HERC: Outpatient Data
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Outpatient Data

HERC Outpatient Average Cost Data

The HERC outpatient file estimates represent the hypothetical Medicare reimbursement average given the Current Procedure and Terminology Codes assigned to the VA visit. Estimates are adjusted so that the estimates tally to actual national VA expenditures for that type of care.

Proc Contents for HERC Outpatient Average Cost Data FY98-FY13
  FY98 FY99 FY00 FY01 FY02 FY03 FY04 FY05 FY06 FY07 FY08 FY09 FY10 FY11 FY12 FY13
Outpatient Costs X X X X X X X X X X X X X X X X

 

Proc Contents for HERC Outpatient Average Cost Data FY14
  FY14
Outpatient Costs X

Data location: on VINCI (\\vhacdwsasrds01.vha.med.va.gov\HERC) or on the SAS 9.4 Grid (on the server VHACDWSASGSUB2.VHA.MED.VA.GOV at /data/prod/HERC).

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HERC Outpatient Person-Level Cost Data

The person-level cost datasets contain total annual costs for VA care received by each individual who used the VA health care system. Currently spanning FY98-FY13, these data allow researchers to observe the annual costs of individual patients without needing to extract and summarize stay and visit level information from numerous VA databases.

Proc Contents for HERC Outpatient Person-Level Cost Data FY98-FY13
  FY98 FY99 FY00 FY01 FY02 FY03 FY04 FY05 FY06 FY07 FY08 FY09 FY10 FY11 FY12 FY13
Person-Level Costs X X X X X X X X X X X X X X X X

 

Proc Contents for HERC Outpatient Person-Level Cost Data FY14
  FY14
Person-Level Costs X

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MCA Outpatient Cost National Data Extract

The US Department of Veterans Affairs (VA) uses the Managerial Cost Accounting System (MCA), formerly Decision Support System (DSS), for fiscal management and to determine the cost of patient care. National Data Extracts (NDEs) have been created to facilitate access to workload and cost information. These extracts report costs of outpatient encounters provided by VA.

OPAT (Outpatient). This dataset includes outpatient costs per clinic stop per day. HERC has created a Guidebook for the MCA NDE. As we describe in the Guidebook, some care is needed to merge this dataset to the Medical SAS outpatient datasets (i.e., National Patient Care Database). This dataset excludes low cost records (see Out2).

OUT2. This dataset is similar to the Opat NDE, but it includes low cost outpatient records (those with cost greater than $-1 and less than $1, including zero-cost encounters). This dataset includes almost all of the outpatient care recording in the Medical SAS outpatient datasets (i.e., National Patient Care Database) that is not recorded in the MCA OPAT NDE.

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MCA Outpatient Cost Intermediate Product Department Data Extract

The intermediate product department for each encounter for outpatient (O-IPD) care. These files provide more detailed cost information for specific types of care. Previously, MCA National Data Extracts reported costs for six broad categories -- medicine/other, laboratory, pharmacy, radiology, nursing, and surgery. These cost sub-totals were dropped from the NDE files while new IPD files were created with a richer set of cost detail. The IPD extract files are available for all fiscal years beginning in 2003.

Opat-IPD (Outpatient intermediate Product Department). This dataset has one record per MCA product department (IPD) utilized within an outpatient encounter. Intermediate products represent work performed in each department and are bundled to make up the outpatient visit.

The IPD national extract files do not contain any formatting for the product department variable (IPD_NUM), so HERC has created a permanent SAS format library for the product department names for files FY 2003 through FY 2008. HERC has made this file available at the Austin Information Technology Center for use by researchers.

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Non-VA Medical Care Outpatient File

The Non-VA Medical Care (Fee) files include information on covered care provided to VA patients by contract providers under the Non-VA Medical Care Program.

Data from the Non-VA Medical Care system input in SAS files at the VA Austin Information Technology Center (AITC). The files that contain Non-VA Medical Care are named in the form:

MDPPRD.MDP.SAS.FEN.FYyy where yy is the last two digits of the year in which the payment was processed.

Outpatient services:
MDPPRD.MDP.SAS.FEN.FYyy.MED
This file contains one diagnosis code and 1 CPT procedure code. It contains information on home health care.

There is an alternative method for accessing summaries of Non-VA Medical Care expenditure data, one that does not require an AITC time-share account. A "Non-VA Care Cube" has been created as part of the national Financial and Clinical Data Mart. The data cube shows combined payments from the four central Non-VA Medical Care files: Inpatient, Outpatient, Inpatient Ancillary, and Pharmacy. One can view and download a series of standard reports or create a unique "view". The data cube does not present individual encounter records. Rather, it shows payment totals summed within category (Purpose of Visit) and time period (month or fiscal year). The data cube is accessed through the VISN Support Services Center (VSSC) web site, also known as the KLFMenu. The site is accessible only through the VA intranet.

 Proc Contents for Non-VA Medical Care Outpatient File (FY00-FY12)
Non-VA Medical Care Data FY00 FY01 FY02 FY03 FY04 FY05 FY06 FY07 FY08 FY09 FY10 FY11 FY12
Outpatient Visit Austin FB PROC CONTENTS File (MED FY00) Austin FB PROC CONTENTS File (MED FY01) Austin FB PROC CONTENTS File (MED FY02) Austin FB PROC CONTENTS File (MED FY03) Austin FB PROC CONTENTS File (MED FY04) Austin FB PROC CONTENTS File (MED FY05) Austin FB PROC CONTENTS File (MED FY06) Austin FB PROC CONTENTS File (MED FY07) Austin FB PROC CONTENTS File (MED FY08) Austin FB PROC CONTENTS File (MED FY09) Austin FB PROC CONTENTS File (MED FY10) Austin FB PROC CONTENTS File (MED FY11) Austin FB PROC CONTENTS File (MED FY12)

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VA National Patient Care Database (NPCD) Medical SAS Outpatient Data

The VA National Patient Care Database (NPCD) has information on outpatient vists. It includes diagnosis, procedure codes, and patient demographics.

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FAQs

What are the Categories of Care (CAT Files) for the Outpatient Average Cost Dataset?

The 12 categories are:

21 Medicine
22 Dialysis
23 Ancillary
24 Rehabilitation
25 Diagnostic
27 Prosthetics
28 Surgery
29 Psychiatry
30 Substance Abuse
31 Dental
32 Adult day Health
33 Home care

Notes

Number 26 is a placeholder for Pharmacy, 99 is the category for unidentified clinic stops.


What is the nature of MCA National Data Extracts (NDEs) that contain low cost outpatient encounters?

The low cost outpatient NDE files contain information on outpatient encounters that were assigned low cost by MCA. "Low cost" MCA data refer to those outpatient encounters that are either not assigned costs or assigned costs between -$1 and $1. In fiscal year (FY) 2004, low cost data represented 8.2% of all MCA data containing information about outpatient care. Technical Report #23, Comparison of MCA Encounter-Level National Data Extracts and the VA National Patient Care Database: FY2004, reveals that by including low cost MCA encounters in a comparison between the MCA and NPCD databases, outpatient utilization thought to be missing from MCA was found, and almost all outpatient care was reported in MCA. The low cost files, which have supplemented MCA outpatient extracts since FY2002, are thus important in identifying VHA outpatient encounters. The low cost files are stored at the Austin Information Technology Center (AITC). To obtain the file names, please contact us.

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