National Health Care Surveys 20072012 Budget Update/Options NCHS Board

National Health Care Surveys 20072012 Budget Update/Options NCHS Board of Scientific Counselors April 24, 2008 Jane E. Sisk Centers for Disease Control and Prevention National Center for Health Statistics

National Health Care Surveys Long-Term Care National Nursing Home Survey (NNHS) 2004: National Nursing Assistants Survey (NNAS) National Home and Hospice Care Survey 2007: National Home Health Aide Survey (NHHAS) National Survey of Residential Care Facilities (NSRCF) Hospital and Ambulatory Care National Ambulatory Medical Care Survey (NAMCS) Physicians in offices National Hospital Ambulatory Medical Care Survey (NHAMCS) Hospital emergency and outpatient departments National Survey of Ambulatory Surgery (NSAS) National Hospital Discharge Survey (NHDS)

Annual Average Expected Cost of Surveys millions of dollars National Nursing Home Survey 4.5 National Home and Hospice Care Survey 5.0 National Survey of Residential Care Facilities National Ambulatory Medical Care Survey 3.9 National Hospital Ambulatory Medical Care Survey National Hospital Discharge Survey 2.0 Redesigned National Hospital Discharge Survey 3.0 National Survey of Ambulatory Surgery (if separate) 3.5 4.7 5.0

National Health Care Surveys, 1992-2012 NNH S NHHCS NSRCF NSAS NHAMCS NAMCS NHDS 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10 11 12 Little change Continually updated Redesigned

National Health Care Surveys 2007-2012 18 16 (millions) 14 Additional funds needed for full funding Available funds 12 10 8 6 4 2 0 2007 2008 2009 2010 2011 2012

National Health Care Surveys Funding 2007-2012 2007 2008 2009 2010 2011 2012 s in millions NCHS Funds Reimbursables Total Revenue 9.6 10.5 10.5 10.5 10.5 10.5 2.1 2.2 Expenses 11.7 12.7 14.1 16.1 16.9 16.2 Deficit 0 2.0 0.8 0.4 0.4 11.7 12.7 12.5 11.3 10.9 10.9 0 - 1.6 - 4.8 - 6.0 - 5.3

Option: Delay Nursing Home Survey Cost savings 2 million FY 2009 2.5 million FY 2010 Pro Avoid deficit Would not disrupt current operations Con Extend period between nursing home surveys Survey last conducted in 2004

Option: Delay Updating Ambulatory Survey Samples Cost savings 2 million FY 10 4 million FY 11 Pro Avoid deficit Con Continued likelihood of estimates’ not accurately reflecting the current demographics of health care providers and patients Last sample of PSUs drawn from 1980 Census

Option: Delay Home and Hospice Care Survey Cost savings Pro Avoid deficit Would not disrupt current operations Con Extend period between home and hospice care surveys Survey conducted in 2007 1 million FY 11 4 million FY 12

Option: Suspend Hospital and/or Ambulatory Care Surveys Cost savings 2 to 10.5 million depending on whether 1, 2, or 3 surveys were suspended Pro Substantial savings Cons Removing crucial data sources at a time of health system transformation Commitments made and funds already received and spent to collect certain data