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Program Update

With the passage of the Fiscal Responsibility Act of 2023 and related rescission of program funds, no further payments will be made to providers under the Provider Relief Fund or the American Rescue Plan Rural Distribution, including no reconsideration payments. Likewise, no additional claims payments will be made under the Uninsured Program or Coverage Assistance Fund. Per the Terms and Conditions of each Program, all reporting and auditing requirements will continue without disruption.

How to Report Patient Metrics

Why Are Patient Metrics Important?

HRSA is collecting information on the number of patient encounters (e.g., visits, admissions, and stays) that took place in settings including outpatient, inpatient, emergency department, or residential facilities. Reporting Entities will report on the following personnel, patient, and facility metrics by quarter for calendar year 2019 through the current period of availability. While providing this information will not be a factor in the risk-based audit strategy, these metrics will enable HRSA to quantify the impact of COVID-19, and the impact of the Provider Relief Fund and American Rescue Plan (ARP) Rural payments, on various provider types.

Patient Visit Types

  • Inpatient admissions include the number of hospital admissions that take place on a provider’s order or where a patient is formally admitted from the emergency department to the hospital.
  • Outpatient visits include the number of in-person or virtual encounters with a provider in an office-based clinic, or hospital outpatient department setting that do not require an inpatient admission. These can also include outpatient surgical centers and a patient’s home or residence.
  • Emergency visits, for purpose of reporting, are defined as the number of unique emergency department encounters for care or treatment. This may include visits for patients on observation status who receive care for no longer than 72 hours and are not formally admitted to a hospital.
  • Facility stays include the number of stays or unique admissions for patients residing in a long-term or short-term care or treatment facility.

If providers are uncertain how to classify their encounters in one these groups, we suggest counting the unique encounters or visits among the most reasonable setting. For instance, an anesthesiologist who sees patients in both outpatient surgical centers and as part of inpatient procedures should separate the encounters between both inpatient admissions and outpatient visits. A home health provider can count their distinct home-based visits as outpatient visits.

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