Office of Inspector General report: "MEDICARE PROVIDER READINESS FOR Y2K"

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Here are the documents, in either html or pdf format. The pdf file is easier to read.

Excerpts:

URBAN AND RURAL PROVIDERS

Overall, there was little significant difference between urban and rural providers regarding most Y2K issues. However, there were a few specific areas where the responses of urban and rural providers differed.

-Rural hospitals were more likely to report having financial and personnel problems, while urban hospitals reported more problems with external vendors. -Additionally, urban hospitals were more likely to have renovated their billing systems and to have identified all of their external vendors and contractors than rural hospitals.

-Urban nursing facilities were more aware of changes to HCFA forms and of the availability of free contractor software than rural nursing facilities. Furthermore, urban nursing facilities were more likely to have identified all of their external vendors and contractors.

Of home health agencies that could not enter 8-digit dates on the HCFA-1450 form, 71 percent of urban agencies said they would be able to within 6 months; only 38 percent of rural agencies reported they would be able to do so. In addition, urban home health agencies were more likely to have renovated their medical records systems.

Rural DME suppliers were more likely to have renovated their medical records systems.

Rural physicians were more aware than urban physicians of contractor Y2K efforts and the availability of free software. Urban physicians were more likely to have identified all of their external vendors and contractors.

USING EXTERNAL BILLING SERVICES FOR CLAIMS SUBMISSION

We found that providers' contracting with a billing service for claims submission and payment activities had a significant impact on just a few variables.

Hospitals using a billing service were much more confident in their ability to enter 8-digit dates on HCFA forms, were more aware of Medicare contractor outreach, and were more likely to have requested free contractor software.

Nursing facilities using a billing service were less aware of the availability of the free contractor software.

Home health agencies using a billing service were more likely to have identified all of their external vendors and contractors.

Physicians not using a billing service reported more dissatisfaction with contractor outreach. Additionally, they were more likely to have discussed Y2K issues with their external vendors.

ADDITIONAL ANALYSIS

In completing our analysis, we examined several other variables to determine if additional factors affected providers' Y2K awareness and readiness. There were very few statistically significant relationships between these variables and our survey questions. We have provided a summary of those that were statistically significant, by provider type.

Hospitals

1. Hospitals that were part of a managed-care organization were more likely to have inventoried and renovated their biomedical equipment.

2. Chain hospitals were much less aware of issues regarding HCFA claim forms and Medicare contractor outreach. For example, while 32 percent of chain hospitals did not know if they could enter 8-digit dates on the HCFA-1500 form, only 15 percent of non-chain hospitals did not know this.

3. Large hospitals (more than 150 beds) were significantly ahead of small hospitals (50 beds or less) in most areas, including assessment, renovation, and communication with vendors. Additionally, 45 percent of small hospitals reported having financial problems, compared to only 20 percent of large hospitals.

Nursing Facilities

1. Nursing facilities that provided care for managed-care organizations were more likely to have developed strategies for dealing with their computer systems and biomedical equipment. Nursing facilities with managed-care contracts also were more likely to have assessed and renovated their clinical systems and biomedical equipment. These nursing facilities also reported having better interaction with their vendors.

2. Chain nursing facilities seem to be trailing non-chains in the billing area. For example, only 38 percent of chains reported that their billing systems were ready, while 56 percent of non-chains said their billing systems were ready.

3. Only 29 percent of freestanding nursing facilities had developed Y2K contingency plans. Meanwhile, 49 percent of non-freestanding facilities had made contingency plans.

Home Health Agencies

1. Non-freestanding home health agencies had taken more steps to prepare their biomedical equipment for Y2K than freestanding agencies. In addition, non-freestanding agencies reported better communication with external vendors.

2. Large home health agencies reported significantly more progress than did small and medium-sized agencies in both their billing and clinical systems. Furthermore, while 60 percent of large home health agencies had developed Y2K contingency plans, only one-third of small and medium-sized agencies had done so.

Durable Medical Equipment Suppliers

1. No chain DME suppliers reported having financial or personnel problems due to Y2K. However, 16 percent of non-chains reported financial problems and 21 percent reported personnel problems. Additionally, chain suppliers were more confident in their ability to enter 8-digit dates on HCFA-1500 forms.

2. Large DME suppliers were more likely to have developed Y2K strategies than small or medium-sized suppliers. Large suppliers also reported better cooperation with their external vendors. In addition, more than three-quarters of large suppliers indicated they could enter 8-digit dates on HCFA-1500 forms; approximately half of small and medium-sized suppliers reported they could do the same.

Physicians

1. Over 80 percent of physicians providing service for a managed-care organization were aware of changes to the HCFA-1500 form, while less than 60 percent of physicians who were not part of a managed-care plan knew about the changes.

2. Physicians who are part of a group practice reported higher levels of Y2K strategizing and system renovation than sole practitioners. Additionally, group physicians reported better communication with their external vendors.

3. Larger physician practices were more likely to have discussed Y2K issues and tested data exchange with external vendors. Furthermore, 82 percent of large practices were receiving Y2K assistance from external sources, while only 56 percent of medium-sized practices and 29 percent of small practices were receiving outside assistance.

We are making no recommendations, as our goal is to respond to your request for additional analysis of our Y2K survey data. We hope that this analysis is helpful in shaping your continued efforts to assist Medicare providers in their Y2K readiness activities. There is no requirement for you to comment on this report. However, if you have any comments or questions, please call me or George Grob, Deputy Inspector General for Evaluation and Inspections, or have your staff contact Mary Beth Clarke at (202) 619-2481.

-- Steve (hartsman@ticon.net), June 10, 1999

Answers

Thanks for the post,

Funny, I just asked my chiropractor yesterday and they still use 5 yr. old plus accounting package on their win. 95 pc, haven't even explored what their remediation needs are or what is available. I commented that I wondered if Medicare (a large percentage of his practice) was going to cut-off providers who couldn't assure billing compliance by a certain date..... it got their attention. Small potatoes but I am afraid there are lots more like this. Time will tell!

-- Kristi (securx@succeed.net), June 10, 1999.


What was the date of the report (issue date?)

Equally important, since many of the comments were "projected" ahead such as "...in six months, expected to be ..", when was the data gathered? That is, six months from "what date?" makes a big difference if the "interview date" is May, not Feb.

Self -reported, no checks either. Guess we'll find who's naughty and who's nice.

-- Robert A. Cook, PE (Kennesaw, GA) (cook.r@csaatl.com), June 10, 1999.


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