11/8/2013 Uniform Data System Calendar Year 2013 Bureau of Primary Health Care Agenda • Brief Introduction to UDS • Available Assistance • Definitions used in the UDS report • Step ‐ by ‐ Step Instructions for Completing UDS Tables • 2013 Changes; 2014 Changes 2 1
11/8/2013 Questions – Do you know? • How many patients are served by the health center program? • How many visits? • What % of patients are uninsured? % having Medicaid? • What is the average cost per medical visit? • What is the average charge for a visit? • What percentage of women age 24 ‐ 64 get a pap test? • What percentage of adults received colorectal cancer screening? • Where can you get this information? • How is this information used? • Why are we here today? 3 Health Center Impact Source: http://bphc.hrsa.gov/healthcenterdatastatistics/index.html Accessed 8/29/13 • 21.1 Million Total Patients (85% served medical patients) are • Total Visits include: dental, MH, medical, SA, Other Vision, and Professional, Enabling services • Employees represent FTE – those employ ed are far greater 4 2
11/8/2013 UDS: The Who, What, When, Why, and How • WHO: 330 Grantees, LALs, and NMHCs who were “funded” prior to October 2013 • WHAT: “Scope of Project” for the period January 1, 2013 ‐ December 31, 2013 • WHEN: February 15, 2014 report due; finalized by March 31 with reviewer • WHY: Program evaluation, public data and reports to Congress and the Administration • HOW: Through “Electronic Handbook” (EHB) 5 12 Tables Provide a Snapshot of Patients and Performance What is Reported Table(s) Patients you serve Tables 3A, 3B, 4 and Zip Types and quantities of services you Tables 5 and 6A provide Staffing mix and tenure Tables 5 and 5A The care you deliver / quality of care Tables 6A, 6B, and 7 Costs of providing services Table 8A Revenue sources Tables 9D and 9E 6 3
11/8/2013 Who Reports Which Tables More than 1 BPHC 330 ‐ 1 BPHC 330 ‐ Funded Funded Program: Look ‐ Alike Health Center: Table Program and NMHCs: Universal + Special Pop. Universal Report Universal Report Grant Reports Zip Codes Yes n/a Yes No Agricultural Worker or Health 3A, 3B, 4 Yes Yes Care for the Homeless detail 5 Yes Visits & Patients, only Yes 5A Yes n/a Yes 6A Yes Yes Not reported 6B Yes n/a Yes 7 Yes n/a Yes 8A Yes n/a Yes No Managed Care or Retroactive 9D Yes n/a details 5 9E Yes n/a No 330 or ARRA grants Available Assistance • Regional trainings • On ‐ line training modules, manual, fact sheets, webinars, and other TA materials available: • www.bphcdata.net • http://bphc.hrsa.gov/healthcenterdatastatistics/ reporting/index.html • PALs • CY 2013: http://bphc.hrsa.gov/policiesregulations/policies/pal201302.html • CY 2014: http://bphc.hrsa.gov/policiesregulations/policies/pal201307.html • Telephone and email helpline: 866 ‐ UDS ‐ HELP or udshelp330@bphcdata.net • Technical support to review submission • Primary Care Associations/Primary Care Offices • EHB Support (see handout) 8 • HRSA Call Center: 877 ‐ 464 ‐ 4772 ● BPHC Help Desk: 301 ‐ 443 ‐ 7356 4
11/8/2013 Strategies for Success Submission • Work as a team • Refer to the manual, fact sheets, and other resources • Check your data before submitting • Refer to last years reviewer ’s letter emailed to the UDS Preparer/Contact • Address all edits • Check data trends • Compare data to benchmarks 9 2013 Changes • Zip code table will ADD patients by primary third party payor or uninsured. • Table 4: CHANGE age breaks for insurance. • Table 6B: Immunizations and Cervical Cancer measures have been CHANGED. • Look ‐ alikes: ADD managed care to table 4 and race/ethnicity to table 7. 10 5
11/8/2013 2014 Changes • Table 4: A line will be added to identify Residents of Public Housing • Table 6A: ADD “first time ever” HIV diagnosis • Table 6B: • ADD to universe women referred for perinatal care even when no care was provided • CHANGE tobacco to one measure • DELETE CAD process measure • ADD follow ‐ up for first time ever HIV diagnosed patients • ADD depression screening • Table 7: • ADD referrals to perinatal outcomes (delivery, birth weight) • ADD lipid control for CAD patients • Simplify HbA1c reporting for diabetic patients 11 THE TABLES: Key Definitions and Step by Step Instructions 11 6
11/8/2013 Patient Profile Tables • Number and socio ‐ demographic characteristics of patients served: – Zip Code Table: zip code by insurance status – Table 3A: by age and gender – Table 3B: by race/ethnicity /language – Table 4: by income, insurance, special populations • Tables 3A, 3B and 4 are completed for each additional funding stream. 13 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 is an unduplicated count. Each patient is counted once and only once regardless of the number or scope of visits. 14 7
11/8/2013 Patient Types: What are the Differences? • Patient counts are unduplicated counts of individuals who have one or more visits during the reporting year. • On Grant Report (only relevant if you receive multiple 330 funding streams) a patient is an individual who receives one or more visits supported by a special population grant. • Patients reported by Service Category are individuals who receive one or more documented “visits” of each specific service type: medical, dental, vision, mental health, substance abuse, enabling, other professional. 15 ZIP CODE TABLE: Patients by Zip Code and Insurance 16 8
11/8/2013 Patients by Zip Code • Report all zip codes with 11 or more patients – Combine the rest as “other zip codes” • 2013 CHANGE: Patients from 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 totals patients on Table 3A and insured patients on table 4 17 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
11/8/2013 TABLES 3A AND 3B: Patient Demographics 19 Table 3A: Patients by Age & Gender • Report total patients • Age is calculated as of June 30 • Count each patient once and only once • Total on line 39 is official total – all other totals must equal this number 20 10
11/8/2013 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 use for Latino + a race to be “more than one race” • Use unreported, line 7 if no race was specified. • Total must equal T3A. 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
11/8/2013 TABLE 4: Other Demographic Data 23 Table 4: Patients by Income • Use income as of your most recent assessment. – Income may be self ‐ reported if permitted by your policy • Income must be from recent patient data (within the last year) – otherwise count as unknown. • Total on Line 6 must = total on table 3A. 24 12
11/8/2013 Table 4: Patients by Medical Insurance • 2013 CHANGE: Break between age 17 and 18 • Report principal 3rd party insurance for MEDICAL care (even if patient is not a medical patient) • Insurance is reported as of the last visit – Even if it did not pay for the visit – Total on Line 12 must = total for ages on Table 3A – Total for each insurance type must equal totals on zip code table 25 Table 4: Medical Insurance Reporting Categories • NONE/UNINSURED – patients with no insurance: may include patients for whom health center may be reimbursed through grant or uncompensated care funds • MEDICAID – report all Medicaid patients including those in managed care programs run by commercial insurers • MEDICARE – report all Medicare patients including Medicare Advantage and Medi ‐ Medi patients 26 13
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