Department of Health and Human Services 
OFFICE OF 
INSPECTOR GENERAL 
Y2K READINESS OF 
MEDICARE PROVIDERS 
JUNE GIBBS BROWN 
Inspector General 
MARCH 1999 
OEI-03-98-00250  OFFICE OF INSPECTOR GENERAL 
The mission of the Office of Inspector General (OIG), as mandated by Public Law 95-452, is to 
protect the integrity of the Department of Health and Human Services programs as well as the 
health and welfare of beneficiaries served by them.  This statutory mission is carried out through a 
nationwide program of audits, investigations, inspections, sanctions, and fraud alerts.  The 
Inspector General informs the Secretary of program and management problems and recommends 
legislative, regulatory, and operational approaches to correct them. 
Office of Evaluation and Inspections 
The Office of Evaluation and Inspections (OEI) is one of several components of the Office of 
Inspector General.  It conducts short-term management and program evaluations (called 
inspections) that focus on issues of concern to the Department, the Congress, and the public.  The 
inspection reports provide findings and recommendations on the efficiency, vulnerability, and 
effectiveness of departmental programs. 
OEI's Philadelphia Regional Office prepared this report under the direction of Robert A. Vito, 
Regional Inspector General, and Linda M. Ragone, Deputy Regional Inspector General.  Principal 
OEI staff included: 
REGION  HEADQUARTERS 
David Tawes, Lead Analyst
 Bambi Straw, Program Specialist

Tara Schmerling
 Stuart Wright, Program Specialist

David Graf
 Scott Horning, Technical Support Staff

Nancy Gross
 Linda Moscoe, Technical Support Staff

Cynthia Hansford
 Brian Ritchie, Technical Support Staff

Robert Katz
 Barbara Tedesco, Technical Support Staff

Erika Q. Lang

Lauren McNulty

Nancy Molyneaux

To obtain copies of this report, please call the Philadelphia Regional Office at (800) 531-9562. 
Reports are also available on the World Wide Web at our home page address: 
http://www.dhhs.gov/progorg/oei  June Gibbs Brown (Original Signed)

Inspector General

OIG Final Report:  "Y2K Readiness of Medicare Providers,"  OEI-03-98-00250

Nancy-Ann Min DeParle

Administrator

Health Care Financing Administration

In December 1998, we sent 5000 anonymous surveys to hospitals, nursing facilities,

home health agencies, durable medical equipment suppliers, and physicians.  The sample

was stratified to ensure equal representation of urban and rural fee-for-service providers. 

We accepted survey responses through early February 1999.  Completed surveys were

received from 49 percent of hospitals, 41 percent of nursing facilities, 27 percent of

home health agencies, 26 percent of durable medical equipment suppliers, and 22 percent

of physicians. 

Y2K Readiness 
About half of the health care providers responding to our survey reported that their 
billing and medical records systems were Y2K ready.  However, providers seemed less 
confident in the Y2K readiness of their biomedical equipment.  Less than half of the 
respondents had developed a contingency plan in preparation for possible Y2K-related 
failures.  Less than half of respondents had received certification or guarantees that 
vendor systems were Y2K compliant.  In addition, few respondents had actually tested 
data exchange with external vendors. 
Assistance By Medicare Contractors 
Less than 60 percent of respondents reported that their Medicare contractor had sent 
them information or offered assistance on Y2K.  Even fewer respondents were aware 
that Medicare contractors offered free Y2K-ready software. 
Focus of Future Readiness Efforts 
This report is intended to give the Health Care Financing Administration and health care 
provider associations current data that could be used to target potential impediments to 
provider Y2K readiness.  While Y2K readiness is the responsibility of each individual 
provider, we suggest that as HCFA and provider associations continue their outreach  and education efforts they focus on the following:  increasing awareness and 
dissemination of available Y2K-compliant software, emphasizing the need to test new or 
renovated systems and equipment, providing information on contingency planning, 
emphasizing the need for providers to discuss Y2K compliance with their external 
vendors, and developing strategies to improve communication between providers and 
their Medicare contractors. 
We recognize that HCFA has taken significant steps to address Medicare provider 
readiness.  This report was designed to provide HCFA and health care provider 
associations with immediate access to our survey results.  In addition, we plan to prepare 
a more in-depth analysis of the survey responses to determine if certain factors impact 
provider readiness.  We hope this information will assist your office in ongoing Y2K 
outreach and education efforts. 
We received comments from your agency and the Assistant Secretary for Management 
and Budget.  We modified our report in response to these comments.  In particular, we 
emphasized that readers should be cautious in using our data to make generalizations 
about the entire provider community. 
If you have any questions or comments, please call me or George Grob, Deputy 
Inspector General for Evaluation and Inspections, or have your staff contact 
Mary Beth Clarke at (202) 619-2481. 
2
 I N T R O D U C T I O N

PURPOSE 
To provide the results of a survey of health care providers readiness for the Year 2000 (Y2K). 
Survey respondents included the following types of Medicare providers: hospitals, nursing 
facilities, home health agencies, durable medical equipment suppliers, and physicians. 
BACKGROUND 
Early programmers had to deal with two major constraints in the first few years of computer

technology:  limited computer memory and high data storage costs.  Todays Year 2000 problems

stem directly from early programmers use of an implied century.  This allowed them to

conserve space by coding the year as a two-digit code rather than a four-digit code in the date

field.  For instance, the year 1970 was entered as 70, and the year 1980 as 80.

Computers that do not rely on implied centuries, and are therefore capable of processing four-

digit years after 1999, are said to be Y2K ready or Y2K compliant.  Computers that are not

Y2K compliant will malfunction when the implied century (the first two digits of a four-digit year)

is not 19.  The year 2000 in a non-Y2K compliant computer is read as 00, and thus interpreted

as 1900.  When this happens, computers will have problems processing information.

Therefore, medical record and billing systems must be updated and made Y2K compliant. 

Additionally, medical devices with embedded microchips could be adversely affected.

The Impact of Y2K on Medicare 
According to the Health Care Financing Administration (HCFA), the Medicare program has 100 
mission-critical computer systems containing almost 50 million lines of programming code.  The 
HCFA has made it a top priority to ensure that these systems are ready for the year 2000. 
In addition to internal systems, HCFA must also be concerned with the compliance of individual 
systems used by Medicare claims-processing contractors and health care providers.  This is 
especially important since the majority of Medicare claims are now sent electronically to the 
contractors (Medicare carriers and fiscal intermediaries) for processing and payment. 
Initially, HCFA established a requirement that all providers submit electronic claims using an 
eight-digit date format by January 1, 1999.  However, recognizing that many providers needed 
more time to prepare their systems, HCFA recently established April 5, 1999 as the new deadline. 
Beginning April 5, all claims submitted without an eight-digit date will be rejected.  To assist 
providers, HCFA has required its contractors to offer free Y2K-ready billing software to 
Medicare providers. 
As part of an outreach effort to Medicare providers, HCFA sent out more than one million letters 
regarding the Y2K issue on January 12, 1999.  The letter to providers stated that HCFA will be 
ready to process and pay all acceptable claims on January 1, 2000, and stressed that providers 
must take steps to ensure their own Y2K readiness.  A checklist was included with the letter to 
assist providers in assessing their Y2K compliance.  Not only must providers ensure that their 
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3  own systems are Y2K ready, they must also review the systems used by their billing services and 
other external vendors. 
Recognizing the importance of provider readiness, the Office of Inspector General and HCFA 
collaborated in the development of this inspection. 
METHODOLOGY 
Utilizing Medicare data bases, we sampled five provider groups for our survey: acute-care 
hospitals, nursing facilities, home health agencies, durable medical equipment (DME) suppliers, 
and physicians.  To fulfill HCFAs request that rural providers be adequately represented, we 
stratified our sample based on urban and rural classification.  We determined this classification 
based on whether a providers address was located in a Metropolitan Area designated by the 
United States Office of Management and Budget.  We selected a random sample of 500 urban and 
500 rural providers from each of the five provider groups. 
We sent anonymous surveys to the 5000 sampled providers during December of 1998.  We 
accepted responses through early February of 1999.  In order to increase response rates, we 
assured providers that we had no way of tracking who responded to our request.  To further 
increase response rates, we mailed a reminder postcard to all providers two weeks after the initial 
survey request was sent.  We received responses from 49 percent of hospitals, 41 percent of 
nursing facilities, 27 percent of home health agencies, 26 percent of durable medical equipment 
suppliers, and 22 percent of physicians 
We developed our data collection surveys to address several key issues: Y2K awareness, 
computer system readiness, contingency planning, vendor coordination, and Medicare contractor 
outreach. We designed the surveys in cooperation with HCFA and several professional and 
national trade associations.  The following organizations worked with us and allowed us to 
highlight their cooperation in the survey instruments sent to providers: American Association of 
Homes and Services for the Aging, American Health Care Association, Health Industry 
Distributors Association, National Association for Home Care, and National Association for 
Medical Equipment Services.  The American Hospital Association and American Medical 
Association also assisted in designing the surveys. 
We analyzed the data based on the urban or rural classification for each provider group.  For each 
survey question, we calculated percentages based on the number of answers provided for each 
response category.  We compared the various groups to determine if differences existed among 
provider types. 
This report provides a summary of the results of the provider surveys.  Providers responses to 
individual survey questions are presented in the appendices.  The data analyzed in this report was 
furnished by individual Medicare providers and was not verified for accuracy.  Furthermore, the 
data presented in this report is based solely on those providers who responded to the survey.  We 
are unable to make any statements about the condition of those who did not respond.  With this is 
mind, readers should be cautious in using our data to make generalizations about the entire 
provider community. 
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4  S U M M A R Y  O F  S U R V E Y  R E S U L T S

