The State of California requires hospitals to prepare and submit quarterly and annual reports to the Office of Statewide Health Planning and Development. OSHPD data are the most readily available set of hospital financial information in the State of California. Not only do these data have reimbursement impact, but they also convey a facility’s public image. In terms of reimbursement there are a multitude of programs that use OSHPD data as a means of determining payment. This includes the on-going Quality Assurance Fee (QAF) program which looks at OSHPD data for a specified period of time, and is updated only with each period’s extension. Also, hospitals that qualify for Medi-Cal Disproportionate Share funding (see “Hospital Reimbursement” Services section) rely heavily on an accurately filed OSHPD report. Small changes in data can determine whether a hospital qualifies for funding or attains a higher level of payment. It is therefore critical that the systems behind the reported data be correct to ensure an accurate filing of the OSHPD report.

  • Evaluation of hospital accounting systems as they relate to state reporting requirements to ensure that appropriate insurance plan and adjustment (deduction from revenue) codes are being used and accounts are being mapped to their proper payer categories.
  • Preparation and submission of quarterly and annual OSHPD disclosure reports. In addition, perform all review and analysis of data related to the information contained in the submitted reports, or other work related to the submitted reports during the OSHPD review and/or audit process.
  • Perform review and analysis of OSHPD annual disclosure reports prepared by hospital or its consultant prior to submission. The objective of this review is to focus on key data elements contained in the draft OSHPD annual disclosure report that appear either to be inconsistent with prior years’ data, statewide averages, or just unusual. This allows the hospital to be in a position to explain various conclusions that are reached by data users well in advance, by having already researched the identified areas for either making corrections or validating the information that is being provided to OSHPD.