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Mar 18 -- The National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC), invites the general public and other federal agencies the opportunity to comment on a proposed information collection project titled the National Ambulatory Medical Care Survey (NAMCS). The goal of this project is to assess the health of the population through patient use of physician and advanced practice provider offices and health centers (HCs), and to monitor the characteristics of physician and provider practices. CDC must receive written comments on or before May 17, 2022.

The National Ambulatory Medical Care Survey (NAMCS) was conducted intermittently from 1973 through 1985, and annually since 1989. NAMCS is part of the ambulatory care component of the National Health Care Surveys (NHCS), a family of provider-based surveys that capture health care utilization from a variety of settings, including hospital inpatient and long-term care facilities. NCHS surveys of health care providers include NAMCS, the National Hospital Ambulatory Medical Care Survey (NHAMCS), the National Hospital Care Survey (NHCS), and National Post-acute and Long-term Care Study (NPALS).

An overarching purpose of NAMCS is to meet the needs and demands for statistical information about the provision of ambulatory medical care services in the United States; this fulfills one of NCHS' missions, to monitor the nation's health. In addition, NAMCS provides ambulatory medical care data to study: (1) Performance of the U.S. health care system, (2) care for the rapidly aging population, (3) changes in services such as health insurance coverage change, (4) introduction of new medical technologies, and (5) use of electronic health records (EHRs). Ongoing societal changes have led to considerable diversification in the organization, financing, and technological delivery of ambulatory medical care. This diversification is evidenced by the proliferation of insurance and benefit alternatives for individuals, the development of new forms of physician group practices and practice arrangements (such as office-based practices owned by hospitals), the increasing role of advanced practice providers delivering clinical care, and growth in the number of alternative sites of care.

Ambulatory services are rendered in a wide variety of settings, including physician/provider offices and hospital outpatient and emergency departments. Since more than 65% of ambulatory medical care visits occur in physician offices, NAMCS provides data on the majority of ambulatory medical care services. In addition to health care provided in physician offices and outpatient and emergency departments, health centers (HCs) play an important role in the health care community by providing care to people who might not be able to afford it otherwise. HCs are local, non-profit, community-owned health care settings, which serve approximately 28 million individuals throughout the United States.

This revision seeks approval to conduct changes to all three components of NAMCS. We plan to adjust the HC Component and Provider Interview sample sizes. In 2022 the goal is to sample 5,000 physicians, 5,000 advanced practice providers, and 110 HCs. In 2023, we plan to sample up to 10,000 physicians, 20,000 advanced practice providers, and 210 HCs, if funds allow. Lastly, if funds allow, in 2024 we will sample up to 20,000 physicians, 40,000 advanced practice providers, and 310 HCs. For 2022-2024, there will be an additional 3,000 physicians sampled yearly for the Provider Electronic Component. Questions on the Health Center Facility Interview will be modified. After 2021, the Physician Induction Interview will shift to a redesigned Ambulatory Care Provider Interview. Visit data collection via abstraction will be placed on a hold and the reinterview study will be discontinued. The provider incentive experiment will also no longer be taking place, as we will begin to conduct other methodological work to improve upon the survey.

NAMCS webpage https://www.cdc.gov/nchs/ahcd/index.htm
Draft NAMCS package, including technical documentation https://www.dropbox.com/sh/y7alakzyfzth3jc/AAA8-fEmPDnkKBcNFizn90V1a?dl=0
FR notice inviting comment: https://www.federalregister.gov/d/2022-05757

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