PROVIDER READINESS FOR THE YEAR 2000 
'	 Billing and Financial Systems: About half of all respondents reported their billing and 
financial systems were Y2K ready.  Of the respondents who were not ready, more than 90 
percent of hospitals responded they will be ready by December 31, 1999.  Only 70 to 84 
percent of the other provider groups responded that their billing and financial systems will 
be ready by this date. 
'	 Submission of Electronic Claims: For most provider types, 50 to 63 percent of 
respondents said they could enter an eight-digit date on electronic claims.  However, 
nursing facility respondents were generally less able to enter an eight-digit date.  Of those 
not able to enter eight-digit dates, between 27 to 71 percent said they will be ready to by 
July 1999. 
'	 Clinical and Medical Record Systems: About half of respondents indicated that their 
clinical and medical records systems were Y2K ready.  For most provider groups, at least 
three-quarters of those not ready reported that they will be ready by the year 2000. 
However, rural physicians (47 percent), urban physicians (64 percent), and rural home 
health agencies (63 percent) were less likely than other providers to have these systems 
ready by that date. 
'	 Biomedical Equipment: Less than one-third of respondents reported that their biomedical 
equipment was Y2K compliant.  Overall, respondents seemed less confident in the Y2K 
compliance of their biomedical equipment than they did the Y2K readiness of their 
computer systems. 
'	 Systems Testing: Less than two-thirds of respondents had renovated or replaced their 
computer systems for Y2K compliance.  More than half of these respondents had tested 
the systems.  Fewer than half of respondents renovated or replaced biomedical equipment. 
Testing of this equipment ranged from 36 to 80 percent. 
CONTINGENCY PLANNING 
'	 Less than half of respondents had developed a contingency plan in preparation for possible 
Y2K-related failures. 
'	 Of the respondents who have not yet developed a contingency plan, almost all hospitals 
plan to develop one, while about half of physicians intend to develop one. 
'	 Most respondents indicated they would submit paper claims if they could not submit 
electronically.  However, some questioned whether the Medicare program would allow or 
be able to handle these paper claims. 
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5  FIGURE 1:  PROVIDER READINESS 
Percentage Who Report Current Y2K Readiness 
0%  10%  20%  30%  40%  50%  60%  70%  80%  90%  100% 
55% 
Rural Hospitals  46% 
31% 
50% 
Urban Hospitals  46% 
23% 
48% 
Rural Nursing Facilities  52% 
21% 
49% 
Urban Nursing Facilities  54% 
21% 
49%  Billing Systems 
Rural Home Health 
47%  Medical Records Systems 
Agencies 
26%  Biomedical Equipment 
50% 
Urban Home Health 
51% 
Agencies 
21% 
59% 
Rural DME Suppliers  51% 
23% 
56% 
Urban DME Suppliers  45% 
28% 
54% 
Rural Physicians  41% 
30% 
45% 
Urban Physicians  40% 
20% 
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6  FIGURE 2:  FUTURE PROVIDER READINESS 
Percentage Who Predict Y2K Readiness by 12/31/99 
0%  10%  20%  30%  40%  50%  60%  70%  80%  90%  100% 
95% 
Rural Hospitals  93% 
88% 
92% 
Urban Hospitals  91% 
90% 
80% 
Rural Nursing Facilities  77% 
63% 
84% 
Urban Nursing Facilities  78% 
62% 
Billing Systems 
70% 
Rural Home Health  Medical Records Systems 
63% 
Agencies 
60%  Biomedical Equipment 
75% 
Urban Home Health 
80% 
Agencies 
68% 
82% 
Rural DME Suppliers  80% 
64% 
79% 
Urban DME Suppliers  83% 
64% 
75% 
Rural Physicians  47% 
45% 
77% 
Urban Physicians  64% 
52% 
Note: Percentages are based on providers who responded 
they were not currently ready. 
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7  FIGURE 3:  CONTINGENCY PLANNING 
Percentage Who Report Having Contingency Plans 
0%  10%  20%  30%  40%  50%  60%  70%  80%  90%  100% 
Rural Hospitals  42% 
Urban Hospitals  51% 
Rural Nursing Facilities  32% 
Urban Nursing Facilities  32% 
Rural Home Health Agencies  34% 
Urban Home Health Agencies  42% 
Rural DME Suppliers  32% 
Urban DME Suppliers  29% 
Rural Physicians  32% 
Urban Physicians  29% 
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8  EXTERNAL VENDORSE
'	 Fifty-one percent of rural hospital and 68 percent of urban hospital respondents contracted 
with an external vendor for claims submission and payment activities.  For the other four 
provider types, only about one-third of respondents reported using an external billing 
service. 
'	 At least 80 percent of responding hospitals have discussed Y2K issues with their vendors. 
Approximately 60 percent of nursing facility and home health agency respondents have 
initiated Y2K discussions with external vendors.  About 45 percent of responding DME 
suppliers and physicians had talked to vendors about Y2K. 
'	 About one-third of nursing facility, DME supplier, and physician respondents had received 
certification from vendors that their systems will be Y2K ready.  Approximately half of 
home health agency and hospital respondents had received certifications.  Less than half of 
respondents had contracts with vendors that guarantee Y2K readiness. 
'	 Less than 20 percent of respondents had tested data exchange between their systems and 
their external vendors systems. 
MEDICARE CONTRACTOR EFFORTSE
'	 Less than 60 percent of respondents reported that their Medicare contractor had sent them 
Y2K information or offered Y2K assistance.  Urban home health agencies reported the 
highest level of outreach (57 percent), and urban physicians reported the lowest level 
(27 percent). 
'	 Less than half of respondents believed that efforts by Medicare contractors had increased 
their Y2K awareness.  Rural nursing facility and urban physician respondents were the 
most critical, with less than 30 percent reporting that contractor outreach had been 
informative. 
'	 Urban home health agency respondents were the most aware that Medicare contractors 
offered free Y2K-ready software (41 percent).  Rural nursing facility and urban physician 
respondents were the least aware (16 percent). 
'	 Very few respondents (10 to 22 percent) had actually requested Y2K-ready software from 
Medicare contractors.  Fifty-five to 86 percent of those who received the software said it 
functioned properly. 
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9  C O N C L U S I O N

We prepared this report in order to give the Health Care Financing Administration and health care 
provider associations current data that could be used to target potential impediments to provider 
Y2K readiness.  While Y2K readiness is the responsibility of each individual provider, we suggest 
that as HCFA and provider associations continue their outreach and education efforts they focus 
on the following:  increasing awareness and dissemination of available Y2K-compliant software, 
emphasizing the need to test new or renovated systems and equipment, providing information on 
contingency planning, emphasizing the need for providers to discuss Y2K compliance with their 
external vendors, and developing strategies to improve communication between providers and 
their Medicare contractors. 
AGENCY COMMENTSE
We received comments from the Health Care Financing Administration and the Assistant 
Secretary for Management and Budget.  We modified our report in response to these comments. 
In particular, we emphasized that readers should be cautious in using our data to make 
generalizations about the entire provider community.  The full text of HCFAs and ASMBs 
comments is presented in Appendices F and G. 
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10  APPENDICES

Hospital Survey Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  A 
Nursing Facility Survey Results  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  B 
Home Health Agency Survey Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  C 
Durable Medical Equipment Supplier Survey Results . . . . . . . . . . . . . . . . . . . . . .  D 
Physician Survey Results  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  E 
Health Care Financing Administration Comments . . . . . . . . . . . . . . . . . . . . . . . . .   F 
Assistant Secretary for Management and Budget Comments  . . . . . . . . . . . . . . . .  G  A P P E N D I X  A

HOSPITAL SURVEY RESULTS

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A - 1
 KEY: 
n = number of responses 
Yes = percentage of n answering "Yes". 
No = percentage of n answering "No". 
DK = percentage of n answering "Don't Know". 
N/A = percentage of n answering "Not Applicable" or providing no response. 
All percentages may not total 100 percent due to rounding. 
Applicable footnotes appear at the bottom of each page. 
SURVEY RESPONSE RATES: 
Total  Number of  Number of  Response 
Number  Surveys Mailed  Surveys Returned  Rate 
Rural Hospitals  2,287  500  281  56% 
Urban Hospitals  3,405  500  208  42% 
Total  5,692  1000  489  49% 
Hospitals, Page A - 2  A. BACKGROUND

