Friends of NCHS Update
Charles J. Rothwell
Acting Director, NCHS
cjr4@cdc.gov
April 23, 2013
THANK YOU!
NCHS Data in the News
2012-2013 Selected Reports
•
Generalist and Specialty Physicians:
Supply and Access, 2009–2010
(NAMCS)
•
Prevalence of Uncontrolled Risk
Factors for Cardiovascular Disease:
United States, 1999–2010 (NHANES)
•
Recent Declines in Infant Mortality in
the United States, 2005–2011
(NVSS)
Today’s Update
•
•
Budget Update
Recent Activities and Program
Highlights
Budget Update
FY 2014 Budget Request
•
$181.475 M for Health Statistics
•
•
+$22.413 M above FY 2012 enacted ($138.683 M)
$20.379 for the new Working Capital Fund*
• Proposed $22.413 M increase supports:
•
Phase in electronic death records in remaining
jurisdictions
•
Development and implementation of new sample
designs for population-based surveys following
2010 Census
•
Improvement and expansion of data collection
methods
* = not an actual budget increase
NCHS Budget Chronology
(adjusted for Working Capital Fund starting in 2012)
PHS Evaluation
200
Working Capital Fund
(181.475)
180
Dollars in millions
160
140
(159.062)
(160.036)
*
20.379
*
20.504
20.379
120
100
80
60
124.701
138.683
138.683
138.683
139.532
159.062
**
40
20
0
FY 2009 FY 2010 FY 2011 FY 2012 FY 2013 FY 2014
* Working capital funds not received in FY 2012 and FY 2013 – adjusted for comparison to FY
2014 only
** FY 2013 PHS Evaluation Funds not final
WCF Overview
A WCF will promote effective cost control and increased
efficiency for programs and service providers.
What is a
working capital
fund?
• A WCF is a revolving fund with no year authority, that allows an agency to bill
and collect fees for services and deposit them into the fund to finance the
fund’s operations
When did CDC
receive
authorization?
• In CDC’s FY 2012 appropriation, Congress authorized CDC to establish a WCF
in FY 2014
Why did CDC
pursue a
working capital
fund?
• To improve the efficiency and effectiveness of business support services
• To promote effective cost control within programs and service organizations
• To achieve greater transparency by establishing a standard process for
developing and reviewing rates and reporting on the actual costs of services
• To enable CDC to finance long-term capital investments, while avoiding
cyclical funding spikes
How will CDC’s
working capital
fund operate?
• In a WCF environment, programs will request services from service providers
and the WCF will bill programs for business services consumed based on preestablished rates.
Achieving greater efficiency, transparency, and accountability of business services.
-9-
WCF Overview: Services
WCF is a new funding mechanism for CDC business support services;
these services enable programs to achieve the Agency’s mission
CDC Mission:
Collaborating to create the expertise, information, and tools that people and
communities need to protect their health – through health promotion, prevention of
disease, injury and disability, and preparedness for new health threats.
WCF Service Categories
Facilities, Safety, Security, and Logistics
Services
IT Services, Support, and Infrastructure
Management Analysis Support Services
Financial Management and Oversight
Procurement and Assistance Services
Travel Services
General Support Services
Human Resources
Achieving greater efficiency, transparency, and accountability of business services.
- 10 -
FY 2012 PPHF Activities
•
$35 M to Healthcare Surveillance/Health Statistics
of which $27 M went to NCHS for the following:
•
NHIS
• Additional questions to monitor ACA
• Expanded sample size from ≈87,500 persons to
≈108,000 persons; more state estimates
•
NAMCS/NHAMCS –
• Increased sample size from ≈3,000 physicians to
≈20,000; more state estimates
• Cardiovascular disease look-back module collected
additional data on patients with heart disease and stroke
•
Funded six states to implement electronic birth record
systems and transition to 2003 birth certificate
•
Monitor implementation of NHANES National Youth
Fitness Survey
FY 2013 PPHF Activities
•
$28 M proposed for Healthcare Surveillance/Health
Statistics (NCHS share to be determined)
•
Proposed activities include:
• NHIS
• Additional questions to monitor ACA
• Continue expanded sample size; more state estimates
• Testing to add biomarkers (height, weight, BP, dried blood
spots
• NAMCS/NHAMCS
• Continue expanded sample size to permit state-specific
estimates of clinical care provided in physician offices and
Community Health Centers, including primary prevention and
clinical management of risk factors for heart disease and
stroke
• Fund states to implement electronic birth record systems
and transition to 2003 birth certificate and EDR expansion.
Activities & Program Highlights
Responding to Data Needs
for Public Health Policies and Programs
Responding to Data Needs: Monitoring
Changes in Health and Health Care
•
Existing questions on NHIS and NAMCS/NHAMCS
provide baseline and trend data for items including:
• Health insurance
• Access to health care
• Care provided in physician offices, emergency and
outpatient departments and community health centers
•
New questions added to NHIS address targeted issues
(ex. financial burden of medical care)
• Added NAMCS/NHAMCS cardiovascular disease lookback module
•
Larger NHIS and NAMCS sample sizes allow more
state-level estimates
Percent of adults aged 19-25 with health insurance, by
coverage type, and percent uninsured: 2009 – Q3 2012
60
Private
50
Percent
40
35.6
Uninsured
26.3
30
Public
20
10
0
Q1
2009
Q2 Q3 Q4 Q1
Q2 Q3 Q4 Q1
2010
Q2 Q3 Q4 Q1
2011
Q2 Q3
2012
Source: Cohen RA, Martinez ME. Health insurance coverage: Early release of estimates from the National
Health Interview Survey, January – September 2012. National Center for Health Statistics. March 2013.
Responding to Data Needs:
Targeted Populations
•
NHIS is collecting sexual identity for
the first time
•
Completed NHANES National Youth
Fitness Survey in 2012, first
assessment of youth physical activity
in over 20 years
•
Continue to oversample Asian
Americans in the NHIS and NHANES
Responding to Data Needs:
Monitoring Long-Term Care
•
The new National
Study of Long-Term
Care Providers
(NSLTCP) will replace
NCHS’ previous
periodic nationally
representative
surveys
•
NSLTCP will be
conducted every other
year starting in 2012
•
First data release:
late 2013
Responding to Data Needs: Innovative
and Complementary Survey Designs
•
Testing methods for collecting biomeasures
in the home as part of the NHIS
•
•
•
•
•
Height
Weight
Dry blood spots
Blood pressure
Launching a web and phone follow-back
survey with sample of NHIS respondents:
ACA-related questions
Responding to Data Needs:
Improved Timeliness for Vital Statistics
• 2011 preliminary reports for births and
deaths published 9 months after the close
of the year ... Best in many years.
• 2012 preliminary reports will come out
even faster ... late this summer!
• Final files released earlier
• National Death Index more current and
flexible
• Fetal death reports and data will be
caught up this year: 2007-2011
Responding to Data Needs:
Health, United States 2012
•
•
Release expected in mid May
•
New interactive Health, United
States, 2011: In Brief lets users
customize charts and tables (2012
release later in summer)
Special feature: Emergency Care in
the United States
• http://archive.nlm.nih.gov/proj/IP/h
us11/InBrief.html
THANK YOU!