – MPC Home Care Provider Questionnaire for Health Care Providers
Home care for non health care providers questionnaire
Attachment 82
Attachment 82 – MPC Home Care Provider Questionnaire for Non-Health Care Providers
Hospitals questionnaire
Attachment 91
Attachment 91 – MPC Hospital Provider Questionnaire
Institutions (non-hospital) questionnaire
Attachment 96
Attachment 96 – MPC Institution Provider Questionnaire
MEPS-HC Core Interview
Attachment 29, Attachment 30 , Attachment 31 , Attachment 32 , Attachment 33 , Attachment 34, Attachment 35 , Attachment 36 , Attachment 37 , Attachment 39 , Attachment 40 , Attachment 41 , Attachment 42 , Attachment 43 , Attachment 44 , Attachment 46 , Attachment 47 , Attachment 48 , Attachment 49 , Attachment 50 , Attachment 51 , Attachment 53 , Attachment 52 HC, Attachment 54 , Attachment 55 , Attachment 56 , Attachment 57 , Attachment 58 , Attachment 59 , Attachment 60 , Attachment 61 , Attachment 62 , Attachment 63 , Attachment 64 , Attachment 65 , Attachment 66 , Attachment 67 , Attachment 68 , Attachment 69 , Attachment 70 , Attachment 71 , Attachment 38 , Attachment 45
Attachment 29 –HC Access to Care Section
,
Attachment 30 – HC Condition Enumeration Section
,
Attachment 31 – Attachment 31 HC Assets Section.
,
Attachment 32 – Attachment 32 HC Calendar Section
,
Attachment 33 Additional healthcare Section
,
Attachment 34 HC Closing Section
,
Attachment 35 HC Start_Restart
,
Attachment 36 HC Charge Payment Section
,
Attachment 37 HC Flat Fee Section
,
Attachment 38 – HC Child Preventive Health Supplement Section
,
Attachment 39 – HC Institutional Care Section
,
Attachment 40 – HC Dental Care Section
,
Attachment 41 – HC Event Driver Section
,
Attachment 42 – HC Employment (EM) Section
,
Attachment 43 – HC Review of Employment Information (RJ) Section
,
Attachment 44 – HC Employment Driver (OE) Section
,
Attachment 45 – HC Employment Wage (EW) Section
,
Attachment 46 – HC Emergency Room Section
,
Attachment 47 Event Roster Section
,
Attachment 48 Health Status Section
,
Attachment 49 HC Help Text
,
Attachment 50 Home Health Section
,
Attachment 51 Health Insurance (HX) Section
,
Attachment 52 HC Private Health Insurance Detail (HP) Section
,
Attachment 53 HC Time Covered Detail (HQ) Section
,
Attachment 54 HC Managed Care (MC) Section
,
Attachment 55 HC Old Employment Health Insurance (OE) Section
,
Attachment 56 HC Old Public Related Insurance (PR) Section
,
Attachment 57 HC Hospital Stay Section
,
Attachment 58 HC Income Section
,
Attachment 59 HC Medical Provider Section
,
Attachment 60 HC Other Medical Expense Section
,
Attachment 61 HC Outpatient Department Section
,
Attachment 62 HC Quality Supplement Section
,
Attachment 63 HC Respondent Forms Section
,
Attachment 64 HC Priority Conditions Enumeration Section
,
Attachment 65 HC Prescribed Medicines Section
,
Attachment 66 HC Provider Probes Section
,
Attachment 67 HC Provider Roster Section
,
Attachment 68 HC Reenumeration Subsection
,
Attachment 69 HC Reenumeration Subsection B
,
Attachment 70 HC RU Information Screener
,
Attachment 71 HC Event Follow Up Section
MEPS-HC Validation Interview
Attachment 26
Attachment 26 HC MEPS Validation Interview
MPC Contact Guide/Screening Call
Attachment 72 , Attachment 73 , Attachment 74 , Attachment 75 , Attachment 76 , Attachment 77
Attachment 72 – MPC Hospital Contact Guide
,
Attachment 73 – MPC Office-Based Doctor Contact Guide
,
Attachment 74 – MPC Home Care Contact
,
Attachment 75 – MPC Institution Contact Guide
,
Attachment 76 – MPC Pharmacy Contact Guide
,
Attachment 77 – MPC Separate Billing Doctor Contact Guide
Medical Organizations Survey Questionaire
9
Attachment 100 – MPC Medical Organizations Survey Draft Questionnaire
Office based providers questionnaire
Attachment 83
Attachment 83 – MPC Office-Based Doctor Provider Questionnaire
Pharmacies questionnaire
Attachment 98
Attachment 98 – MPC Pharmacy Provider Questionnaire
Separately billing doctors questionnaire
Attachment 87
Attachment 87 – MPC Separately Billing Doctor Provider Questionnaire
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
311,519
339,044
0
-21,525
-6,000
0
Annual Time Burden (Hours)
77,666
86,702
0
-7,536
-1,500
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:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
The total estimated annual burden hours for the MEPS have been decreased from 86,702 hours in the previous clearance to 77,666 hours in this clearance request, a decrease of 9,036 hours.
Annual Cost to Federal Government:
$51,382,086
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
Yes
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Yes
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
Agency Contact:
Erwin Brown 301 427-1652 erwin.brown@ahrq.hhs.gov
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:
09/14/2018
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