n  Yes  No  DK  N/A 
1.  Do you contract with an external vendor for claims submission and payment activities?  Rural  281  51%  44%  0%  5% 
Urban  208  68%  26%  3%  3% 
2.	 Is an external vendor or contractor assisting in your effort to solve Y2K-related computer problems?  Rural  281  49%  42%  2%  8% 
Urban  208  58%  37%  1%  3% 
3.	 Have you contacted an external vendor or contractor to assist you in completing this survey?  Rural  281  6%  89%  0%  5% 
Urban  208  5%  92%  0%  3% 
B. Y2K AWARENESS AND PLANNING 
n  Yes  No  DK  N/A 
4.	 Have you thought about how Y2K problems could affect your hospital?  Rural  281  100%  0%  0%  0% 
Urban  208  98%  0%  0%  2% 
5.  Have you developed a strategy for dealing with potential Y2K problems associated with your: 
a. 	Billing/financial systems?  Rural  281  96%  3%  0%  1% 
Urban  208  95%  3%  1%  0% 
b. 	Clinical/medical records systems?  Rural  281  93%  4%  1%  2% 
Urban  208  96%  2%  1%  1% 
c. 	Biomedical equipment?  Rural  281  93%  4%  2%  1% 
Urban  208  97%  2%  0%  1% 
6.  Are you facing any of the following obstacles in identifying or fixing potential Y2K problems: 
a. Lack of financial resources?  Rural  281  38%  56%  6%  0% 
Urban  208  25%  68%  6%  1% 
b. Lack of skilled personnel?  Rural  281  40%  58%  2%  1% 
Urban  208  31%  64%  5%  0% 
c. Lack of vendor cooperation?  Rural  281  33%  58%  9%  1% 
Urban  208  44%  48%  8%  0% 
d. Lack of billing service cooperation?  Rural  281  3%  82%  6%  9% 
Urban  208  5%  75%  7%  13% 
7.  Have you thought about the impact to your hospital if all systems are not Y2K ready?  Rural  281  99%  0%  0%  0% 
Urban  208  99%  1%  0%  0% 
Hospitals, Page A - 3  B. Y2K AWARENESS AND PLANNING (cont.) 
n  Yes  No  DK  N/A 
8.  Have you developed contingency plans in case your hospital experiences Y2K-related failures?  Rural  281  42%  55%  2%  1% 
Urban  208  51%  47%  0%  2% 
9.	 If you have not developed contingency plans, do you plan to do so? 1  Rural  155  91%  4%  5%  1% 
Urban  97  99%  0%  0%  1% 
10.	 Do you feel that your ability to provide quality care could be compromised by Y2K-related failures?  Rural  281  41%  47%  10%  2% 
Urban  208  47%  42%  9%  2% 
a. If your hospital has a quality assurance committee, is it involved in Y2K planning?  Rural  281  57%  36%  2%  5% 
Urban  208  56%  35%  3%  6% 
C. COMPUTER SYSTEMS 
n  Yes  No  DK  N/A 
11. Have you made a complete inventory of your: 
a. Billing/financial systems?  Rural  281  93%  6%  1%  0% 
Urban  208  97%  2%  1%  0% 
b. Clinical/medical records systems?  Rural  281  90%  7%  1%  1% 
Urban  208  95%  3%  0%  2% 
c. Biomedical equipment?  Rural  281  89%  10%  1%  0% 
Urban  208  94%  5%  0%  1% 
12. Have you assessed the Y2K readiness of your: 
a. Billing/financial systems?  Rural  281  92%  7%  1%  0% 
Urban  208  92%  6%  1%  1% 
b. Clinical/medical records systems?  Rural  281  88%  9%  2%  2% 
Urban  208  89%  8%  0%  3% 
c. Biomedical equipment?  Rural  281  82%  14%  4%  0% 
Urban  208  80%  16%  0%  3% 
1 Only analyzed if respondent answered "No" to question 8. 
Hospitals, Page A - 4  C. COMPUTER SYSTEMS (cont.) 
n  Yes  No  DK  N/A 
13.  If necessary, have you renovated or replaced your: 
a. Billing/financial systems?  Rural  281  58%  31%  0%  10% 
Urban  208  63%  21%  3%  14% 
b. Clinical/medical records systems?  Rural  281  49%  36%  1%  14% 
Urban  208  56%  26%  2%  16% 
c. Biomedical equipment?  Rural  281  40%  47%  5%  7% 
Urban  208  47%  38%  5%  10% 
14.  Have you tested your new or renovated: 
a. Billing/financial systems? 2  Rural  164  61%  35%  0%  4% 
Urban  130  58%  38%  2%  2% 
b. Clinical/medical records systems? 2  Rural  138  58%  36%  1%  5% 
Urban  116  61%  33%  3%  3% 
c. Biomedical equipment? 2  Rural  113  58%  36%  1%  5% 
Urban  98  59%  32%  5%  4% 
15. Have you begun to use your new or renovated: 
a. Billing/financial systems? 2  Rural  164  71%  27%  1%  1% 
Urban  130  60%  38%  0%  2% 
b. Clinical/medical records systems? 2  Rural  138  62%  36%  1%  2% 
Urban  116  64%  34%  0%  2% 
c. Biomedical equipment? 2  Rural  113  68%  23%  2%  7% 
Urban  98  62%  32%  2%  4% 
16. Are the following currently Y2K ready: 
a. Billing/financial systems?  Rural  281  55%  39%  5%  1% 
Urban  208  50%  38%  9%  3% 
b. Clinical/medical records systems?  Rural  281  46%  38%  11%  5% 
Urban  208  46%  38%  9%  7% 
c. Biomedical equipment?  Rural  281  31%  47%  20%  3% 
Urban  208  23%  57%  16%  4% 
2 Only analyzed if respondent answered "Yes" to question 13a, 13b, or 13c, respectively. 
Hospitals, Page A - 5  C. COMPUTER SYSTEMS (cont.) 
n  Yes  No  DK  N/A 
17. Will the following be Y2K ready by December 31, 1999: 
a. 	Billing/financial systems? 3  Rural  124  95%  2%  3%  0% 
Urban  97  92%  2%  5%  1% 
b. 	Clinical/medical records systems? 3  Rural  139  93%  4%  2%  1% 
Urban  99  91%  2%  6%  1% 
c. 	Biomedical equipment? 3  Rural  187  88%  3%  9%  1% 
Urban  151  90%  3%  7%  1% 
D. MEDICARE CLAIM FILING 
n  Yes  No  DK  N/A 
18.	 Are you aware that several fields on HCFA claim forms now require or will soon require 8-digit dates?  Rural  281  83%  11%  5%  1% 
Urban  208  85%  7%  6%  2% 
19. Can you: 
a. 	Enter 8-digit dates in the required fields of the paper HCFA Form 1450?  Rural  281  48%  16%  19%  17% 
Urban  208  47%  15%  22%  16% 
b. 	Enter 8-digit dates in the required fields of the paper HCFA Form 1500?  Rural  281  60%  17%  17%  5% 
Urban  208  53%  16%  20%  11% 
20. Can you: 
a. 	Enter 8-digit dates in the required fields of the electronic UB-92 (UB-92/X12 837)?  Rural  281  62%  17%  18%  3% 
Urban  208  61%  13%  21%  5% 
b. 	Enter 8-digit dates in the required fields of the electronic HCFA Form 1500 (NSF/X12 837)?  Rural  281  59%  16%  18%  7% 
Urban  208  54%  13%  19%  13% 
21.	 Will you be able to enter 8-digit dates in these fields in the next six months? 4  Rural  105  48%  2%  50%  0% 
Urban  76  62%  0%  37%  1% 
E. MEDICARE CONTRACTOR EFFORTS 
n  Yes  No  DK  N/A 
22.	 Has your Medicare contractor sent you information on Y2K or offered assistance with Y2K issues?  Rural  281  56%  26%  14%  4% 
Urban  208  52%  26%  17%  5% 
3 Only analyzed if respondent answered "No" or "Don't Know" to question 16a, 16,b, or 16c, respectively. 
4 Only analyzed if respondent answered "No" or "Don't Know" to questions 20a or 20b. 
Hospitals, Page A - 6  E. MEDICARE CONTRACTOR EFFORTS (cont.) 
n  Yes  No  DK  N/A 
23. Have efforts from your Medicare contractor increased your Y2K awareness?  Rural  281  37%  51%  7%  5% 
Urban  208  35%  46%  12%  7% 
24.	 Are you aware that Medicare contractors have free Y2K-ready billing software available for use?  Rural  281  30%  62%  4%  4% 
Urban  208  29%  55%  9%  6% 
25.	 Have you requested Y2K-ready software from your Medicare contractor?  Rural  281  21%  68%  6%  5% 
Urban  208  17%  64%  12%  7% 
26.	 Have you received Y2K-ready software from your Medicare contractor? 5  Rural  281  15%  68%  9%  8% 
Urban  208  12%  62%  16%  11% 
27.	 Have you installed the Y2K-ready software provided by your Medicare contractor? 6  Rural  43  88%  7%  2%  2% 
Urban  25  80%  16%  0%  4% 
28.	 Have you submitted any claims using the Y2K-ready software provided by your Medicare contractor? 6  Rural  43  70%  28%  2%  0% 
Urban  25  72%  20%  8%  0% 
29.	 Does your Medicare contractor's Y2K-ready software function properly? 6  Rural  43  70%  7%  19%  5% 
Urban  25  68%  0%  32%  0% 
F.  VENDORS AND CONTRACTORS 
n  Yes  No  DK  N/A 
30.	 Have you identified all external vendors and contractors with whom you conduct business?  Rural  281  72%  23%  4%  2% 
Urban  208  84%  14%  1%  1% 
31.	 Have you discussed Y2K issues with your vendors and contractors?  Rural  281  80%  17%  1%  2% 
Urban  208  86%  12%  1%  1% 
32.	 Have you received certification from vendors and contractors that their systems will be Y2K ready?  Rural  281  55%  38%  3%  4% 
Urban  208  60%  33%  3%  4% 
33.	 Do your contracts with vendors and contractors guarantee Y2K readiness?  Rural  281  33%  46%  16%  4% 
Urban  208  38%  49%  10%  2% 
34.	 Have you tested Y2K data exchange between your systems and your vendors and contractors?  Rural  281  13%  74%  8%  5% 
Urban  208  19%  68%  7%  6% 
5 Rural Hosp: 40 of 59 who requested software received it. Urban Hosp: 23 of 36 who requested software received it. 
6 Only analyzed if respondent answered "Yes" to question 26. 
Hospitals, Page A - 7  G.  OVERALL ASSESSMENT

Strongly  Strongly 
Agree.................................................................Disagree 
n 1 2 3 4 5 6 
35.  I have an excellent understanding of Y2K issues:  Rural  281  23%  43%  25%  6%  2%  1% 
Urban  208  43%  41%  13%  1%  0%  0% 
36.	 I am very concerned about Y2K issues:  Rural  281  46%  34%  14%  4%  2%  0% 
Urban  208  53%  35%  8%  2%  1%  0% 
37.	 My hospital is currently Y2K ready:  Rural  281  4%  16%  35%  26%  12%  7% 
Urban  208  1%  16%  37%  20%  13%  11% 
38.	 My hospital will be Y2K ready by December 31, 1999:  Rural  281  52%  37%  5%  3%  0%  1% 
Urban  208  62%  32%  2%  1%  0%  0% 
39.	 My Medicare patients' access to quality care will not be affected by Y2K problems:  Rural  281  50%  32%  11%  3%  1%  2% 
Urban  208  50%  38%  8%  0%  0%  0% 
40.	 My Medicare contractor has been very helpful in providing Y2K information/support:  Rural  281  5%  10%  29%  18%  12%  10% 
Urban  208  5%  9%  25%  13%  16%  8% 
41.	 My vendors have been very helpful in providing Y2K information/support:  Rural  281  8%  20%  39%  19%  8%  2% 
Urban  208  8%  20%  34%  20%  13%  2% 
KEY: 
1 = Strongly Agree 
2 = Moderately Agree 
3 = Slightly Agree 
4 = Slightly Disagree 
5 = Moderately Disagree 
6 = Strongly Disagree 
N/A = No Response or Not Applicable 
Hospitals, Page A - 8  N/A 
0% 
1% 
0% 
2% 
1% 
1% 
1% 
2% 
1% 
3% 
17% 
22% 
3% 
3% 
Hospitals, Page A - 9  G.  OVERALL ASSESSMENT (cont.)

