2012 HAR Education and
Information Session
Jonathan Peters, MHA
Lucas Hovila, MHA
Amy Camp, MDH
2012 Education and
Information Topics
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Changes to the 2012 Formset &
Extension Requests
Data Requests & Usage
Capital Expenditure Hospital and
System Level Reporting
Diagnostic Imaging Reporting
Clinic Reporting on the HAR
Self-Pay and Charity Care
Reminders, Resources, and Tips
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Medical Care Surcharge Estimator
2012 Formset Changes
•NO CHANGES!
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.
New Changes to
Extension Policy
• For the 2012 HAR, MHA is now only
able to grant an initial extension of
21 days.
• If a hospital is 30 days late
submitting their HAR (compared to
60 days in the past), the hospital will
be turned over to MDH.
Extension Requests
• In FY 2011, 65% of hospitals asked
for an extension.
• Of the 65% of hospitals that asked
for an extension, 22% 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 (2011)
Medical/
Surgical
Central
Cardiac
Chemical
Dependency
Mental
Health
Neurology
(Psychiatric)
Obstetrics Orthopedic Rehabilitation
Other
Specialty
Total
Available
Beds
828
15
19
84
29
118
29
20
0
1,145
2,983
677
103
645
222
538
382
179
210
5,939
Northeast
652
110
0
94
20
64
70
89
67
1,170
Northwest
314
0
0
22
0
23
0
17
12
390
South
Central
461
0
0
48
0
40
0
0
0
557
Southeast
1,225
57
0
108
0
96
25
37
56
1,604
Southwest
521
6
0
18
0
16
0
0
0
591
West
Central
248
13
0
14
0
39
0
14
0
328
7,232
878
122
1,033
271
934
506
356
345
11,724
Metro
Total
Source: MDH analysis of hospital annual reports
Minnesota Hospital Community Benefits
by Type, 2010 to 2011
$450
$427.2
$400
$350
$354.1
In Millions
$300
$250
$200
$188.0
$157.6$152.0
$150
$130.8
$96.0
$100
$98.2
$50
$0
$42.2 $38.7
State Health Care
Programs
Underpayments
Charity Care
Education
Operating
Subsidized
Services
$28.9
$13.0
$10.6$12.3
Community Health Financial and InCommunity
Services
Kind Contributions Benefit Operation
2010
$11.6 $14.3
Research
$5.0
$7.5
Community
Building Activities
2011
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
Minnesota Health Care Provider Capital Spending on Medical Equipment
2007 to 2009
(Millions of Dollars)
Robotic Surgical
Equipment, $19.8
Angiography
Equipment, $19.7
Radiation
Therapy
Equipment,
$31.3
Other Equipment,
$60.2
MRI Scanners,
$38.9
Diagnostic Imaging,
$97.2
CT Scanners,
$25.5
Other Diagnostic
Imaging
(Mammography, PET,
X-Ray, etc.), $32.7
Source: MDH Research Brief “Minnesota Health Care Provider Capital Spending 2007 to 2009”, Forthcoming
Trends at Minnesota Community Hospitals, 2008 to
2011
Percent Change from Previous Year
14.0%
12.0%
2008 to 2009
2009 to 2010
10.0%
2010 to 2011
8.0%
6.0%
4.0%
2.0%
0.0%
-2.0%
-4.0%
-6.0%
-8.0%
*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
Amy Camp
HCCIS Administrator
Minnesota Department of Health
651-201-3575
Amy.Camp@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.
Diagnostic Imaging
Reporting Guidelines for
Diagnostic Imaging
Diagnostic Imaging Provider
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For Diagnostic Imaging Services, if your hospital has the service available
on site (either by the hospital or contracted services), you will be asked to
provide the name of the provider.
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This is being asked to help tie diagnostic imaging provider information
(which is collected on separate report) to the HAR data.
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Contact your Radiation Safety Officer to confirm the DI equipment
available at your facility.
Diagnostic Imaging
• If the hospital has a fee per
scan/exam plan, the service should
be listed as available and must list
the owner of the equipment.
• If the hospital has a Capital Lease for
a scanner then for purposes of
HCCIS, the scanner should be listed
as being hospital owned.
Diagnostic Imaging
• There will be an audit check to match
the availability of service, the machine
type, and the owner of the machine to
what was reported the previous year.
• If anything has changed, please provide
a note describing the change.
• This information is also verified against
a report that DI providers supply MDH.
Self-Pay and Charity Care
Reporting Self-Pay and Charity Care on the HAR
Self Pay and Charity Care
The percentage discount
offered to Self Pay patients
will be collected. Please
note that this will be non
public data.
Charity Care Adjustments
will be broken out into
Insured vs. Uninsured.
Within Uninsured, three
further pieces of data will
be collected:
•Amount that was 100%
discounted
•Amount that was only a
partial discount of full bill
•The average partial
discount given to
uninsured patients
Self Pay and Charity Care
Remember that only
Uninsured Patients Charity
Care needs to be broken out
into Full and Partial Charity
Care (accounts 7573 and
7574, respectively), not the
total charity care adjustment
amount.
Partial Charity Care (account
7574) is now an autocalculated cell to aid
preparers in filling this
section out correctly.
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 2012.
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 2011, 2010 and 2009 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 Amy Camp 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
• Amy Camp, MDH (651) 201-3575