What HCP data is
Under the Private Health Insurance Act 2007, all hospitals must submit Hospital Casemix Protocol (HCP) data to health insurers.
Both public and private hospitals submit data for each episode of admitted hospital treatment for which health insurers have paid a benefit.
HCP data covers privately insured admitted patients and includes de-identified:
- clinical information, using a patient care classification system
- demographic information
- financial information, such as
- hospital charges
- medical services and charges
- prosthetic items and charges
- private health insurance and Medicare benefits
- consumer out-of-pocket expenses.
We have been collecting this data since 1995.
Uses of HCP data
We use HCP data:
- to develop policy
- in the Medical Costs Finder app.
The Independent Health and Aged Care Pricing Authority uses HCP data when it calculates the national efficient price (NEP) for hospital services. The NEP informs the amount of Australian Government funding for public hospitals in Australia.
HCP data is also a valuable tool for:
- research
- evaluating services.
Who can collect and access HCP data
Private health insurers collect HCP data. They then supply it to us.
We provide researchers with access to data according to our data strategy.
How hospitals submit HCP data
New hospitals must contact us to get an account created.
Hospitals, including day facilities, initially upload their HCP data to our Data Submission Portal (DSP) for data validation.
Once the files are validated, hospitals upload them to individual health insurer portals. They must submit data every month, within 6 weeks of a patient being discharged.
Health insurers then submit the data to our DSP within 20 weeks of the end of the reporting month.
We store it in our Enterprise Data Warehouse.
Data specifications for the various files you need to upload are included in our hospital data collection.
Resources
Hospital data collection
Hospital data resources
PHI circulars
See our PHI circulars for any updates about HCP data.
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