n  mean7  median7  mode7 
35.  I have an excellent understanding of Y2K issues:  Rural  281  2.23  2  2

Urban  205  1.72  2  1

36.	 I am very concerned about Y2K issues:  Rural  281  1.83  2  1

Urban  204  1.61  1  1

37.	 My hospital is currently Y2K ready:  Rural  277  3.49  3  3

Urban  205  3.63  3  3

38.	 My hospital will be Y2K ready by December 31, 1999:  Rural  277  1.62  1  1

Urban  204  1.44  1  1

39.	 My Medicare patients' access to quality care will not be affected by Y2K problems:  Rural  278  1.79  1  1

Urban  201  1.60  1  1

40.	 My Medicare contractor has been very helpful in providing Y2K information/support:  Rural  234  3.61  3  3

Urban  162  3.65  3  3

41.	 My vendors have been very helpful in providing Y2K information/support:  Rural  273  3.07  3  3

Urban  202  3.18  3  3

KEY: 
1 = Strongly Agree 
2 = Moderately Agree 
3 = Slightly Agree 
4 = Slightly Disagree 
5 = Moderately Disagree 
6 = Strongly Disagree 
N/A = No Response or Not Applicable 
7 N/A responses were not used to calculate the mean, median, and mode. 
Hospitals, Page A - 10
 H.  INFORMATION ABOUT YOUR BUSINESS 
n 
42.	 If your hospital is not currently Y2K ready, by what date do you expect to be Y2K ready?8  Rural  241  Largest Response Categories: 12/31/99 (19%), 6/30/99 (20%), 7/1/99 (12%) 
Urban  186  Largest Response Categories: 12/31/99 (16%), 6/30/99 (17%), 7/1/99 (11%) 
43.	 What percentage of your business is represented by Medicare?8  Rural  243  Approx. 1/2 answered between 45% and 65%. Median: 55% 
Urban  199  Approx. 1/2 answered between 35% and 55%. Median: 45% 
44.	 Approximately how many acute-care beds does your hospital have?8  Rural  275  Approx. 3/4 answered less than 80 beds. Median: 44 beds 
Urban  201  Approx. 1/2 answered between 100 and 350 beds. Median: 200 beds 
n  Yes  No  N/A 
45.	 Is your facility part of a chain of hospitals?  Rural  281  21%  78%  0% 
Urban  208  42%  57%  0% 
46.	 Are you a provider for a managed care organization?  Rural  281  58%  40%  2% 
Urban  208  75%  23%  2% 
47.	 Do you provide services for Medicaid patients?  Rural  281  99%  0%  0% 
Urban  208  100%  0%  0% 
48.	 How long could you continue to serve Medicare patients if payments were delayed?8  Rural  237  Largest Response Categories: 1-2 months (43%), 3-6 months (24%) 
Urban  157  Largest Response Categories: 1-2 months (42%), 3-6 months (21%) 
49.	 If you couldn't submit electronically due to Y2K problems, how would you submit claims?8  Rural  223  Largest Response Categories: Paper Claims (87%), Don't Know (4%) 
Urban  161  Largest Response Categories: Paper Claims (82%), Will Be Ready (6%) 
8 Non-responses were not used in the analysis of these questions. 
Hospitals, Page A - 10  A P P E N D I X  B

NURSING FACILITY SURVEY RESULTS

)))))))))))
B - 1
 KEY: 
n = number of responses 
Yes = percentage of n answering "Yes". 
No = percentage of n answering "No". 
DK = percentage of n answering "Don't Know". 
N/A = percentage of n answering "Not Applicable" or providing no response. 
All percentages may not total 100 percent due to rounding. 
Applicable footnotes appear at the bottom of each page. 
SURVEY RESPONSE RATES: 
Total  Number of  Number of  Response 
Number  Surveys Mailed  Surveys Returned  Rate 
Rural Nursing Facilities  5,767  500  221  44% 
Urban Nursing Facilities  10,982  500  191  38% 
Total  16,749  1000  412  41% 
Nursing Facilities, Page B - 2  A. BACKGROUND

n  Yes  No  DK  N/A 
1.  Do you contract with an external vendor for claims submission and payment activities?  Rural  221  34%  62%  1%  3% 
Urban  191  28%  66%  1%  5% 
2.	 Is an external vendor or contractor assisting in your effort to solve Y2K-related computer problems?  Rural  221  37%  53%  3%  7% 
Urban  191  38%  42%  7%  13% 
3.	 Have you contacted an external vendor or contractor to assist you in completing this survey?  Rural  221  5%  89%  1%  5% 
Urban  191  4%  90%  1%  6% 
B. Y2K AWARENESS AND PLANNING 
n  Yes  No  DK  N/A 
4.	 Have you thought about how Y2K problems could affect your facility?  Rural  221  95%  3%  1%  1% 
Urban  191  96%  2%  1%  1% 
5.  Have you developed a strategy for dealing with potential Y2K problems associated with your: 
a. 	Billing/financial systems?  Rural  221  77%  15%  4%  4% 
Urban  191  82%  12%  3%  3% 
b. 	Clinical/medical records systems?  Rural  221  76%  16%  5%  3% 
Urban  191  80%  10%  3%  7% 
c. 	Biomedical equipment?  Rural  221  49%  19%  9%  23% 
Urban  191  50%  18%  9%  23% 
6.  Are you facing any of the following obstacles in identifying or fixing potential Y2K problems: 
a. Lack of financial resources?  Rural  221  19%  69%  10%  2% 
Urban  191  19%  73%  7%  2% 
b. Lack of skilled personnel?  Rural  221  23%  69%  6%  1% 
Urban  191  24%  71%  5%  1% 
c. Lack of vendor cooperation?  Rural  221  15%  72%  10%  3% 
Urban  191  12%  78%  7%  3% 
d. Lack of billing service cooperation?  Rural  221  4%  76%  7%  13% 
Urban  191  5%  75%  4%  16% 
7.  Have you thought about the impact to your facility if all systems are not Y2K ready?  Rural  221  90%  7%  0%  3% 
Urban  191  90%  7%  1%  2% 
Nursing Facilities, Page B - 3  B. Y2K AWARENESS AND PLANNING (cont.) 
n  Yes  No  DK  N/A 
8.  Have you developed contingency plans in case your facility experiences Y2K-related failures?  Rural  221  32%  55%  7%  5% 
Urban  191  32%  50%  12%  7% 
9.	 If you have not developed contingency plans, do you plan to do so? 1  Rural  122  74%  7%  16%  4% 
Urban  95  82%  7%  7%  3% 
10. Do you feel that your ability to provide quality care could be compromised by Y2K-related failures?  Rural  221  27%  61%  10%  3% 
Urban  191  27%  63%  9%  2% 
C. COMPUTER SYSTEMS 
n  Yes  No  DK  N/A 
11. Have you made a complete inventory of your: 
a. Billing/financial systems?  Rural  221  76%  16%  3%  5% 
Urban  191  84%  10%  3%  3% 
b. Clinical/medical records systems?  Rural  221  75%  16%  4%  6% 
Urban  191  83%  10%  4%  4% 
c. Biomedical equipment?  Rural  221  47%  19%  10%  24% 
Urban  191  45%  22%  12%  21% 
12. Have you assessed the Y2K readiness of your: 
a. Billing/financial systems?  Rural  221  76%  15%  3%  5% 
Urban  191  83%  11%  4%  2% 
b. Clinical/medical records systems?  Rural  221  78%  14%  3%  6% 
Urban  191  80%  13%  3%  4% 
c. Biomedical equipment?  Rural  221  44%  21%  9%  26% 
Urban  191  45%  22%  12%  21% 
13.  If necessary, have you renovated or replaced your: 
a. Billing/financial systems?  Rural  221  49%  32%  3%  16% 
Urban  191  54%  31%  3%  11% 
b. Clinical/medical records systems?  Rural  221  48%  33%  3%  17% 
Urban  191  50%  31%  3%  15% 
c. Biomedical equipment?  Rural  221  19%  36%  10%  35% 
Urban  191  22%  37%  13%  28% 
1 Only analyzed if respondent answered "No" to question 8.  Nursing Facilities, Page B - 4  C. COMPUTER SYSTEMS (cont.) 
n  Yes  No  DK  N/A 
14.  Have you tested your new or renovated: 
a. Billing/financial systems? 2  Rural  109  50%  36%  3%  11% 
Urban  104  56%  36%  1%  8% 
b. Clinical/medical records systems? 2  Rural  105  52%  34%  3%  10% 
Urban  96  56%  32%  3%  8% 
c. Biomedical equipment? 2  Rural  42  36%  36%  7%  21% 
Urban  42  50%  29%  2%  19% 
15. Have you begun to use your new or renovated: 
a. Billing/financial systems? 2  Rural  109  59%  39%  2%  1% 
Urban  104  62%  38%  0%  0% 
b. Clinical/medical records systems? 2  Rural  105  67%  30%  1%  2% 
Urban  96  65%  35%  0%  0% 
c. Biomedical equipment? 2  Rural  42  48%  48%  2%  2% 
Urban  42  50%  45%  2%  2% 
16. Are the following currently Y2K ready: 
a. Billing/financial systems?  Rural  221  48%  37%  11%  5% 
Urban  191  49%  39%  9%  3% 
b. Clinical/medical records systems?  Rural  221  52%  32%  10%  5% 
Urban  191  54%  30%  10%  6% 
c. Biomedical equipment?  Rural  221  21%  25%  23%  31% 
Urban  191  21%  28%  25%  27% 
17. Will the following be Y2K ready by December 31, 1999: 
a. Billing/financial systems? 3  Rural  105  80%  2%  18%  0% 
Urban  92  84%  0%  16%  0% 
b. Clinical/medical records systems? 3  Rural  93  77%  2%  20%  0% 
Urban  77  78%  1%  21%  0% 
c. Biomedical equipment? 3  Rural  106  63%  3%  33%  1% 
Urban  100  62%  5%  33%  0% 
2 Only analyzed if respondent answered "Yes" to question 13a, 13b, or 13c, respectively. 
3 Only analyzed if respondent answered "No" or "Don't Know" to question 16a, 16,b, or 16c, respectively. 
Nursing Facilities, Page B - 5  D. MEDICARE CLAIM FILING

