Background on HCCIS
The Minnesota Healthcare Cost Information System (HCCIS) was established in 1984 to provide accurate and reliable information about the financial, utilization, and service characteristics of hospitals and freestanding outpatient surgical centers (FOSC) in Minnesota. The financial and statistical data are used to make public policy decisions, to implement the hospital medical care surcharge, and to assist hospitals in comparing their financial, utilization, and services information to aggregated data and other hospitals.
The annual reporting of financial, utilization, and services data by all Minnesota hospitals and freestanding outpatient surgical centers to Minnesota Department of Health (MDH) is mandated by Minnesota Statutes, sections 144.695 - 144.703, 144.562, 144.564 and Minnesota Administrative Rules, Chapter 4650.
In 1996, four hospital data collection reports were combined to create the Hospital Annual Report (HAR) that is currently administered under HCCIS - Minnesota Administrative Rules, Chapter 4650.
- Financial data was collected using the Revenue and Expense Report from 1984 - 1995.
- Services data was collected on the Annual Statistical Report.
- The Hospital Swing Bed Report.
- The Hospital Subacute/Transitional Care Annual Report.
In 2001, Minnesota Administrative Rules, Chapter 4650 were amended to define and clarify the difference between "Hospital Patient Care Services" and "Other Patient Care Services" (that are provided by the hospital). This clarification was done in an effort to level the playing field in the calculation of the Medical Care Surcharge by the Department of Human Services (DHS) and make the hospitals more comparable for researchers using the data.
Under an agreement with MDH, the Minnesota Hospital Association (MHA), serves as a Voluntary Nonprofit Reporting Organization. In this capacity, MHA staff collects and audits financial and statistical information from each hospital and forwards it to MDH.
Each year, HCCIS staff work with MDH researchers and MHA to refine the data collected and to be sure that everything that is collected is truly useful.
Hospital financial, utilization, and services data is collected through an annual survey, the Hospital Annual Report (HAR). All acute-care hospitals (excluding federal hospitals) are required to complete hospital-specific sections of the HAR and submit copies of their Audited Financial Statement and Medicare Cost Report. Psychiatric and specialized hospitals are required to complete a shorter version of the HAR with utilization and services information and total operating revenue and expenses only. Data is reported for the hospital's fiscal year. All data except that on administrative costs is classified as public and is reported on a facility-level.
In general, the hospital form collects information related to the number of beds at a given facility; information on revenue (charges by service category and payer) and expenses (by category of expense) and discounts by those payer categories; charity care and bad debt; information on staffing, including wages and salaries, number of Full Time Equivalents (FTEs) and number of staff. This form also collects information on use of services (hospital days, length of stay, admissions) and availability of services such as whether CT/MRI/PET is available, Chemical Dependency treatment services, etc.
The data contained on the HAR report has been consistently collected over time, therefore it provides a good consistent time series of information.
Freestanding Outpatient Surgical Center (FOSC) financial, utilization, and services data is collected through an annual survey, the FOSC Annual Report. All licensed surgical centers are required to complete the FOSC report and submit copies of their Audited Financial Statement and Medicare Cost Report. Data is reported for the FOSC's fiscal year. All data except that on administrative costs is classified as public and is reported on a facility-level.
In general, the FOSC form collects information related to the number of operating rooms available at a given facility; information on revenue (charges by category of payer), total expenses, and discounts by those payer categories; charity care and bad debt; and information on Full Time Equivalents (FTEs). This form also collects information on use of services number of surgical procedures performed and availability of services such as whether non-surgical services are provided.
Diagnostic Imaging Facility utilization data is collected through an annual survey, the Diagnostic Imaging Facility-Utilization Data Annual Report. All Freestanding and Mobile Diagnostic Imaging Facilities are required to complete the Diagnostic Imaging Facility report. Data is reported for the Diagnostic Imaging Facility's fiscal year. All data is classified as public and is reported on a facility-level.
In general, the Diagnostic Imaging Facility form collects information related to the number of (CT, PET, MRI) procedures performed for each health plan payer or public program. This form also collects names of any individuals with a financial or economic interest in the Diagnostic Imaging Facility.
The HCCIS data is self reported and wherever possible, it is audited against the facility specific Audited Financial Statement (or internal financial statements) and Medicare Cost Report. Electronic audits are performed to verify calculations and compare to consistency in previous years reporting.
Each year, HCCIS staff work with MDH researchers and MHA to refine the audit procedure and incorporate any known changes in the industry and to accommodate any changes to the formset.
No data is released to the public until it has passed all steps in the audit procedure or until the facility has provided sufficient documentation as to why the data does not meet the parameters of the audit. This is a policy that is enforced by both MDH and MHA.
Any approved exclusions to the data are stored in a database at MDH.
Uses of the Data
Over the years, every category of data collected on hospitals has been used in studies done by MDH. Staffing information was used for a study for the legislature on labor costs, trends in utilization of services and financial trends were used in a study on the hospital industry, and most of the information is used to track general trends in the industry to help respond to legislative requests. Currently, the hospital data collected under HCCIS is being used to examine the preparedness and capacity at Minnesota’s hospitals. This data is also used within MDH for determining eligibility and awards for several hospital grant programs.
The Minnesota Department of Human Services (DHS) also uses this data for implementing the annual Hospital Medical Care Surcharge under Minnesota Statutes, section 256.9657.
In addition to State of MN researchers using this data, annual requests for this data have come from the media, MN Nurses' Association, private researchers, the hospitals and surgical centers themselves, and many out of state researchers looking to compare our state in their studies.