2013 HAR Education and
Information Session
Jonathan Peters, MHA
Lucas Hovila, MHA
Tracy Johnson, MDH
2013 Education and
Information Topics
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Changes to the 2013 Formset &
Extension Requests
Data Requests & Usage
Capital Expenditure Hospital and
System Level Reporting
Provision for Bad Debts
Clinic Reporting on the HAR
Reminders, Resources, and Tips
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Medical Care Surcharge Estimator
2013 Formset Changes
• The one change to the 2013 HAR
Formset is that Provision for Bad
Debts is now being reported as a
Contractual Adjustment and no
longer as an Operating Expense.
We will discuss this change later
in the presentation.
Extension Requests
• Increasingly, the legislature and the public
are looking for more up-to-date information
from government. MDH wants to work with
MHA and hospitals on reducing the need for
data filing extensions beyond the initial 21
days. We hope MDH will need to grant
longer extension requests only in the most
extreme cases, where sticking to the
timeline would pose and undue hardship on
hospitals or compromise the quality of the
report.
Extension Policy
• For the 2013 HAR, MHA is able to
grant an initial extension of 21
days.
• If a hospital is 30 days late
submitting their HAR, the
hospital will be turned over to
MDH.
Extension Requests
• In FY 2012, 42% of hospitals asked
for an extension.
• Of the 42% of hospitals that asked
for an extension, 20% of hospitals
asked for an extension of 30 days or
greater.
Who Requests HAR
Data?
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Other Areas of MDH
MN Legislature
MN Department of Human Services
Media
MN Nurses Association
Researchers in Public Policy
What HAR Data is
Requested?
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Uncompensated Care
Community Benefit
Capital Expenditures
Staffing
Payer Mix
Financial Performance of the Industry
Trends in Utilization
Bed Type Information
How is HAR Data Used?
• Community Benefit Report to the
Legislature
http://www.health.state.mn.us/divs/hpsc/hep/publications/legislative/communitybenefits2009.pdf
• Capital Expenditure Reporting
• Minnesota Health Care Markets
Chartbook (section 8)
http://www.health.state.mn.us/divs/hpsc/hep/chartbook/index.html
Inpatient Bed Capacity at Minnesota
Community Hospitals by Region &
Specialty Bed Units (2012)
Medical/
Surgical
Central
Cardiac
Chemical
Dependency
Mental
Health
Neurology
(Psychiatric)
Obstetrics Orthopedic Rehabilitation
Other
Specialty
Total
Available
Beds
845
15
19
84
37
127
29
30
0
1,189
2,943
691
96
649
245
544
375
172
168
5,883
Northeast
616
117
0
94
20
65
70
83
96
1,165
Northwest
314
0
0
22
0
23
0
17
12
390
South
Central
454
0
0
50
0
43
0
0
0
559
Southeast
1,206
48
0
104
0
101
25
38
80
1,622
Southwest
526
6
0
18
0
15
0
0
0
585
West
Central
248
13
0
14
0
39
0
14
0
328
7,152
890
115
1,035
302
957
499
354
356
11,721
Metro
Total
Source: MDH analysis of hospital annual reports
Minnesota Hospital Community Benefits
by Type, 2011 to 2012
Source: Source: Community Benefit Provided by Minnesota’s Hospitals in 2011, Health Economics Program, Minnesota Dept. of Health, forthcoming
Use of Capital
Expenditure Information
• Capital expenditure information is
used by MDH to fulfill statutory
requirements to review major
spending commitments by hospitals
and other providers.
• MDH also uses capital expenditure
data to produce informational
documents to inform the public on
spending trends.
Analysis of Capital Expenditure
Information
Medical Equipment Capital Expenditures in Minnesota,
2007 to 2012
($709 million Total)
Other Medical
Equipment
$141 million
Radiation Therapy
$262 million
CT Scanners
$67 million
Diagnostic Imaging
$256 million
MRI Scanners
$113 million
Other Imaging
(Mammography, PET,
X-Ray, ect.)
$75 million
Other Surgical
Equipment
$30 million
da Vinci® Robotic
Surgical Equipment
$50 million
Source: MDH analysis of data submitted under Minnesota Statutes, Section 62J.17. This spending includes building and
space as well as other expenses related to medical equipment projects.
Trends at Minnesota Community Hospitals, 2009 to
2012
Percent Change from Previous Year
*Actual Value
Source: MDH analysis of hospital annual reports
Capital Expenditures
A Guide to Minnesota
Capital Expenditure Reporting
Contact Information
A Capital Expenditure
Contact is required by all
hospitals. This should
list the individual
responsible for any
questions relating to
Capital Expenditures.
The Capital
Expenditure Contact is
required, and is not
optional.
Reporting Requirements
There are two separate reporting
requirements for Capital
Expenditures
 Reporting of major capital expenditure
commitments greater than one million dollars (see
HAR sections 56 & 57).
 Providing sufficient project specific information
about capital expenditure commitments for MDH
to complete a retrospective review of each project
greater than one million dollars (see capital
expenditure project specific tab of the formset).