n  Yes  No  DK  N/A 
18. Are you aware that several fields on HCFA claim forms now require or will soon require 8-digit dates?  Rural  221  67%  22%  3%  9% 
Urban  191  76%  14%  6%  5% 
19. Can you: 
a. 	Enter 8-digit dates in the required fields of the paper HCFA Form 1450?  Rural  221  34%  15%  27%  24% 
Urban  191  37%  15%  26%  22% 
b. 	Enter 8-digit dates in the required fields of the paper HCFA Form 1500?  Rural  221  33%  14%  25%  28% 
Urban  191  36%  15%  26%  24% 
20. Can you: 
a. 	Enter 8-digit dates in the required fields of the electronic UB-92 (UB-92/X12 837)?  Rural  221  40%  20%  25%  14% 
Urban  191  52%  17%  23%  7% 
b. 	Enter 8-digit dates in the required fields of the electronic HCFA Form 1500 (NSF/X12 837)?  Rural  221  30%  14%  27%  29% 
Urban  191  36%  12%  27%  24% 
21.	 Will you be able to enter 8-digit dates in these fields in the next six months? 4  Rural  107  39%  5%  55%  1% 
Urban  89  43%  6%  51%  1% 
E. MEDICARE CONTRACTOR EFFORTS 
n  Yes  No  DK  N/A 
22.	 Has your Medicare contractor sent you information on Y2K or offered assistance with Y2K issues?  Rural  221  42%  31%  13%  14% 
Urban  191  41%  29%  18%  12% 
23.	 Have efforts from your Medicare contractor increased your Y2K awareness?  Rural  221  27%  49%  7%  18% 
Urban  191  30%  41%  13%  15% 
24.	 Are you aware that Medicare contractors have free Y2K-ready billing software available for use?  Rural  221  16%  62%  5%  18% 
Urban  191  26%  48%  13%  14% 
25.	 Have you requested Y2K-ready software from your Medicare contractor?  Rural  221  11%  66%  6%  17% 
Urban  191  19%  60%  9%  12% 
26.	 Have you received Y2K-ready software from your Medicare contractor? 5  Rural  221  10%  60%  9%  21% 
Urban  191  17%  60%  9%  14% 
4 Only analyzed if respondent answered "No" or "Don't Know" to question 20.

5 Rural NF: 16 of 24 who requested software received it. Urban NF: 29 of 36 who requested software received it.

Nursing Facilities, Page B - 6  E. MEDICARE CONTRACTOR EFFORTS (cont.) 
n  Yes  No  DK  N/A 
27.	 Have you installed the Y2K-ready software provided by your Medicare contractor? 6  Rural  22  91%  9%  0%  0% 
Urban  33  79%  18%  0%  3% 
28.	 Have you submitted any claims using the Y2K-ready software provided by your Medicare contractor? 6  Rural  22  59%  32%  5%  5% 
Urban  33  61%  36%  0%  3% 
29.	 Does your Medicare contractor's Y2K-ready software function properly? 6  Rural  22  55%  0%  32%  14% 
Urban  33  73%  3%  21%  3% 
F.  VENDORS AND CONTRACTORS 
n  Yes  No  DK  N/A 
30.	 Have you identified all external vendors and contractors with whom you conduct business?  Rural  221  59%  30%  6%  5% 
Urban  191  69%  18%  7%  6% 
31.	 Have you discussed Y2K issues with your vendors and contractors?  Rural  221  59%  31%  5%  5% 
Urban  191  59%  27%  8%  6% 
32.	 Have you received certification from vendors and contractors that their systems will be Y2K ready?  Rural  221  33%  51%  9%  8% 
Urban  191  31%  47%  12%  10% 
33.	 Do your contracts with vendors and contractors guarantee Y2K readiness?  Rural  221  25%  43%  26%  6% 
Urban  191  32%  34%  27%  7% 
34.	 Have you tested Y2K data exchange between your systems and your vendors and contractors?  Rural  221  13%  71%  7%  10% 
Urban  191  15%  63%  10%  12% 
6 Only analyzed if respondent answered "Yes" to question 26.  Nursing Facilities, Page B - 7  G.  OVERALL ASSESSMENT

Strongly  Strongly 
Agree.................................................................Disagree 
n 1 2 3 4 5 6 
35.  I have an excellent understanding of Y2K issues:  Rural  221  14%  23%  30%  17%  8%  5% 
Urban  191  23%  26%  28%  9%  3%  6% 
36.	 I am very concerned about Y2K issues:  Rural  221  34%  23%  26%  10%  2%  2% 
Urban  191  32%  24%  26%  8%  6%  1% 
37.	 My facility is currently Y2K ready:  Rural  221  7%  14%  29%  16%  18%  11% 
Urban  191  5%  15%  31%  17%  15%  10% 
38.	 My facility will be Y2K ready by December 31, 1999:  Rural  221  43%  29%  14%  5%  2%  1% 
Urban  191  53%  25%  9%  5%  1%  1% 
39.	 My Medicare patients' access to quality care will not be affected by Y2K problems:  Rural  221  45%  22%  14%  3%  5%  1% 
Urban  191  58%  20%  7%  5%  3%  1% 
40.	 My Medicare contractor has been very helpful in providing Y2K information/support:  Rural  221  9%  10%  19%  16%  13%  13% 
Urban  191  10%  12%  19%  17%  13%  9% 
41.	 My vendors have been very helpful in providing Y2K information/support:  Rural  221  5%  12%  35%  15%  14%  8% 
Urban  191  8%  16%  31%  20%  10%  5% 
KEY: 
1 = Strongly Agree 
2 = Moderately Agree 
3 = Slightly Agree 
4 = Slightly Disagree 
5 = Moderately Disagree 
6 = Strongly Disagree 
N/A = No Response or Not Applicable 
Nursing Facilities, Page B - 8  N/A 
3% 
5% 
3% 
4% 
3% 
7% 
6% 
7% 
10% 
6% 
21% 
20% 
11% 
10% 
Nursing Facilities, Page B - 9  G.  OVERALL ASSESSMENT (cont.)

n  mean7  median7  mode7 
35.  I have an excellent understanding of Y2K issues:  Rural  215  2.95  3  3

Urban  181  2.57  2  3

36.	 I am very concerned about Y2K issues:  Rural  215  2.28  2  1

Urban  184  2.32  2  1

37.	 My facility is currently Y2K ready:  Rural  214  3.59  3  3

Urban  177  3.56  3  3

38.	 My facility will be Y2K ready by December 31, 1999:  Rural  208  1.92  2  1

Urban  178  1.71  1  1

39.	 My Medicare patients' access to quality care will not be affected by Y2K problems:  Rural  199  1.92  1  1

Urban  179  1.68  1  1

40.	 My Medicare contractor has been very helpful in providing Y2K information/support:  Rural  175  3.66  4  3

Urban  153  3.50  3  3

41.	 My vendors have been very helpful in providing Y2K information/support:  Rural  197  3.48  3  3

Urban  172  3.26  3  3

KEY: 
1 = Strongly Agree 
2 = Moderately Agree 
3 = Slightly Agree 
4 = Slightly Disagree 
5 = Moderately Disagree 
6 = Strongly Disagree 
N/A = No Response or Not Applicable 
7 N/A responses were not used to calculate the mean, median, and mode. 
Nursing Facilities, Page B - 10
 H.  INFORMATION ABOUT YOUR BUSINESS 
n 
42.	 If your facility is not currently Y2K ready, by what date do you expect to be Y2K ready?8  Rural  137  Largest Response Categories: 12/31/99 (26%), 6/30/99 (17%), 7/1/99 (10%) 
Urban  126  Largest Response Categories: 12/31/99 (29%), 6/30/99 (14%), 6/1/99 (7%) 
43.	 What percentage of your business is represented by Medicare?8  Rural  202  Approx. 3/4 of responses were below 25%. Median:10% 
Urban  183  Approx. 3/4 of responses were below 20%. Median:10% 
44.	 Approximately how many beds does your nursing facility have?8  Rural  206  Approx. 1/2 answered between 52 and 106. Median: 82 
Urban  179  Approx. 1/2 answered between 64 and 164. Median: 101 
n  Yes  No  N/A 
45.	 Is your facility part of a national chain?  Rural  221  30%  67%  2% 
Urban  191  32%  65%  3% 
46.	 Is your facility free-standing?  Rural  221  70%  26%  5% 
Urban  191  72%  24%  4% 
47.	 Are you a provider for a managed care organization?  Rural  221  22%  75%  3% 
Urban  191  51%  45%  4% 
48.	 Do you provide services for Medicaid patients?  Rural  221  95%  2%  3% 
Urban  191  94%  4%  2% 
49.	 How long could you continue to serve Medicare patients if payments were delayed?8  Rural  176  Largest Response Categories: 1-2 months (28%), 3-6 months (21%) 
Urban  142  Largest Response Categories: 1-2 months (30%), 3-6 months (19%) 
50.	 If you couldn't submit electronically due to Y2K problems, how would you submit claims?8  Rural  162  Largest Response Categories: Paper Claims (71%), Don't Know (13%) 
Urban  137  Largest Response Categories: Paper Claims (68%), Don't Know (9%) 
8 Non-responses were not used in the analysis of these questions. 
Nursing Facilities, Page B - 10  A P P E N D I X  C

