Hospital Casemix Protocol (HCP) data

All hospitals must submit HCP data to health insurers, who then submit it to us. Find out what HCP data is, what its uses are, who collects the data and has access to it and how hospitals submit the data.

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:

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.


Hospital data collection

Hospital data resources

This collection contains resources to help hospitals meeting their data reporting requirements. It includes data specifications, a user guide and annual reports.

PHI circulars

See our PHI circulars for any updates about HCP data.


Hospital data management contact

Contact us for account creation (for new hospitals) and help with submitting Hospital Casemix Protocol (HCP) and Private Health Data Bureau (PHDB) data.
Date last updated:

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