Information Bulletin, February 2001


HIPAA News
Version 6 Inpatient Files Now Being Accepted
Emergency Department Data Initiative
Source of Admission
1999 SPARCS Annual Report

HIPAA News

With the publication of the final Transactions and Codes rule, the implementation date for health providers to transmit the mandated transactions to payers is October 16, 2002. Since the SPARCS system was established in the late 1970's, submission requirements have utilized current electronic billing standard formats. When the HIPAA claim format (837) is mandated in the fall of 2002, SPARCS will make the necessary system changes to conform. We anticipate testing to begin during the first quarter of 2002.

The first step in that process will be a re-publication of the SPARCS documentation with mappings of the current required data elements to the 837 standard. The anticipated publication is in early March on our public Web site. Additional documentation will follow throughout the year.

Version 6 Inpatient Files Now Being Accepted

SPARCS now accepts UDS Version 6 format files for inpatient data. Support for Version 6 formatted files for outpatient data is coming soon. The SPARCS system will also accept Version 5 formatted files for both inpatient and outpatient submissions. Both Version 5 and 6 formatted files will continue to be accepted during the migration to the HIPAA mandated claim transaction standard, 837. SPARCS support for both Version 5 and 6 formatted submission files will continue into the 2003 calendar year.

Emergency Department Data Initiative

With the health care market changes and the increasing demand for statewide health care information it has become important to move beyond inpatient data to non-inpatient data sets. Emergency department data is one non-inpatient data set that SPARCS believes would be key to the improved assessment of health care in New York State.

Therefore, SPARCS has initiated Health Department interest in developing regulations towards the statewide collection of emergency department data. SPARCS will be building on systems already in place to collect this data and will be soliciting input from providers and potential users of this data from within as well as outside of the Health Department.

Additionally, SPARCS will be working within the HIPAA legislative mandates to standardize the reporting system. Interest in improving health care costs, quality, and accessibility is high and emergency room data combined with inpatient data will provide a needed and invaluable tool.

Source of Admission

As SPARCS data is being used by independent organizations for comparisons of facilities, the quality of the data reported becomes increasingly important. The reporting of the Source of Admission data field can easily affect how mortality statistics of a facility are viewed.

It is understood that comparing gross mortality rates of one facility to another barring other factors is unfair. To make the statistics more comparable, independent variables such as age, gender, and source of admission are included. Because age and gender are used heavily in many comparisons, the data is reliable. Source of admission is not as heavily used.

Based on the 1998 - 2000 SPARCS inpatient data received thru October, 2000, 48% of the inpatients are admitted thru the emergency room, 31% are physician referral, 10% are newborns, 3.5% are clinic referrals, 3.4% are hospital transfers, 1% are SNF transfers, 1% are HMO referrals, and 1.5% are unknown. Is it possible that HMO referrals and SNF transfers are under reported and emergency room admissions are over reported? How accurately does your facility report Source of Admission?

1999 SPARCS Annual Report

We are pleased to announce that the 1999 SPARCS Annual Report has been published and mailed to all hospital administrators. The narrative and 19 statistical tables will soon be available on our public Web site in accessible HTML format. Until that time, the report can be downloaded from our Web site under Annual Report Downloads in Corel WordPerfect 8 format.