Data Reporting Information for New Facilities

All licensed health care facilities are responsible for providing administrative data to the Pennsylvania Health Care Cost Containment Council (PHC4) on a quarterly basis. PHC4 is notified by the Pennsylvania Department of Health, Division of Licensing when a health care facility is granted a license to do business in Pennsylvania.

PHC4 was established as an independent state agency in 1986 by the Pennsylvania General Assembly. PHC4's mission is to address the cost and quality of health care in Pennsylvania by promoting health care competition through the collection, analysis, and public dissemination of health care information. To fulfill this mission, Act 89 (as reauthorized by Act 3 of 2009 ), the Health Care Cost Containment Act, mandates the collection of data from all health care facilities licensed in Pennsylvania, including hospitals and ambulatory service facilities. The information is then used to produce a number of widely distributed public reports for use by payers, providers, purchasers of health care and the general public.

PHC4 validates submitted data and provides facilities with the opportunity to correct errors. However, it is the responsibility of the facilities to ensure data accuracy.

The next section is an introduction to the types of data PHC4 collects, followed by documents to help facilities with submitting data to PHC4.

Inpatient Discharges and Select Ambulatory/Outpatient Surgical Procedures

Administrative and clinical data are collected on a quarterly basis and received 90 days from the close of each quarter. The following table shows the frequency of data submission to PHC4:

For Quarter Ending Data Is Due
March 31 June 30
June 30 September 30
September 30 December 31
December 31 March 31

Newly-licensed facilities will be notified several months in advance before their first data submission is due. However, it is highly recommended that facilities send data early to gain familiarity with the data submission process and test their data in advance. Facilities submit data via PHC4's Web-based portal, which is free, safe, and provides proof that data was sent. Data can be entered directly online or submitted by data upload. Data upload instructions are included in the list of Instructions and Manuals below.

Annual Financial and Utilization Data

All licensed facilities provide annual financial, utilization and payer data. In addition, hospitals send annual malpractice expense data. Facilities enter this data on PHC4's Web portal and concurrently send annual financial statements. The reporting or fiscal year used for financial data collection is the same accounting year used by the facility. Facilities that provide a Medicare Cost Report (MCR) to CMS are asked to send a copy of the MCR to PHC4 at the normal MCR filing date.

Depending on the facility's fiscal year end, PHC4 will send the facility a notice of the forthcoming filing date with the facility’s username and password for PHC4's Web portal. New facilities send data for their first accounting period that is six months or longer.

The following section contains several documents to help facilities with sending data to PHC4.

Instructions and Manuals

Forms

New Facility Questionnaires

PHC4 Public Reports

PA Uniform Claims and Billing Form Reporting Manual (UB‑04) – Inpatient and Ambulatory/Outpatient
The list of Instructions and Manuals has two manuals that describe the specifications and formats for the data to be sent to PHC4. There are separate manuals for Inpatient and Ambulatory/Outpatient data. The Ambulatory/Outpatient manual lists the surgical procedures that are sent to PHC4. The manuals are updated periodically, and are available on the PHC4 Web site at http://www.phc4.org/dept/dc/.
Administrative Data Forms
The list of Forms contains the Hospital Initiated Change Form and the Delete Record Form for changing and deleting data. These forms are useful after data has been submitted to PHC4, during the error correction process. These forms are also available on the PHC4 Web site at http://www.phc4.org/dept/dc/.
Annual Financial and Utilization Documents
The list of Instructions and Manuals contains instructions and definitions related to submitting financial data via PHC4's Web portal. The list of Forms contains example forms showing the type of financial data submitted to PHC4 by general acute care hospitals and ambulatory surgery centers.
New Facility Questionnaires
One questionnaire needs to be completed (for either a hospital or an ambulatory surgery center) to designate a contact person(s) for the administrative/clinical data submission process. The questionnaires are located in the list of New Facility Questionnaires. The person(s) designated as the PHC4 contact will receive information such as error reports and e-mail notifications on a regular basis. This person is also responsible for responding to PHC4's inquiries, and must be knowledgeable of the facility's internal systems and processes.

* The new facility questionnaire (for either a hospital or an ambulatory surgery center) needs to be returned to PHC4 within two weeks from the date that the facility is notified that it must begin submitting data.

PHC4 Public Reports
The list of PHC4 Public Reports contains links to PHC4's most popular public reports. PHC4 has historically relied on input from the health care provider community to guide its decisions regarding data. This support and assistance has enabled Pennsylvania to develop and maintain an excellent reputation for high-quality health care data.
Questions and Contact Information
Please contact PHC4 at (717) 232-8958 or email us at with any questions. Additionally, PHC4's Web site has up-to-date information at http://www.phc4.org/dept/dc/ .