Reporting Forms
Providers submit capital expenditures
on existing annual financial reports
 Hospitals - Hospital Annual Report (HAR)
 Surgical Centers – Freestanding Outpatient
Surgical Center (FOSC) Report
 Imaging Centers - Diagnostic Imaging Facility
Report
 Physician Clinics or Clinic Systems – System
Capital Expenditure Report
 Health Care Systems - Capital Expenditure Report
Health Care Systems
Decision Chart
Contact Information:
http://www.health.state.mn.us/healtheconomics
Tracy Johnson
HCCIS Staff
Minnesota Department of Health
651-201-3572
Tracy.L.Johnson@state.mn.us
Clinic Reporting
Reporting Guidelines for Clinic
Information on the Hospital
Annual Report
Clinic Decision Flowchart
Offsite Locations Tab
• All outpatient departments, clinics, and
components not located on the hospital's
premise
• Offsite locations where services provided are
billed under the hospital's Medicare and
Medicaid provider numbers
• Verified against hospital license application
Offsite Locations Tab
• Reminder:
– This tab is matched against Gross Clinic
Charges (account 0207) and Other
Institution Charges (account 0208).
– If there is an offsite entity being listed in
account 0207 and/or 0208, please list
these entities on the Offsite Locations Tab.
– For each entity that is listed on the Offsite
Locations Tab, please fill out all data fields.
Provision for Bad Debts
Reporting Guidelines for
Provision for Bad Debts
New Way to Report
Provision for Bad Debts
• In previous years, the HAR Formset has
asked for Provision for Bad Debts to be
included in Total Operating Expense.
• Due to a change in Financial
Accounting Standards Board (FASB)
rules, Provision for Bad Debts is now
included in Total Adjustments and
Uncollectibles.
New Way to Report
Provision for Bad Debts
• Please note that since Provision
for Bad Debts is now reported as
an adjustment it will be reported
as a negative number.
Institution Reporting for
Provision for Bad Debts
• For the Institution Section, Provision for Bad
Debts will be reported in account 0216 and
included in Total Adjustments and Uncollectibles
(account 0220).
Hospital Only Reporting for
Provision for Bad Debts
• Provision for Bad Debts for the Hospital only will
be reported in account 0739 and included in Total
Adjustments and Uncollectibles (account 8063).
Change to Section 14: Primary
Payer Adjustments & Uncollectibles
• Provision for Bad Debts along with breakout
accounts for Hospital Patient Care Services and
Other Patient Care Services is now automatically
reported on page 7 of the HAR in Section 14.
These are auto-calculated cells.
Reminder
• If your hospital chooses to provide
internal numbers and not use the
formulas in Sections 23-26, please be
sure to include Provision for Bad
Debts in the Adjustments on the
schedules.
Example
For example in
Section 23,
now that Bad
Debt is
reported as an
adjustment,
Physician Bad
Debt needs to
be included in
Physician
Adjustments
(account 5503).
Reminders, Tips, and Resources for
Preparers
General Guidelines and Places for Further
Information
Medical Care Surcharge
Estimator
A Medical Care
Surcharge
Estimation Tool has
been included on a
separate tab in the
HAR 2013.
After completing the
HAR, please review
this tab to verify that
the information
reported on the HAR
for these key
accounts is accurate.
DHS remains the sole determiner of your surcharge, and this tool is to be used only to
give guidance and help in the correct completion of the HAR.
MCR and Audited Financial
Statement Submission
• MHA has the ability to receive the
Medicare Cost Report in the ECR file
format.
• ECR format is the preferred format for
the MCR.
• Your hospital’s AFS and MCR should be
submitted as soon as they become
available.
Data Transmission Method
Available
• HTTPS data transmission available
– Transmission encrypted and secure
– As easy as web e-mail or online banking
– Hospitals can download their prior year’s Commentary or
Hospital Profile report from same site as well.
– More safe and secure than postal mail or e-mail
– No file size restrictions, unlike e-mail
• This method is highly recommended by MDH and MHA
for data transmission
• Please contact MHA to receive your login and password
• Web address: https://har.mnhospitals.org
Places for Further Information
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Both MDH and MHA’s website have further information on HAR related issues.
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MDH Website: http://www.health.state.mn.us/divs/hpsc/dap/hccis/index.html
MHA Website: http://www.mnhospitals.org/data-reporting/mandatory-reporting/health-care-costs-informationsystems-hccis
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All Deadlines and Events are posted on websites.
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Power Point presentation of 2012, 2011 and 2010 HAR Education and Information Sessions
available at sites above.
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Electronic Newsletters covering the following topics:
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Getting Started
Microsoft Excel Tips and Useful Tools
Expense Allocation Methodology
Primary Payer Charges and Adjustments
Outpatient Charges
If a question or problem arises while completing the Hospital Annual Report, please
contact Jonathan Peters or Lucas Hovila at MHA or Tracy Johnson at MDH (see last slide
for contact information).
Contact Information
• MHA staff at (800) 462-5393 or (651) 641-1121
• Jonathan Peters, MHA (651) 659-1422
• Lucas Hovila, MHA (651) 603-3536
• Tracy Johnson, MDH (651) 201-3572