MHDO Hospital Inpatient and Outpatient Data

Hospital Inpatient and Outpatient Data

Hospitals must file with the MHDO a completed hospital inpatient and outpatient data set for every service provided to each patient. See Rule Chapter 241 on our Rules and Statutes page for a complete definition of the data which must be submitted, and by which hospitals.

For those involved with or impacted by the development and implementation of our new hospital data submission system and testing the addition of ICD-10 fields, please see the Hospital Data Submitters page.

Available Datasets

The elements available in the various data sets can be reviewed in the document Hospital Encounter Release Elements.
In addition you may review the specific set of validations the hospital data are measured against before the MHDO accepts into our database.
If you are interested in requesting data, our Request Data or Reports page has all the information you need.

July 17, 2018 - The New MHDO Hospital Data Dictionary is now available.

The data dictionary is an interactive tool designed to assist data users with understanding the content, format and structure of the MHDO Hospital Inpatient and Outpatient Data Sets. The Hospital Data Dictionary is integrated with the APCD Data Dictionary and available here: https://mhdo.maine.gov/mhdo-data-dictionary/search. The data dictionary is designed to support users in:

  • Improved navigation of the data elements
  • Understanding relationships between data elements and which elements are included with each type of data release
  • Access to underlying code sets

Recent Releases

Note: Expected release dates of hospital inpatient and outpatient encounter data can be found on our Data Release Schedules page.

7/11/18 CY2017 Outpatient Hospital Encounter Data Released

A link to the Hospital Encounter Data section of the FAQ web page was provided to the users as part of the release.
In addition, a link to the newly launched Hospital Data Dictionary at https://mhdo.maine.gov/mhdo-data-dictionary/search, which is now integrated with the APCD Data Dictionary, was made available.

Note ID Release Version Note Text Start Data Year End Data Year
1 5 New Release File: This release contains a new file: OP61_Narrow. This file contains the same detail information as the existing OP61 file. However, it has been restructured. Rather than each row having three sets of fields documenting revenue codes, HCPCS codes, etc., the OP61_Narrow format only has a single set of fields. So, if an encounter has 2 records with all fields populated on the OP61 table with OP6102_SequenceNumbers 1-2, these would appear as 6 records on OP61_Narrow with OP6102_SequenceNumbers 1-6. The MHDO will continue to supply the OP61 information in both formats for reasons of backwards compatibility. 1/1/2017 12/31/2017
2 5 Hospital Specific Notes:
Calais Regional Hospital (200055) – lower counts in February 2017 due to loss of physicians and services at hospital.

Mount Desert Island Hospital (200038) – lower count in February 2017 due to few of the high-volume providers on vacation during that month, having significant impact on their volume.

Pen Bay Medical Center (200063) - lower record count for Pen Bay physician clinic data is due to the change in EMR vendors. The new system includes multiple procedures in one encounter record; whereas previous did not.
1/1/2017 12/31/2017
3 5 Missing Data:
Maine Coast Physician Offices (200072) – Missing Q4 2017 data due to unresolved issues with their data vendor. MHDO is working with submitter in hopes that the missing Q4 2017 data will be submitted and included in the next release of hospital outpatient data.

Mount Desert Island Health Centers (200086) – Missing data due to issues with new vendor and system. MHDO is working with submitter in hopes that the missing Q4 2017 data will be submitted and included in the next release of hospital outpatient data.

Dorothea Dix Psychiatric Center (200057) – Dorothea Dix reported to MHDO that they do not have final bills for Q4 2017 and will include any Q4 2017 outpatient encounters in the next reporting cycle.
1/1/2017 12/31/2017
4 5 Closings:
Riverview Psychiatric Center-Medication Management Clinic (200056) –Riverview notified the MHDO that their Medication Management Clinic closed January 2017, so beginning with Q1 2017 there will be no outpatient claims to submit.
1/1/2017 12/31/2017
6/1/18 Q4 2017 Inpatient Hospital Encounter Data Released

In addition to providing a link to the Hospital Encounter Data section of the FAQ web page, the following information was provided to the users as part of the release.

Note ID Release Version Note Text Start Data Year End Data Year
8 11 This release contains October – December (Q4) 2017 Hospital Inpatient Encounter data. It contains inpatient encounter data for all Maine hospitals required to submit according to MHDO Rule Chapter 241. Data issues to note in this release: 10/1/2017 12/30/2017
    Per our Q3 release note on ED visits, Mayo Hospital continues to have lower counts for ED visits compared to Q1 and Q2 2017 data.    
3/2/18 Q3 2017 Inpatient Hospital Encounter Data Released

The following information was provided to the users as part of the release.

