10/15/2014 Uniform Data System Calendar Year 2014 Bureau of Primary Health Care Agenda • Brief introduction to UDS • 2014 changes • 2015 proposed changes • Definitions used in the UDS report • Step ‐ by ‐ step instructions for completing UDS tables • Available assistance and strategies for successful reporting 2 1
10/15/2014 UDS: The Who, What, When, Why, and How 3 UDS: The Who • Who : – 330 ‐ funded grantees under the CHC, HCH, MHC or PHPC programs – Look ‐ alikes designated by BPHC – BHW primary care clinics – Urban Indian Health Centers (reported under separate system) – Native Hawaiian Health Centers (not through EHB) • Who were funded or designated prior to October 2014 4 2
10/15/2014 UDS: The What • What : – “Scope of Project” which includes (and is limited to) the staff, services, patients, income, expenses, etc. that are spelled out in funding or designation applications • Does not include sites or services which are not approved by BPHC – For the period January 1, 2014 ‐ December 31, 2014 • Calendar year reporting, not based on grant year or fiscal year 5 UDS: The When • When : – January 1, 2015: the UDS “opens” in your Electronic Handbook and you can begin to enter data. https://grants3.hrsa.gov/2010/WebEPSExternal//Interface/common/accesscontrol/login.aspx – by February 15, 2015: All data tables must be completed and the report must be officially “submitted” by CEO or their assigned delegate. – March 1 ‐ March 31 (approximately): Revisions are made to correct errors or explain apparent issues. (work with reviewer.) – March 31, 2015: Report must be finalized at close of business. 6 3
10/15/2014 UDS: The Why • Why : The UDS is used: – To inform HHS, OMB and the Executive Branch of the accomplishments of the program – To inform Congress and the legislators who are responsible for funding the program – To provide information to HRSA in evaluating the operation of individual health centers and, occasionally, to alter funding levels – To inform the public of the operations of federally supported health centers – To provide data to scholars studying health care delivery in general and services to poor in particular 7 UDS: The How • How : – On line through “Electronic Handbook” (EHB) https://grants3.hrsa.gov/2010/WebEPSExternal//Interface/common/accesscontrol/login.aspx – By authorized staff at each health center • More than one person can work on the UDS at the same time as long as they are in different tables. – By the CEO or designee certifying by submission that they have reviewed and approved the data being submitted 8 4
10/15/2014 12 Tables Provide a Detailed Picture of Your Health Center What is Reported Table(s) Patients served & their socio ‐ demographic 3A, 3B, 4, ZIP Code characteristics Types and quantities of services you provide 5, 6A Staffing mix and tenure 5, 5A The care you deliver/quality of care 6A, 6B, 7 Costs of providing services 8A Revenue sources 9D, 9E 9 Who Reports Which Tables 1 BPHC 330 ‐ Funded More than 1 BPHC 330 ‐ Program and BHW Funded Program: Look ‐ Alike Health Center: Table Primary Care Clinic: Universal + Special Pop. Universal Report Universal Report Grant Reports ZIP Codes Yes n/a Yes 3A, 3B, 4 Yes Yes Yes 5 Yes Visits & Patients, only Yes 5A Yes n/a Yes 6A Yes Yes Yes 6B Yes n/a Yes 7 Yes n/a Yes 8A Yes n/a Yes 9D Yes n/a Yes 9E Yes n/a No 330 grants 10 5
10/15/2014 2014 Changes • Table 4: – Line 26: Total number of patients who live in public housing • Table 6A: – New Line 1 ‐ 2a: Newly diagnosed with HIV – Look ‐ alikes will report this table for the first time • Table 6B : – Tobacco use assessment and cessation intervention measures have been combined into one measure, line 14a, “Tobacco Use Screening and Cessation Intervention” – New measure, line 20: Newly Identified HIV Cases and Follow ‐ Up – New measure, line 21: Patients Screened for Depression and Follow ‐ Up – Prenatal care tracking for women referred for prenatal care services 11 2014 Changes Continued • Table 7 : – Categories of HbA1c “less than 7%” and “7% ‐ <8%” have been combined into a single category of “less than 8%” – Outcomes for women referred for prenatal care services at centers which do not provider prenatal care • Table 9D: – Look ‐ alikes will report all elements of this table 12 6
