Health Professions

Healthcare Integrity and Protection Data Bank

Note: 

1. The FY 2009 target was developed with the assumption that the final regulations implementing Section 1921 of the SSA would go into effect in FY 2009. At this time, it appears that these regulations will not go into effect in FY 2009.

INTRODUCTION

The Healthcare Integrity and Protection Data Bank (HIPDB) program’s performance measures and activities build upon HRSA’s long-range goal to “Improve the Quality of Health Care” and are keyed to the following HRSA objective:

• Promote patient safety and improve patient protections

This program maintains a data base that provides critical information to State and Federal agencies, law enforcement officials, and health plans concerning adverse licensure and contract actions; health care related judgments; and criminal convictions against health care practitioners, providers and suppliers.  This information is to combat fraud and abuse in health insurance and health care delivery to protect patients and provide for a better health care system.

Performance measure information, some of which is updated monthly, is used by the program to assess the success of the Data Banks in meeting goals for querying and use of the information by queriers for decision making in individual licensing and credentialing cases.  Overall the information, which is assessed annually, is used to help determine the degree to which the program is meeting the needs of the queriers.

DISCUSSION OF RESULTS AND TARGETS

Long-Term Objective:  Promote patient safety and improve patient protections.

8.III.B.3. Increase annually the use of the HIPDB for licensing and credentialing decision-making, operationalized as the number of licensing and credentialing decisions which limit practitioner’s ability to practice because of information contained in HIPDB reports.
(Baseline – 2005: 1,120 Decisions)

In FY 2007, 1,300 licensing or credentialing decisions were impacted by information supplied by the HIPDB. This was an increase over the FY 2006 actual of 1,150 and about 9 percent above the target. Implementation of Section 1921 regulations will place most reports currently in the HIPDB into the NPDB. This is expected to substantially decrease querying of the HIPDB. The FY 2009 target is 809 decisions. The FY 2009 target was developed with the assumption that the final regulations implementing Section 1921 of the SSA would go into effect in FY 2009. At this time, it appears that these regulations may not go into effect in FY 2009.

8.III.B.4.  Increase annually the number of times information provided by HIPDB is considered useful by the querying entity which received it.

In 13,150 cases in FY 2007 the querying entity considered the information provided by HIPDB to be useful.  This represents an increase over the FY 2006 actual of 11,650 and is about 8 percent above the target level.  The FY 2009 target is 8,217 cases.  The targets will be adjusted as needed after Section 1921 regulations are adopted.

8.E.  Increase annually the number of queries for which NPDB and HIPDB responded within 240 minutes.

The length of time it takes the NPDB-HIPDB to process a query and return results to the querier has been reduced while both the number of queries and the number of reports in the system have continually increased.  When the NPDB opened in 1990, it took days to process queries.  The system has changed from paper documents to an internet-based system containing electronic documents.  Queries are now responded to within 240 minutes.  The volume of queries has increased greatly over the years, to over 4.7 million queries in FY 2007 that were responded to within 240 minutes.  The FY 2009 target is 4.9 million queries.