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Sept 30 -- The Centers for Disease Control and Prevention (CDC) invites comments to OMB by November 21, 2022 regarding The National Ambulatory Medical Care Survey (NAMCS). [CDC submitted the proposal to OMB on October 21.]

The National Ambulatory Medical Care Survey (NAMCS) was conducted intermittently from 1973 through 1985, and annually since 1989. The survey is conducted under authority of Section 306 of the Public Health Service Act (42 U.S.C. 242k). 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) (OMB Control No. 0920-0278), the National Hospital Care Survey (OMB Control No. 0920-0212), and the National Post-acute and Long-term Care Study (OMB Control No. 0920-0943).

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 collect, analyze, and disseminate timely, relevant, and accurate health data and statistics. In addition, NAMCS provides ambulatory medical care data to study: (1) the 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) the introduction of new medical technologies; and (5) the 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 29 million individuals throughout the United States. NAMCS collects and provides data on HCs via the NAMCS HC Component. In addition to the HC component NAMCS includes a Provider Interview Component and a Provider Electronic Component. The Provider Interview Component samples ambulatory care providers to collect information on their characteristics and the characteristics of their practice. The Provider Electronic Component gathers information on a sample of electronic data providers including characteristics of the provider, as well as a full year of electronic patient visit data. Lastly, the HC Component samples HCs and collects characteristics of the center as well as a full year of electronic patient visit data.

This revision seeks approval to continue previously approved survey activities for the completion of the 2022 HC Component's data and to conduct the full 2023, 2024, and 2025 data years. CDC plans to implement changes to all three components of NAMCS. HC Component and Provider Interview Component sample sizes will be adjusted. In 2022, the goal is to target 100 HCs overall, while the Provider Interview Component is paused for redesign. In 2023, the goal for NAMCS is to sample 5,000 physicians, 5,000 advanced practice providers, and up to 150 HCs overall. In 2024, we plan to sample up to 10,000 physicians, 20,000 advanced practice providers, and up to 200 HCs overall (if funds allow). Lastly, in 2025 CDC will sample up to 20,000 physicians, 40,000 advanced practice providers, and up to 250 HCs overall.

For 2023-2025, there will be an additional 3,000 physicians sampled yearly for the Provider Electronic Component. The Provider Electronic Component is modifying its Provider Facility Interview questionnaire and there are plans to implement a set-up fee in the future. Also, for the Provider Electronic Component we plan to conduct research on supplementing electronic visit data with electronic data obtained from third-party sources. Questions on the Health Center Facility Interview questionnaire will be modified, and a Set-up Fee Questionnaire will be implemented. In 2023, the Physician Induction Interview will shift to a redesigned Ambulatory Care Provider Interview. Also beginning in 2023, a Tracing Questionnaire will be utilized for the Provider Interview Component, to increase response rates. Visit data collection via abstraction will be placed on hold to evaluate improved methods for collection of these data, 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
NAMCS submission to OMB: https://www.reginfo.gov/public/do/PRAViewICR?ref_nbr=202210-0920-012 Click IC List for data collection instruments, View Supporting Statement for newly added technical documentation. Submit comments through this webpage. [Comments due 30 days after submission, i.e., Nov 21]
FRN: https://www.federalregister.gov/d/2022-21218

For AEA members wishing to submit comments, "A Primer on How to Respond to Calls for Comment on Federal Data Collections" is available at https://www.aeaweb.org/content/file?id=5806

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