Chapter DHS 120

DHS 120.25(2) (2) Contents. The uncompensated health care services report shall contain all of the following information:

DHS 120.25(2)(a) (a) For each hospital, the report shall list all of the following:

DHS 120.25(2)(a)1. 1. The city in which the hospital is located.

DHS 120.25(2)(a)2. 2. The type of the hospital.

DHS 120.25(2)(a)3. 3. The dollar amount of charity care provided for the most recent fiscal year.

DHS 120.25(2)(a)4. 4. The proportion of total annual gross patient revenue that constitutes the charity care.

DHS 120.25(2)(a)5. 5. The annual amount of bad debt.

DHS 120.25(2)(a)6. 6. The proportion of total annual gross patient revenue that constitutes the bad debt.

DHS 120.25(2)(a)7. 7. The total annual dollar amount of charity care and bad debt.

DHS 120.25(2)(a)8. 8. The proportion of total annual gross patient revenue that constitutes both charity care and bad debt.

DHS 120.25(2)(a)9. 9. The proportion of total nongovernmental patient revenue that constitutes the charity care.

DHS 120.25(2)(a)10. 10. The proportion of total nongovernmental patient revenue that constitutes the bad debt.

DHS 120.25(2)(a)11. 11. The proportion of total annual nongovernmental patient revenue that constitutes both charity care and bad debt.

DHS 120.25(2)(a)12. 12. The number of patients that received charity care during the most recent fiscal year.

DHS 120.25(2)(a)13. 13. The number of patients projected to receive charity care during the subsequent fiscal year.

DHS 120.25(2)(a)14. 14. The number of bad debt patient accounts during the most recent fiscal year.

DHS 120.25(2)(a)15. 15. The number of bad debt patient accounts projected for the subsequent fiscal year.

DHS 120.25(2)(a)16. 16. The total number of charity care and bad debt cases during the most recent fiscal year.

DHS 120.25(2)(a)17. 17. The total number of charity care and bad debt cases projected for the subsequent fiscal year.

DHS 120.25(2)(a)18. 18. Whether and to what extent the hospital has outstanding obligations on state loan funds, excluding fund proceeds from the Wisconsin health and educational facilities authority, during the most recent fiscal year.

DHS 120.25(2)(b) (b) For each hospital with county general relief revenues greater than $500,000 or 1% of total gross patient revenue for the most recent fiscal year, the report shall list all of the following:

DHS 120.25(2)(b)1. 1. The county in which the hospital is located.

DHS 120.25(2)(b)2. 2. The amount of general relief revenues the hospital received.

DHS 120.25(2)(b)3. 3. The proportion of total gross revenue that the general relief revenue represents.

DHS 120.25(2)(b)4. 4. The proportion of charges for general relief cases that were reimbursed by counties.

DHS 120.25(2)(c) (c) A copy of the department’s hospital uncompensated health care plan survey.

DHS 120.25(2)(d) (d) A copy of the department’s hospital fiscal survey.

DHS 120.25(2)(e) (e) A glossary of terms used in the report.

DHS 120.25(2)(f) (f) Brief discussions of all of the following:

DHS 120.25(2)(f)1. 1. The definition of uncompensated health care services.

DHS 120.25(2)(f)2. 2. Problems associated with measuring hospitals’ charitable contributions to their communities.

DHS 120.25(2)(f)3. 3. Summary statistics pertaining to uncompensated health care services.

DHS 120.25(2)(f)4. 4. How hospitals project uncompensated health care.

DHS 120.25(2)(f)5. 5. How hospitals verify the need for charity care.

DHS 120.25(2)(f)6. 6. A list of hospitals with obligations to provide reasonable amounts of charity care.

DHS 120.25(2)(f)7. 7. How hospitals notify the public about charity care.

DHS 120.25(3) (3) Report dissemination. The department shall distribute a paper copy of the report at no charge to the governor, the legislature and a board-approved list of individuals and agencies. The department shall make the paper version of the report available for purchase by others. The department shall make available from the department’s website an electronic version of the report at no charge.

DHS 120.25(4) (4) Suggested uses of report. Some suggestions for using the report are as follows:

DHS 120.25(4)(a) (a) By legislators and policymakers to determine the level of uncompensated health care provided in various areas of the state and, in turn, whether the burden of uncompensated health care is fairly shared by all hospitals.

DHS 120.25(4)(b) (b) In conjunction with other available information, by insurance companies and other third-party payers and by business or consumer groups to determine the extent to which uncompensated health care affects hospitals’ charges and hospitals’ ability to provide services to a community.

DHS 120.25(4)(c) (c) As a resource document for persons wishing to conduct research or seek information on uncompensated health care.

DHS 120.25 History History: Cr. Register, December, 2000, No. 540, eff. 1-1-01.

DHS 120.26 DHS 120.26 Hospital quality indicators report.

DHS 120.26(1) (1) Data source. The hospital quality indicators report shall be based on hospital inpatient data collected by the department under s. DHS 120.12 (5). The inpatient discharge data are reformatted by the department to be consistent with nationally recognized quality indicators.

DHS 120.26 Note Note: An example of nationally recognized quality indicators are the health care utilization project (HCUP) quality indicators.