Hospital Encounter FAQ's (updated)

Note ID Release Version Note Text Start Data Year End Data Year
7 10 This release contains July – September (Q3) 2017 Hospital Inpatient Encounter data. It contains inpatient encounter data for all Maine hospitals required to submit according to MHDO Rule Chapter 241. Data issues to note in this release: 7/1/2017 9/30/2017
    1) As of August 2017, Calais Hospital no longer delivers babies.    
    2) Emergency Department (ED) visits – MHDO’s methodology for flagging ED visits remains unchanged – visits that have a revenue code of 0450, 0452, 0456, or 0459 are flagged and considered ED visits. In this release we noticed around a 50% drop in flagged ED visits for two facilities in the 3rd quarter – Calais Hospital and Mayo Hospital. Note: the number of total encounters at these facilities remained consistent with historical counts. Both hospitals are Critical Access Hospitals with CPSI as their data vendor. Based on our research of these issues it appears that our methodology to flag ED visits as described above may not be catching ED visits at critical access hospitals for certain payers. What has come to our attention from these two CAH’s that is impacting our ability to apply our flagging methodology is a billing practice referred to as “split” billing. Feedback from these hospitals is as follows:

Calais Hospital: MHDO’s methodology described above is only flagging non-Medicare patients with ED visits at Calais Hospital. The reason for this is as described by Calais Hospital: All Medicare accounts at our facility “split” off to bill the ED separately, meaning any inpatient with Medicare will not show any ED charges (Rev codes in the 0450’s) on their Inpatient record. Instead there will be a separate record (ED only) created after discharge to bill the ED portion of the stay.

Mayo Hospital: MHDO’s methodology described above is only flagging non-Medicare, MaineCare, VA, Workers Comp and Medicare Replacement plans at Mayo Hospital.

MHDO/HSRI will discuss with CAH’s the best way to identify all ED visits regardless of the payer for future releases.
   
12/1/17 2017 Q1 & Q2 Inpatient Hospital Encounter Data Released

The following information was provided to the users as part of the release.

Hospital Encounter FAQ's (updated)

Note ID Release Version Note Text Start Data Year End Data Year
5 6 This release contains January-June (Q1 & Q2) 2017 Hospital Inpatient Encounter data.
It contains inpatient encounter data for all Maine hospitals required to submit according to
Chapter 241 and there are no data quality issues to note.
1/1/2017 6/30/2017
6/30/17 2016 Outpatient Hospital Encounter Data Released today

The following documents were provided to users as part of the release.

6/13/17 2016 Inpatient Hospital Encounter Data Released 6/13/17

The following documents were provided to users as part of the release.

4/21/17 2015 Outpatient Hospital Encounter Data Released 4/21/17

The following documents were provided to users as part of the release.

3/20/17 2015 Inpatient Hospital Encounter Data Released 3/17/17

The following documents were provided to users as part of the release.

5/2/16 2014 Inpatient and Oupatient Hospital Encounter Data Released 4/29/16

The following documents were provided to users as part of the release.

Update 4/11/16 2013 Outpatient Data Released on 3/11/16: See the 2013 Hospital Outpatient Data Release Notes

Update 4/11/16 2012 Hospital Data and 2013 Inpatient Hospital Data Refresh

On 3/11/16 MHDO released a refresh of the 2012 Inpatient and Outpatient data and of the 2013 Inpatient data.

The refresh release notes are below.

Update 12/4/15 Corrections/Clarifications to the release notes for 2012 hospital inpatient and outpatient, and 2013 inpatient data were made available. The release documentation is available upon request. Call 207 287-6722 or email Webcontact.MHDO@maine.gov.

11/4/15 Data Release: 2012 Inpatient, 2012 Outpatient, and 2013 Inpatient Data Were Released

Information Regarding 2012 Outpatient Data Release of 8/15/14:

In spite of the extensive internal and external QC that is performed on data prior to release, an issue involving duplicate records has only now been uncovered in the Maine 2012 Outpatient data which was released in August of 2014. In total, there were 49,985 records that appear more than once, most often under two different hospitals. This represents 0.8% of the total release data.

The duplicate system ID file contains a list of record ID (Sysid) that need to be removed from the release data to correct for this error. Any record on either the Encounter or Detail table that has a Sysid on the list should be removed from any analysis of the data.

Removing these records from the previously sent data seems to be the most expedient way to resolve this issue, as users will have already loaded the data into their systems. Any user that would prefer to receive a complete replacement of the release files should contact the MHDO.

Going forward an additional check will be added to the internal QC process to identify and remove any exact duplicate records prior to release.

If you have any questions or concerns, please contact Karynlee Harrington at 207-446-0890.

Outpatient Hospital Encounter Data for CY 2012 were released 8/15/2014. As we continue to work on improving our documentation we provided users with several documents as part of the release.