HOME HEALTH AGENCY SURVEY RESULTS

)))))))))))
C - 1
 KEY: 
n = number of responses 
Yes = percentage of n answering "Yes". 
No = percentage of n answering "No". 
DK = percentage of n answering "Don't Know". 
N/A = percentage of n answering "Not Applicable" or providing no response. 
All percentages may not total 100 percent due to rounding. 
Applicable footnotes appear at the bottom of each page. 
SURVEY RESPONSE RATES: 
Total  Number of  Number of  Response 
Number  Surveys Mailed  Surveys Returned  Rate 
Rural Home Health Agencies  2,905  500  136  27% 
Urban Home Health Agencies  6,193  500  133  27% 
Total  9,098  1000  269  27% 
Home Health Agencies, Page C - 2  A. BACKGROUND

n  Yes  No  DK  N/A 
1.  Do you contract with an external vendor for claims submission and payment activities?  Rural  136  34%  64%  1%  1% 
Urban  133  41%  56%  2%  2% 
2.	 Is an external vendor or contractor assisting in your effort to solve Y2K-related computer problems?  Rural  136  51%  39%  3%  7% 
Urban  133  50%  40%  2%  9% 
3.	 Have you contacted an external vendor or contractor to assist you in completing this survey?  Rural  136  5%  88%  0%  7% 
Urban  133  12%  80%  0%  8% 
B. Y2K AWARENESS AND PLANNING 
n  Yes  No  DK  N/A 
4.	 Have you thought about how Y2K problems could affect your agency?  Rural  136  98%  1%  1%  0% 
Urban  133  99%  1%  0%  0% 
5.  Have you developed a strategy for dealing with potential Y2K problems associated with your: 
a. 	Billing/financial systems?  Rural  136  79%  15%  5%  0% 
Urban  133  83%  14%  2%  2% 
b. 	Clinical/medical records systems?  Rural  136  76%  15%  1%  7% 
Urban  133  78%  13%  2%  7% 
c. 	Biomedical equipment?  Rural  136  49%  13%  4%  35% 
Urban  133  49%  14%  5%  33% 
6.  Are you facing any of the following obstacles in identifying or fixing potential Y2K problems: 
a. Lack of financial resources?  Rural  136  36%  57%  7%  0% 
Urban  133  39%  50%  6%  5% 
b. Lack of skilled personnel?  Rural  136  29%  67%  4%  0% 
Urban  133  32%  62%  5%  2% 
c. Lack of vendor cooperation?  Rural  136  13%  77%  6%  4% 
Urban  133  11%  76%  9%  5% 
d. Lack of billing service cooperation?  Rural  136  8%  71%  5%  16% 
Urban  133  7%  71%  5%  17% 
7.  Have you thought about the impact to your agency if all systems are not Y2K ready?  Rural  136  96%  3%  1%  0% 
Urban  133  99%  1%  0%  0% 
Home Health Agencies, Page C - 3  B. Y2K AWARENESS AND PLANNING (cont.) 
n  Yes  No  DK  N/A 
8.  Have you developed contingency plans in case your agency experiences Y2K-related failures?  Rural  136  34%  59%  6%  1% 
Urban  133  42%  52%  4%  2% 
9.	 If you have not developed contingency plans, do you plan to do so? 1  Rural  80  75%  5%  20%  0% 
Urban  69  81%  7%  9%  3% 
10. Do you feel that your ability to provide quality care could be compromised by Y2K-related failures?  Rural  136  31%  60%  9%  0% 
Urban  133  24%  66%  8%  2% 
C. COMPUTER SYSTEMS 
n  Yes  No  DK  N/A 
11. Have you made a complete inventory of your: 
a. Billing/financial systems?  Rural  136  84%  12%  3%  1% 
Urban  133  83%  14%  2%  0% 
b. Clinical/medical records systems?  Rural  136  79%  13%  3%  6% 
Urban  133  78%  14%  2%  5% 
c. Biomedical equipment?  Rural  136  49%  10%  2%  39% 
Urban  133  48%  14%  5%  34% 
12. Have you assessed the Y2K readiness of your: 
a. Billing/financial systems?  Rural  136  82%  13%  4%  0% 
Urban  133  90%  8%  2%  0% 
b. Clinical/medical records systems?  Rural  136  76%  13%  3%  7% 
Urban  133  80%  14%  2%  5% 
c. Biomedical equipment?  Rural  136  43%  13%  4%  40% 
Urban  133  43%  17%  5%  35% 
13.  If necessary, have you renovated or replaced your: 
a. Billing/financial systems?  Rural  136  38%  46%  4%  13% 
Urban  133  48%  37%  2%  14% 
b. Clinical/medical records systems?  Rural  136  30%  44%  4%  22% 
Urban  133  42%  35%  1%  22% 
c. Biomedical equipment?  Rural  136  16%  35%  3%  46% 
Urban  133  19%  32%  5%  44% 
1 Only analyzed if respondent answered "No" to question 8.  Home Health Agencies, Page C - 4  C. COMPUTER SYSTEMS (cont.) 
n  Yes  No  DK  N/A 
14.  Have you tested your new or renovated: 
a. Billing/financial systems? 2  Rural  51  63%  31%  2%  4% 
Urban  64  59%  36%  2%  3% 
b. Clinical/medical records systems? 2  Rural  41  71%  22%  2%  5% 
Urban  56  61%  36%  2%  2% 
c. Biomedical equipment? 2  Rural  22  59%  27%  5%  9% 
Urban  25  64%  24%  8%  4% 
15. Have you begun to use your new or renovated: 
a. Billing/financial systems? 2  Rural  51  61%  31%  2%  6% 
Urban  64  66%  31%  2%  2% 
b. Clinical/medical records systems? 2  Rural  41  66%  32%  0%  2% 
Urban  56  63%  34%  2%  2% 
c. Biomedical equipment? 2  Rural  22  68%  23%  0%  9% 
Urban  25  64%  28%  0%  8% 
16. Are the following currently Y2K ready: 
a. Billing/financial systems?  Rural  136  49%  38%  12%  2% 
Urban  133  50%  37%  11%  3% 
b. Clinical/medical records systems?  Rural  136  47%  32%  10%  11% 
Urban  133  51%  29%  8%  11% 
c. Biomedical equipment?  Rural  136  26%  23%  10%  41% 
Urban  133  21%  26%  14%  39% 
17. Will the following be Y2K ready by December 31, 1999: 
a. Billing/financial systems? 3  Rural  67  70%  6%  24%  0% 
Urban  63  75%  3%  22%  0% 
b. Clinical/medical records systems? 3  Rural  57  63%  5%  30%  2% 
Urban  50  80%  2%  18%  0% 
c. Biomedical equipment? 3  Rural  45  60%  4%  29%  7% 
Urban  53  68%  2%  26%  4% 
2 Only analyzed if respondent answered "Yes" to question 13a, 13b, or 13c, respectively. 
3 Only analyzed if respondent answered "No" or "Don't Know" to question 16a, 16,b, or 16c, respectively. 
Home Health Agencies, Page C - 5  D. MEDICARE CLAIM FILING

n  Yes  No  DK  N/A 
18. Are you aware that several fields on HCFA claim forms now require or will soon require 8-digit dates?  Rural  136  81%  15%  3%  1% 
Urban  133  89%  8%  2%  2% 
19.	 Can you enter 8-digit dates in the required fields of the paper HCFA Form 1450?  Rural  136  54%  14%  24%  8% 
Urban  133  56%  11%  17%  16% 
20.	 Can you enter 8-digit dates in the required fields of the electronic UB-92 (UB-92/X12 837)?  Rural  136  55%  16%  24%  4% 
Urban  133  63%  18%  16%  3% 
21.	 Will you be able to enter 8-digit dates in these fields in the next six months? 4  Rural  55  38%  0%  62%  0% 
Urban  45  71%  2%  27%  0% 
E. MEDICARE CONTRACTOR EFFORTS 
n  Yes  No  DK  N/A 
22.	 Has your Medicare contractor sent you information on Y2K or offered assistance with Y2K issues?  Rural  136  54%  28%  11%  7% 
Urban  133  57%  27%  11%  5% 
23.	 Have efforts from your Medicare contractor increased your Y2K awareness?  Rural  136  38%  44%  6%  12% 
Urban  133  42%  48%  5%  5% 
24.	 Are you aware that Medicare contractors have free Y2K-ready billing software available for use?  Rural  136  33%  52%  8%  7% 
Urban  133  41%  50%  5%  5% 
25.	 Have you requested Y2K-ready software from your Medicare contractor?  Rural  136  21%  65%  7%  7% 
Urban  133  22%  68%  8%  3% 
26.	 Have you received Y2K-ready software from your Medicare contractor? 5  Rural  136  15%  67%  9%  10% 
Urban  133  17%  70%  7%  6% 
27.	 Have you installed the Y2K-ready software provided by your Medicare contractor? 6  Rural  20  70%  30%  0%  0% 
Urban  23  74%  22%  4%  0% 
28.	 Have you submitted any claims using the Y2K-ready software provided by your Medicare contractor? 6  Rural  20  55%  45%  0%  0% 
Urban  23  65%  30%  0%  4% 
29.	 Does your Medicare contractor's Y2K-ready software function properly? 6  Rural  20  55%  0%  40%  5% 
Urban  23  65%  0%  22%  13% 
4 Only analyzed if respondent answered "No" or "Don't Know" to question 20.

5 Rural HHA: 16 of 29 who requested software received it. Urban HHA: 19 of 29 who requested software received it.

6 Only analyzed if respondent answered "Yes" to question 26.  Home Health Agencies, Page C - 6  F.  VENDORS AND CONTRACTORS

n  Yes  No  DK  N/A 
30. Have you identified all external vendors and contractors with whom you conduct business?  Rural  136  68%  16%  7%  9% 
Urban  133  73%  17%  4%  6% 
31. Have you discussed Y2K issues with your vendors and contractors?  Rural  136  65%  20%  5%  10% 
Urban  133  65%  27%  3%  5% 
32.	 Have you received certification from vendors and contractors that their systems will be Y2K ready?  Rural  136  46%  31%  13%  10% 
Urban  133  50%  40%  6%  5% 
33.	 Do your contracts with vendors and contractors guarantee Y2K readiness?  Rural  136  38%  30%  21%  11% 
Urban  133  41%  34%  21%  5% 
34.	 Have you tested Y2K data exchange between your systems and your vendors and contractors?  Rural  136  10%  71%  10%  10% 
Urban  133  18%  66%  8%  8% 
Home Health Agencies, Page C - 7  G.  OVERALL ASSESSMENT

