1. Department of Public Health Medically Indigent Care Reporting System (MICRS) Medically Indigent Services Program (MISP) 1

2. Fresno County Indigent Healthcare Data Two sources of indigent health data: MICRS (Medically Indigent Care Reporting System) MISP Eligibility System 2

3. Overview of MICRS  MICRS MICRS is healthcare data reported to the County by healthcare providers as a condition of receiving reimbursement for uncompensated care: MICRS data is collected from the following programs: o MISP o EMS (Maddy Funds-Court fines/fees) – Reimbursement for uncompensated emergency care to indigents. o CHIP/EMSA (not funded in current State budget) 3

4.  MICRS Data Elements Demographic o Age o Gender o Ethnicity o Primary source of income/Type of employment o Zip code of patient Medical o Primary diagnosis o Service (outpatient, inpatient, ambulatory surgery, and ER) Financial/Cost o Claims o Expenditures/Charges o Payor source o # of patient days of outpatient and inpatient services o Outpatient visits by type of provider (i.e., Physician, Podiatrist, Dentist, etc.) and by clinic 4

5. Overview of MISP Eligibility System Data  MISP Eligibility Data Web based database utilized for eligibility determination utilizing adopted eligibility criteria. MISP Data Elements o Income o Age o Home addresses o Gender, Ethnicity, socioeconomic/income status o Clients current/historical eligibility status o Share of cost information o Waiver utilization (Hardship, Medical) o Application dates o Interviewer Names 5

6. The Five W’s of MISP MISP Demographics  Who  What  When  Why  Where 6

7. Who: 7

8. Who (continued)  Gender Female = 49.5% Male = 50.5%  Income Level (FY 10-11) – (92% below 114% FPL) 82% of clients between 0% - 75% of FPL 10% of clients between 76% - 114% of FPL 8% of clients between 115% - 224% of FPL 0% of clients between 225% - 350% of FPL  Approximately 73% of MISP clients are approved only once during a year with the remaining 27% of clients having more than one MISP approval within a year. 8

9. When 9

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11. Why (Continued)  Top 6 Diagnoses in FY 09-10 * (MICRS Required Reportable Diagnoses) 1Diabetes Mellitus11.00% 2Hypertension6.00% 3Disorders of the back2.00% 4Rehablitiation2.00% 5Asthma1.50% 6Special examinations1.00% 11

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16. Questions? 16