10/15/2014 2015 Proposed Changes • Table 4 : – New line 9a: Dually Eligible (Medicare and Medicaid) » this is a subset of line 9 (Medicare). Dually eligible patients will be reported on both line 9 and 9a. • Tables 6A, 6B, and 7: – Use of ICD ‐ 10 coding begins October 1, 2015 » Use ICD ‐ 9 for services from January 1 through September 30 » Use ICD ‐ 10 from October 1 through December 31 • Table 7: – The detail for reporting diabetic HbA1c will be further reduced. In 2015, health centers will only report those patients with HbA1c “greater than 9% or No Test During Year” (Column 3f) 13 THE TABLES: Key Definitions and Step by Step Instructions 14 7
10/15/2014 Who Counts: Patient Defined • An individual who has one or more visits reported on Table 5 during the calendar year is considered a “patient.” – Medical, dental, behavioral health, vision, other professional and selected enabling services • Whenever “patients” are counted, it must be an unduplicated count. • Each patient is counted once and only once regardless of the number or scope of visits. • But they may be counted in each category of “patient” that they fall in • E.g., could be 1 medical patient and 1 dental patient 15 ZIP CODE TABLE: Patients by ZIP Code and Insurance 16 8
10/15/2014 Patients by ZIP Code • Report all ZIP codes with 11 or more patients – Combine the rest as “other zip codes” • Patients in each ZIP code are reported by their primary medical insurance – This is the third party MEDICAL insurance that would be billed first if the patient had a medical visit – Must be reported for ALL patients including those patients who are not being seen for medical services – There is no unknown insurance category • Totals must tie to total patients on Table 3A and insured patients 17 on Table 4 Patients by ZIP Code Continued • Additional instructions for Special Populations – Homeless: Use ZIP code of location where patient receives services if no better data exist. – Agricultural: Use ZIP code of the temporary housing they occupy when patient is in the area. 18 9
10/15/2014 TABLES 3A AND 3B: Patient Demographics 19 Table 3A: Patients by Age & Gender • Report total patients by age and gender • Age is calculated as of June 30 • Count each patient once and only once • Total on line 39 is used for unduplicated patient count – totals from ZIP Code, table 3B, income of table 4, and insurance of table 4 must equal this number 20 10
10/15/2014 Table 3B: Patients by Hispanic or Latino Ethnicity/Race/Language • Use Column B if patient does not indicate “Latino” or “Hispanic.” • Use Line 6 only if patient chooses two or more listed races. – “More than one” shouldn’t be a choice – don’t report Latino + a race as “more than one race” • Use unreported, Line 7 if no race was specified. • Total must equal Table 3A. 21 Table 3B: Patients by Language • Report all patients who would best be served in a language other than English including: – Bilingual persons not fluent in medical English – Persons who are served by a bilingual provider – Persons who receive interpretation services – Persons using sign language – Persons in Puerto Rico or the Pacific where a language other than English is used • This is the only UDS cell that may be estimated. 22 22 11
10/15/2014 TABLE 4: More Demographic Data 23 Table 4: Patients by Income – Lines 1 ‐ 6 • Report income as of your most recent assessment. – Income may be self ‐ reported if permitted by your policy – May report using a method different than that used for your sliding discount system • Income must be current (obtained within the last year) – otherwise report as unknown. • Total on Line 6 must equal total on table 3A. 24 12
10/15/2014 Table 4: Patients by Medical Insurance – Lines 7 ‐ 12 • Report principal third party insurance for medical care (even if patient is not a medical patient) • Insurance is reported as of the last visit – Even if insurance source did not pay for the visit – Total on Line 12 must equal total on Table 3A and line 6 on Table 4 – Total for each insurance type must equal totals on ZIP code table 25 Table 4: Medical Insurance Reporting Categories • None/Uninsured, line 7 – patients with no insurance : may include patients whose services are reimbursed through grant, contract or uncompensated care funds • Medicaid, lines 8a, 8b, 8 – report all Medicaid patients including those in managed care programs run by commercial insurers • Medicare, line 9 – report all Medicare patients including Medicare Advantage and Medi ‐ Medi patients 26 13
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