Strongly  Strongly 
Agree.................................................................Disagree 
n 1 2 3 4 5 6 
35.  I have an excellent understanding of Y2K issues:  Rural  136  15%  31%  24%  18%  5%  7% 
Urban  133  20%  26%  32%  11%  8%  3% 
36.	 I am very concerned about Y2K issues:  Rural  136  34%  30%  21%  10%  2%  3% 
Urban  133  40%  26%  20%  8%  2%  2% 
37.	 My agency is currently Y2K ready:  Rural  136  9%  26%  24%  14%  15%  13% 
Urban  133  13%  17%  23%  17%  13%  16% 
38.	 My agency will be Y2K ready by December 31, 1999:  Rural  136  55%  23%  10%  3%  5%  1% 
Urban  133  61%  26%  7%  1%  1%  1% 
39.	 My Medicare patients' access to quality care will not be affected by Y2K problems:  Rural  136  55%  19%  14%  4%  4%  4% 
Urban  133  64%  23%  4%  3%  2%  2% 
40.	 My Medicare contractor has been very helpful in providing Y2K information/support:  Rural  136  9%  13%  26%  18%  12%  14% 
Urban  133  12%  14%  21%  17%  8%  15% 
41.	 My vendors have been very helpful in providing Y2K information/support:  Rural  136  15%  20%  28%  17%  7%  6% 
Urban  133  19%  20%  30%  12%  5%  6% 
KEY: 
1 = Strongly Agree 
2 = Moderately Agree 
3 = Slightly Agree 
4 = Slightly Disagree 
5 = Moderately Disagree 
6 = Strongly Disagree 
N/A = No Response or Not Applicable 
Home Health Agencies, Page C - 8  N/A 
0% 
1% 
0% 
2% 
1% 
1% 
3% 
5% 
1% 
2% 
9% 
13% 
7% 
8% 
Home Health Agencies, Page C - 9  G.  OVERALL ASSESSMENT (cont.)

n  mean7  median7  mode7 
35.  I have an excellent understanding of Y2K issues:  Rural  136  2.87  3  2

Urban  132  2.70  3  3

36.	 I am very concerned about Y2K issues:  Rural  136  2.25  2  1

Urban  131  2.10  2  1

37.	 My business is currently Y2K ready:  Rural  135  3.38  3  2

Urban  132  3.48  3  3

38.	 My business will be Y2K ready by December 31, 1999:  Rural  132  1.81  1  1

Urban  127  1.50  1  1

39.	 My Medicare patients' access to quality care will not be affected by Y2K problems:  Rural  135  1.92  1  1

Urban  131  1.61  1  1

40.	 My Medicare contractor has been very helpful in providing Y2K information/support:  Rural  124  3.58  3  3

Urban  116  3.45  3  3

41.	 My vendors have been very helpful in providing Y2K information/support:  Rural  126  3.00  3  3

Urban  122  2.80  3  3

KEY: 
1 = Strongly Agree 
2 = Moderately Agree 
3 = Slightly Agree 
4 = Slightly Disagree 
5 = Moderately Disagree 
6 = Strongly Disagree 
N/A = No Response or Not Applicable 
7 N/A responses were not used to calculate the mean, median, and mode. 
Home Health Agencies, Page C - 10 
 H.  INFORMATION ABOUT YOUR BUSINESS

n 
42.	 If your agency is not currently Y2K ready, by what date do you expect to be Y2K ready?8  Rural  85  Largest Response Categories: 12/31/99 (22%), 6/1/99 (12%), 71/99 (11%) 
Urban  97  Largest Response Categories: 12/31/99 (30%), 6/30/99 (13%), 7/1/99/99 (11%) 
43.	 What percentage of your business is represented by Medicare?8  Rural  132  Approx. 3/4 answered more than 70 percent. Median: 85% 
Urban  126  Approx. 3/4 answered more than 60 percent. Median: 80% 
44.	 Approximately how many patients does your agency see per year?8  Rural  122  Approx. 3/4 answered 570 or less. Median: 225 
Urban  121  Approx. 3/4 answered 600 or less. Median: 300 
Yes  No  N/A 
45.	 Is your agency free-standing?  Rural  136  46%  50%  4% 
Urban  133  43%  55%  2% 
46.	 Are you a provider for a managed care organization?  Rural  136  38%  60%  3% 
Urban  133  42%  57%  1% 
47.	 Do you provide services for Medicaid patients?  Rural  136  90%  7%  3% 
Urban  133  96%  4%  0% 
48.	 How long could you continue to serve Medicare patients if payments were delayed?8  Rural  117  Largest Response Categories: 1-2 months (38%), 3-6 months (18%) 
Urban  116  Largest Response Categories: 1-2 months (38%), 3-6 months (19%) 
49.	 If you couldn't submit electronically due to Y2K problems, how would you submit claims?8  Rural  113  Largest Response Categories: Paper Claims (82%), Don't Know (8%) 
Urban  111  Largest Response Categories: Paper Claims (85%), Don't Know (5%) 
8 Non-responses were not used in the analysis of these questions. 
Home Health Agencies, Page C - 10  A P P E N D I X  D

DURABLE MEDICAL EQUIPMENT SUPPLIER SURVEY RESULTS

)))))))))))
D - 1
 KEY: 
n = number of responses 
Yes = percentage of n answering "Yes". 
No = percentage of n answering "No". 
DK = percentage of n answering "Don't Know". 
N/A = percentage of n answering "Not Applicable" or providing no response. 
All percentages may not total 100 percent due to rounding. 
Applicable footnotes appear at the bottom of each page. 
SURVEY RESPONSE RATES: 
Total  Number of  Number of  Response 
Number  Surveys Mailed  Surveys Returned  Rate 
Rural DME Suppliers  24,612  500  145  29% 
Urban DME Suppliers  84,817  500  117  23% 
Total  109,429  1000  262  26% 
Durable Medical Equipment Suppliers, Page D - 2  A. BACKGROUND

n  Yes  No  DK  N/A 
1.  Do you contract with an external vendor for claims submission and payment activities?  Rural  145  28%  70%  0%  2% 
Urban  117  32%  59%  2%  7% 
2.	 Is an external vendor or contractor assisting in your effort to solve Y2K-related computer problems?  Rural  145  46%  38%  3%  14% 
Urban  117  47%  32%  3%  18% 
3.	 Have you contacted an external vendor or contractor to assist you in completing this survey?  Rural  145  4%  86%  1%  10% 
Urban  117  12%  79%  0%  9% 
B. Y2K AWARENESS AND PLANNING 
n  Yes  No  DK  N/A 
4.	 Have you thought about how Y2K problems could affect your business?  Rural  145  92%  5%  1%  3% 
Urban  117  92%  2%  1%  5% 
5.  Have you developed a strategy for dealing with potential Y2K problems associated with your: 
a. 	Billing/financial systems?  Rural  145  73%  19%  2%  6% 
Urban  117  75%  11%  5%  9% 
b. 	Clinical/medical records systems?  Rural  145  68%  16%  2%  14% 
Urban  117  62%  11%  4%  23% 
c. 	Biomedical equipment?  Rural  145  37%  19%  6%  38% 
Urban  117  41%  15%  8%  36% 
6.  Are you facing any of the following obstacles in identifying or fixing potential Y2K problems: 
a. Lack of financial resources?  Rural  145  16%  71%  7%  6% 
Urban  117  13%  74%  5%  9% 
b. Lack of skilled personnel?  Rural  145  21%  69%  5%  5% 
Urban  117  16%  73%  3%  8% 
c. Lack of vendor cooperation?  Rural  145  8%  77%  10%  5% 
Urban  117  3%  81%  7%  9% 
d. Lack of billing service cooperation?  Rural  145  5%  72%  5%  19% 
Urban  117  2%  70%  5%  23% 
7.  Have you thought about the impact to your business if all systems are not Y2K ready?  Rural  145  90%  6%  1%  3% 
Urban  117  90%  2%  3%  6% 
Durable Medical Equipment Suppliers, Page D - 3  B. Y2K AWARENESS AND PLANNING (cont.) 
n  Yes  No  DK  N/A 
8.  Have you developed contingency plans in case your business experiences Y2K-related failures?  Rural  145  32%  58%  6%  5% 
Urban  117  29%  56%  5%  10% 
9.	 If you have not developed contingency plans, do you plan to do so? 1  Rural  84  61%  17%  19%  4% 
Urban  65  72%  11%  17%  0% 
10. Do you feel that your ability to provide quality care could be compromised by Y2K-related failures?  Rural  145  28%  57%  12%  3% 
Urban  117  27%  64%  4%  5% 
C. COMPUTER SYSTEMS 
n  Yes  No  DK  N/A 
11. Have you made a complete inventory of your: 
a. Billing/financial systems?  Rural  145  72%  16%  5%  8% 
Urban  117  68%  22%  2%  9% 
b. Clinical/medical records systems?  Rural  145  68%  12%  4%  16% 
Urban  117  58%  21%  2%  20% 
c. Biomedical equipment?  Rural  145  35%  19%  9%  37% 
Urban  117  38%  17%  5%  39% 
12. Have you assessed the Y2K readiness of your: 
a. Billing/financial systems?  Rural  145  81%  10%  3%  6% 
Urban  117  73%  18%  1%  9% 
b. Clinical/medical records systems?  Rural  145  71%  12%  3%  14% 
Urban  117  62%  15%  2%  22% 
c. Biomedical equipment?  Rural  145  37%  17%  7%  39% 
Urban  117  36%  17%  5%  42% 
13.  If necessary, have you renovated or replaced your: 
a. Billing/financial systems?  Rural  145  49%  29%  3%  19% 
Urban  117  39%  30%  3%  28% 
b. Clinical/medical records systems?  Rural  145  43%  26%  3%  29% 
Urban  117  25%  35%  3%  38% 
c. Biomedical equipment?  Rural  145  17%  28%  6%  50% 
Urban  117  13%  28%  5%  54% 
1 Only analyzed if respondent answered "No" to question 8.  Durable Medical Equipment Suppliers, Page D - 4  C. COMPUTER SYSTEMS (cont.) 
n  Yes  No  DK  N/A 
14.  Have you tested your new or renovated: 
a. Billing/financial systems? 2  Rural  71  61%  37%  0%  3% 
Urban  46  80%  20%  0%  0% 
b. Clinical/medical records systems? 2  Rural  62  58%  37%  2%  3% 
Urban  29  86%  14%  0%  0% 
c. Biomedical equipment? 2  Rural  24  54%  42%  4%  0% 
Urban  15  80%  20%  0%  0% 
15. Have you begun to use your new or renovated: 
a. Billing/financial systems? 2  Rural  71  72%  25%  0%  3% 
Urban  46  76%  22%  0%  2% 
b. Clinical/medical records systems? 2  Rural  62  60%  35%  2%  3% 
Urban  29  79%  21%  0%  0% 
c. Biomedical equipment? 2  Rural  24  67%  25%  4%  4% 
Urban  15  73%  27%  0%  0% 
16. Are the following currently Y2K ready: 
a. Billing/financial systems?  Rural  145  59%  26%  8%  8% 
Urban  117  56%  28%  4%  11% 
b. Clinical/medical records systems?  Rural  145  51%  22%  10%  17% 
Urban  117  45%  22%  8%  25% 
c. Biomedical equipment?  Rural  145  23%  17%  16%  44% 
Urban  117  28%  14%  15%  44% 
17. Will the following be Y2K ready by December 31, 1999: 
a. Billing/financial systems? 3  Rural  49  82%  0%  18%  0% 
Urban  38  79%  5%  11%  5% 
b. Clinical/medical records systems? 3  Rural  46  80%  2%  17%  0% 
Urban  35  83%  6%  9%  3% 
c. Biomedical equipment? 3  Rural  47  64%  0%  34%  2% 
Urban  33  64%  6%  24%  6% 
2 Only analyzed if respondent answered "Yes" to question 13a, 13b, or 13c, respectively. 
3 Only analyzed if respondent answered "No" or "Don't Know" to question 16a, 16,b, or 16c, respectively. 
Durable Medical Equipment Suppliers, Page D - 5  D. MEDICARE CLAIM FILING

