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H H S Department of Health and Human Services
Health Resources and Services Administration
Primary Care: The Health Center Program

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Uniform Data System Changes for 2013

Program Assistance Letter 2013-02

I.       Background

This Program Assistance Letter (PAL) provides information on the Health Resources and Services Administration’s (HRSA) changes to the calendar year (CY) 2013 Uniform Data System (UDS) to be reported by Health Center Program grantees in early 2014. 

The changes include: (1) two revised clinical measures; (2) and reporting patients by zip codes,   insurance source, and age categories.

II.     2013 Changes to Uniform Data System (UDS)

  1. Clinical Performance Measures
  2. Childhood Immunization
  3. Remove Hepatitis A, Rotavirus, and Influenza immunizations from the immunization test battery.
  4. Revise the time frame for shot completion from by age 2 to by age 3.

Reason for change:  To align this measure with current Healthy People 2020 goals and to be consistent with previous years’ reporting on this measure.   

  • Numerator:  Number of children among those included in the denominator who were fully immunized on or before their 3rd birthday.  A child is fully immunized if s/he has been vaccinated or there is documented evidence of contraindication for the vaccine or a history of illness for ALL of the following:  4 DTP/DTaP, 3 IPV, 1 MMR, 2 Hib, 3 HepB, 1VZV (Varicella), and 4 Pneumoccocal conjugate prior to or on their 3rd birthday.
  • Denominator:  Number of all children with at least one medical visit during the reporting period, who had their 3rd birthday during the reporting period or a sample of 70 of these children.  For measurement year 2013, this includes all children with date of birth between January 1, 2010 and December 31, 2010.  Children who were never seen by the clinic prior to their second birthday are to be excluded.  There will no doubt be a number of children for whom no vaccination information is available and/or who were first seen at a point when there was simply not enough time to fully immunize them prior to their second birthday.  They should still be included in the universe and thus in the denominator.

Table 6B is changed as shown below:

Childhood Immunization

Total Number of patients with  3rd  birthday during measurement year

( a )

Number Charts Sampled

or EHR total

 ( b )

Number of Patients Immunized

 ( c )

10

MEASURE:  Children who have received age appropriate vaccines prior to reaching their 3rd  birthday during measurement year (on or prior to 31 December)   
     
  1. Cervical cancer screening

Count as compliant women age 24 to 64 years with a Pap test every 3 years and women age 30 to 64 years who choose a 5 year interval for Pap tests when accompanied by an HPV test.

Whereas the current measure counts as compliant women age 24 to 64 years with 3 year intervals between screenings, the revision allows 5 year intervals for women age 30 to 64 years with a Pap test accompanied by an HPV test.  This change aligns with the 2012 recommendation of the U.S Preventive Services Task Force.

  • Numerator:  Number of female patients in the denominator who received one or more documented Pap tests during the measurement year or during the two years prior to the measurement year OR, for women over 30, received a Pap test accompanied with an HPV test done during the measurement year or the four years prior.
  • Denominator:  Number of all female patients age 24 - 64 years of age during the measurement year who had at least one medical visit during the reporting year, or a sample of these women.  For measurement year 2013, this includes patients with a date of birth between January 1, 1949 and December 31, 1989. 

There is no change to Table 6B shown below: 

Section D – Cervical Cancer Screening

Pap Tests

Total number of Female Patients 

24-64 years of Age

( a )

Number Charts Sampled or EHR total

( b )

Number of Patients Tested

 

( c )

11

MEASURE:  Female patients aged 24-64 who received one or more Pap tests to screen for cervical cancer   
     
  1. Insurance Source by Zip Codes and Age        

B.1 Patient Zip Codes by Insurance Source

Current Table:

Zip CodePatients
03301 
03302 
03303 
Other zip codes 
Unknown  
Proposed Table:

Zip Code

 

(a)

None/

Uninsured

(b)

Medicaid/CHIP/ Other Public

(c)

Medicare

 

(d)

Private Insurance

(e)

03301    
03302    
03303    
Other zip codes    
Unknown    

B.2 Revised Age Break to Summarize Insurance Source Data

Change in age categories from 0-19 years and 20 years and older to match the census categories 0-17 years and 18 years and older

Current Table:

TABLE 4 – SELECTED PATIENT CHARACTERISTICS

Principal Third Party Medical Insurance Source

0-19 years old ( a )

20 and older ( b )

7.

None/ Uninsured

  

8a.

Regular Medicaid (Title XIX)  

8b.

CHIP Medicaid  

8.

Total Medicaid (Line 8a + 8b)

 

 

9.

Medicare (Title XVIII)

  

10a.

Other Public Insurance Non-CHIP (specify:)  

10b.

Other Public Insurance CHIP     

10.

Total Public Insurance (Line 10a + 10b)

  

11.

Private Insurance

  

12.

Total (Sum Lines 7 + 8 + 9 +10 +11)

  
Proposed Table:

TABLE 4 – SELECTED PATIENT CHARACTERISTICS

Principal Third Party Medical Insurance Source0-17 YEARS OLD ( a )18 AND OLDER ( b )

7.

None/ Uninsured

  

8a.

Regular Medicaid (Title XIX)  

8b.

CHIP Medicaid  

8.

Total Medicaid (Line 8a + 8b)

 

 

9.

Medicare (Title XVIII)

  

10a.

Other Public Insurance Non-CHIP (specify:)  

10b.

Other Public Insurance CHIP     

10.

Total Public Insurance (Line 10a + 10b)

  

11.

Private Insurance

  

12.

Total (Sum Lines 7 + 8 + 9 +10 +11)

  
The above changes to the UDS will be described in detail in scheduled trainings and in the 2013 UDS Manual. 
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