DHS 120.26(2) (2) Contents. The hospital quality indicators report shall present variations in the delivery of inpatient care at individual hospitals without identifying the individual hospitals. The purpose of the report is to promote improvements in the overall quality of hospital care by providing an analysis of the variations in care delivery across the state. Where appropriate, national comparisons serve as improvement benchmarks. Each report shall include all the following information:

DHS 120.26(2)(a) (a) A description of the report’s data and the limitations in interpreting the data.

DHS 120.26(2)(b) (b) A description of nationally recognized quality indicators.

DHS 120.26(2)(c) (c) A discussion of how to interpret the analysis of the variations in care delivery across the state.

DHS 120.26(2)(d) (d) A graphical presentation of the performance of hospitals relative to the quality indicators selected for presentation in the report.

DHS 120.26(2)(e) (e) A discussion of how a hospital may obtain from the department hospital-specific information resulting from application of the nationally recognized quality indicators.

DHS 120.26(3) (3) Report dissemination.

DHS 120.26(3)(a) (a) The department shall distribute a paper copy of the report at no charge to the governor, the legislature and a board-approved list of individuals and agencies. The department shall make the paper version of the report available for purchase by others. The department shall make available from the department’s website an electronic version of the report at no charge.

DHS 120.26(3)(b) (b) The department may not release the identity of the individual hospitals in the report. Individual hospitals may request information from the department that allows the hospital to assess the hospital’s standing relative to a group of hospitals with comparable patient volumes or state or national benchmarks.

DHS 120.26(4) (4) Suggested uses of report. Some suggestions for using the report are as follows:

DHS 120.26(4)(a) (a) By legislators and policymakers to examine the variation in indicators of hospital quality for various diagnoses and procedures and, in turn, whether the variation suggests the need for improvements in the quality of the health care delivery system.

DHS 120.26(4)(b) (b) In conjunction with other available information, by commercial and public health care purchasers to determine the extent of variation in indicators of hospital quality. Contracts between health care purchasers and health plans and providers may address concerns arising from the reported indicators of quality.

DHS 120.26(4)(c) (c) As a resource document for persons wishing to conduct research or seek information on hospital quality indicators.

DHS 120.26(4)(d) (d) As a resource for consumers interested in learning about the expected outcomes of hospital care associated with a specific diagnostic category or a procedure.

DHS 120.26(4)(e) (e) As a resource for individual hospitals that want to assess the need for quality improvement projects.

DHS 120.26 History History: Cr. Register, December, 2000, No. 540, eff. 1-1-01.

subch. V of ch. DHS 120 Subchapter V — Data Dissemination

DHS 120.29 DHS 120.29 Public use files.

DHS 120.29(1) (1) Public use data files based on information submitted by health care providers other than hospitals or ambulatory surgery centers may not permit the identification of specific patients, employers or health care providers. The department shall protect identification of patients, employers and health care providers by all necessary means, including all of the following:

DHS 120.29(1)(a) (a) The deletion of patient identifiers.

DHS 120.29(1)(b) (b) The use of calculated variables and aggregated variables.

DHS 120.29(1)(c) (c) The specification of counties as to residence rather than zip codes.

DHS 120.29(1)(d) (d) The use of 5-year categories for age rather than exact age.

DHS 120.29(1)(e) (e) Not releasing information concerning a patient’s race or ethnicity, or dates of admission, discharge, procedures or visits.

DHS 120.29(1)(f) (f) Masking sensitive diagnoses and procedures by use of larger diagnostic and procedure categories.

DHS 120.29(2) (2) Public use data files under s. 153.45 (1) (b) 2., Stats., may include only the following:

DHS 120.29(2)(a) (a) The patient’s county of residence.

DHS 120.29(2)(b) (b) The payment source, by type.

DHS 120.29(2)(c) (c) The patient’s age category, by 5-year intervals.

DHS 120.29(2)(d) (d) The patient’s procedure code.

DHS 120.29(2)(e) (e) The patient’s diagnostic code.

DHS 120.29(2)(f) (f) Charges assessed with respect to the procedure code.

DHS 120.29(2)(g) (g) The name and address of the facility in which the patient’s services were rendered.

DHS 120.29(2)(h) (h) The patient’s gender.

DHS 120.29(2)(i) (i) Information that contains the name of the health care provider who is an individual, if the independent review board first reviews and approves the release or if the department promulgates rules that specify the circumstances under which the independent review board need not review and approve the release.

DHS 120.29(2)(j) (j) Calendar quarters of service during which the patient visit or procedure occurred, except if the department determines the number of data records included in the public use file is too small to enable protection of patient confidentiality.

DHS 120.29(2)(k) (k) Information, other than patient-identifiable data, as defined in s. 153.50 (1) (b), Stats., as approved by the independent review board.

DHS 120.29(3) (3) 

DHS 120.29(3)(a) (a) Public use data files based on information submitted by hospitals and ambulatory surgery centers may not permit the identification of specific patients or employers.

DHS 120.29(3)(b) (b) The department shall protect the identification of patients and employers by all necessary means, including all of the following:

DHS 120.29(3)(b)1. 1. The deletion of patient identifiers.

DHS 120.29(3)(b)2. 2. The use of calculated variables and aggregated variables.

DHS 120.29(3)(b)3. 3. Not releasing information concerning a patient’s race or ethnicity, or dates of admission, discharge, procedures or visits.

DHS 120.29(3)(c) (c) The department shall suppress or mask zip code information in the public use data file when the number of persons having a given zip code is insufficient to mask their identity.