Information Bulletin, December 1996

Holiday Greetings
Legislative Review
Summary of 1997 Changes
Looking to 1997 and Beyond
Vision for the Immediate Future
Holiday Greetings

The entire SPARCS support staff wodld like to wish you and your families a happy and healthy holiday season. Reflecting back on the past three years, a lot has been accomplished. Our efforts to improve the quality of inpatient and ambulatory surgery information by adopting national standards has brought new life to the SPARCS system. Without a doubt the key factor in these changes has been the hard work and dedication of all the facility staff responsible for reporting data to SPARCS. With changes in the State reimbursement law and probable federal mandates regarding administrative simplification, continued cooperation will be vital as we move forward. Our challenge for the years to come is to join you in delivering quality health care at an affordable price.

Legislative Review

A question frequently asked since the passage of the New York Health Care Reform Act (NYHCRA) of 1996 is: What will happen to SPARCS? We are all aware that under the old reimbursement law, SPARCS data was used to calcdlate rates for all New York State payers. With most rates now being negotiated, we are confident that the use of SPARCS data will expand to provide valuable information to a larger popdlation needing accurate administrative data.

This summer President Clinton signed the Insurance Portability and Accountability Act of 1996. Included in this legislation are mandates for administrative simplification. It is these provisions that codld affect how health-related data in New York is collected. Since we have already migrated to a HCFA standard, version 4.1, we are well positioned for any of the likely choices being discussed as the national standard for claims. It is important to note that this legislation will mandate electronic claims submission. The only question is what will be the standard.

Summary of 1997 Changes

Included below is a summary of our 1997 changes as a final reminder. Each of these items has been previously published in prior bulletins and in our updated documentation distributed this fall on diskette. It shodld be noted that our policy is to give a one-year transition period for all new data elements that we collect. For any new requirements in 1997, data submitted for prior years may optionally contain the 1997 additions. In 1998 any new elements will be required for all submissions. It shodld also be noted that elements new in 1996 will now be required on all submissions. Listed below is a summary of the new 1997 requirements and enhancements.

Looking to 1997 and Beyond
  • New Data Elements
    For outpatient submissions the Unique Personal Identifier is required for all 1997 ambulatory surgery discharges.

    For inpatient submissions new condition codes are available to report homeless and foreign-born patients in conformance with standards established by the National Uniform Billing Committee.

    For inpatient submissions it is no longer necessary to report the Placement of Bed Indicator.

    Effective in 1998 the discharge date must be reported in the Statement Covers Thru Date field for inpatient and outpatient submissions. This is being done to make the SPARCS requirements conform to the national version 4.1 format.

    Effective in 1998 the Prehospital Care Report Number will no longer be required by SPARCS for inpatient submissions.

  • New Edits
    An edit has been implemented to ensure that newborns weighing less than 1500 grams and discharged to home have a length of stay greater than 10 days. This edit was implemented to correct data anomalies found by department researchers.

    Appendix R of the SPARCS Documentation details our continued efforts to identify ICD-9-CM coding conditions in cooperation with the New York Health Information Management Association.

  • Goodies Bag
    The next release of the HCNAPPS software, version 4.12, will be sent out shortly. This release incorporates the above mentioned changes for 1997. A new feature has been added to the Administration menu. This option enables users to change the record status of all records in a category. This routine was recommended by several users of the HCNAPPS software.

    The 1994 and 1995 SPARCS Annual Reports are being finalized, and are expected to be mailed to all facility CEOs in January.

    SPARCS coming to a Web site near you. We have received approval to develop a home page in the New York State Department of Health World Wide Web site ( www.health.state.ny.us ). Warm up your browsers for this addition sometime mid-winter.

    Updates to the contact files are still being received. The goal for 1997 is to get all facilities up and active on electronic mail, and to keep the contact names current to ensure all communications reach the appropriate person at each facility.

    Don't be surprised if you periodically receive letters from us asking about reporting patterns with selected required data elements. It is our goal to continuously analyze the data sent to us in order to validate the accuracy of reporting. Letters have been sent or are being prepared notifying facilities of possible reporting problems with the Payer Identification Number and the Emergent Diagnosis Indicators.
Vision for the Immediate Future

We are encouraging more and more facilities to submit their data to SPARCS electronically. We believe this step into the new age will provide a significant reduction in administrative costs for facilities and SPARCS.

In closing, our New Years resolution to you is that we will look closely at the data elements we collect to determine their ongoing value. Elements that are no longer needed will no longer be required.