n  Yes  No  DK  N/A 
18. Are you aware that several fields on HCFA claim forms now require or will soon require 8-digit dates?  Rural  145  75%  19%  3%  3% 
Urban  117  74%  17%  2%  7% 
19.	 Can you enter 8-digit dates in the required fields of the paper HCFA Form 1500?  Rural  145  65%  12%  16%  7% 
Urban  117  69%  12%  7%  12% 
20.	 Can you enter 8-digit dates in the required fields of the electronic HCFA Form 1500 (NSF/X12 837)?  Rural  145  50%  14%  21%  15% 
Urban  117  55%  13%  15%  17% 
21.	 Will you be able to enter 8-digit dates in these fields in the next six months? 4  Rural  51  51%  0%  49%  0% 
Urban  33  45%  3%  48%  3% 
E. MEDICARE CONTRACTOR EFFORTS 
n  Yes  No  DK  N/A 
22.	 Has your Medicare contractor sent you information on Y2K or offered assistance with Y2K issues?  Rural  145  42%  30%  10%  19% 
Urban  117  41%  29%  15%  15% 
23.	 Have efforts from your Medicare contractor increased your Y2K awareness?  Rural  145  34%  34%  8%  23% 
Urban  117  38%  41%  7%  15% 
24.	 Are you aware that Medicare contractors have free Y2K-ready billing software available for use?  Rural  145  23%  58%  4%  15% 
Urban  117  29%  48%  9%  14% 
25.	 Have you requested Y2K-ready software from your Medicare contractor?  Rural  145  15%  65%  2%  18% 
Urban  117  14%  66%  4%  16% 
26.	 Have you received Y2K-ready software from your Medicare contractor? 5  Rural  145  18%  57%  6%  19% 
Urban  117  13%  64%  7%  16% 
27.	 Have you installed the Y2K-ready software provided by your Medicare contractor? 6  Rural  26  77%  15%  0%  8% 
Urban  15  100%  0%  0%  0% 
28.	 Have you submitted any claims using the Y2K-ready software provided by your Medicare contractor? 6  Rural  26  65%  27%  4%  4% 
Urban  15  80%  13%  7%  0% 
29.	 Does your Medicare contractor's Y2K-ready software function properly? 6  Rural  26  73%  8%  19%  0% 
Urban  15  80%  0%  20%  0% 
4 Only analyzed if respondent answered "No" or "Don't Know" to question 20.

5 Rural DME: 21 of 22 who requested software received it. Urban DME: 11 of 16 who requested software received it.

6 Only analyzed if respondent answered "Yes" to question 26.  Durable Medical Equipment Suppliers, Page D - 6  F.  VENDORS AND CONTRACTORS

n  Yes  No  DK  N/A 
30. Have you identified all external vendors and contractors with whom you conduct business?  Rural  145  58%  28%  7%  7% 
Urban  117  56%  27%  4%  14% 
31. Have you discussed Y2K issues with your vendors and contractors?  Rural  145  45%  44%  3%  8% 
Urban  117  43%  37%  5%  15% 
32.	 Have you received certification from vendors and contractors that their systems will be Y2K ready?  Rural  145  37%  48%  6%  9% 
Urban  117  29%  48%  7%  16% 
33.	 Do your contracts with vendors and contractors guarantee Y2K readiness?  Rural  145  29%  38%  23%  10% 
Urban  117  21%  34%  27%  17% 
34.	 Have you tested Y2K data exchange between your systems and your vendors and contractors?  Rural  145  13%  68%  3%  17% 
Urban  117  12%  56%  8%  24% 
Durable Medical Equipment Suppliers, Page D - 7  G.  OVERALL ASSESSMENT

Strongly  Strongly 
Agree.................................................................Disagree 
n 1 2 3 4 5 6 
35.  I have an excellent understanding of Y2K issues:  Rural  145  11%  32%  28%  13%  8%  4% 
Urban  117  18%  18%  37%  11%  6%  3% 
36.	 I am very concerned about Y2K issues:  Rural  145  30%  30%  19%  10%  5%  3% 
Urban  117  28%  23%  22%  10%  3%  4% 
37.	 My business is currently Y2K ready:  Rural  145  13%  23%  23%  15%  8%  12% 
Urban  117  18%  18%  22%  12%  11%  9% 
38.	 My business will be Y2K ready by December 31, 1999:  Rural  145  47%  31%  8%  3%  1%  0% 
Urban  117  43%  27%  9%  1%  2%  2% 
39.	 My Medicare patients' access to quality care will not be affected by Y2K problems:  Rural  145  51%  22%  14%  6%  2%  1% 
Urban  117  55%  25%  8%  2%  0%  3% 
40.	 My Medicare contractor has been very helpful in providing Y2K information/support:  Rural  145  7%  12%  23%  19%  8%  6% 
Urban  117  15%  11%  15%  12%  6%  12% 
41.	 My vendors have been very helpful in providing Y2K information/support:  Rural  145  10%  18%  21%  21%  10%  6% 
Urban  117  18%  16%  21%  14%  3%  6% 
KEY: 
1 = Strongly Agree 
2 = Moderately Agree 
3 = Slightly Agree 
4 = Slightly Disagree 
5 = Moderately Disagree 
6 = Strongly Disagree 
N/A = No Response or Not Applicable 
Durable Medical Equipment Suppliers, Page D - 8  N/A 
4% 
7% 
4% 
9% 
7% 
10% 
10% 
16% 
4% 
8% 
26% 
28% 
15% 
21% 
Durable Medical Equipment Suppliers, Page D - 9  G.  OVERALL ASSESSMENT (cont.)

n  mean7  median7  mode7 
35.  I have an excellent understanding of Y2K issues:  Rural  139  2.86  3  2

Urban  109  2.78  3  3

36.	 I am very concerned about Y2K issues:  Rural  139  2.36  2  1

Urban  107  2.46  2  1

37.	 My business is currently Y2K ready:  Rural  135  3.18  3  2

Urban  105  3.07  3  3

38.	 My business will be Y2K ready by December 31, 1999:  Rural  130  1.65  1  1

Urban  98  1.77  1  1

39.	 My Medicare patients' access to quality care will not be affected by Y2K problems:  Rural  139  1.85  1  1

Urban  108  1.68  1  1

40.	 My Medicare contractor has been very helpful in providing Y2K information/support:  Rural  107  3.36  3  3

Urban  84  3.25  3  1

41.	 My vendors have been very helpful in providing Y2K information/support:  Rural  123  3.21  3  3

Urban  117  2.83  3  3

KEY: 
1 = Strongly Agree 
2 = Moderately Agree 
3 = Slightly Agree 
4 = Slightly Disagree 
5 = Moderately Disagree 
6 = Strongly Disagree 
N/A = No Response or Not Applicable 
7 N/A responses were not used to calculate the mean, median, and mode. 
Durable Medical Equipment Suppliers, Page D - 10
 H. INFORMATION ABOUT YOUR BUSINESS

n 
42. If your business is not currently Y2K ready, by what date do you expect to be Y2K ready?8  Rural  74  Largest Response Categories: 12/31/99 (23%), 7/1/99 (15%), 10/1/99 (10%) 
Urban  57  Largest Response Categories: 12/31/99 (28%), 6/30/99 (16%), 6/1/99 (12%) 
43. What percentage of your business is represented by Medicare?8  Rural  141  Approx. 3/4 answered less than 50%. Median: 25% 
Urban  104  Approx. 3/4 answered less than 50%. Median: 20% 
44. Approximately how many Medicare claims do you submit per year?8  Rural  117  Approx. 3/4 answered less than 2000 claims.  Median: 500 claims 
Urban  82  Approx. 3/4 answered less than 3000 claims.  Median: 450 claims 
n  Yes  No  N/A 
45. Is your business part of a national chain?  Rural  145  6%  93%  1% 
Urban  117  11%  86%  3% 
46. Are you a provider for a managed care organization?  Rural  145  43%  54%  3% 
Urban  117  55%  41%  4% 
47. Do you provide services for Medicaid patients?  Rural  145  94%  4%  1% 
Urban  117  78%  17%  5% 
48. How long could you continue to serve Medicare patients if payments were delayed?8  Rural  125  Largest Response Categories: 1-2 months (30%), 3-6 months (36%) 
Urban  88  Largest Response Categories: 1-2 months (31%), 3-6 months (25%) 
49. If you couldn't submit electronically due to Y2K problems, how would you submit claims?8  Rural  117  Largest Response Categories: Paper Claims (91%), Will Be Ready (3%) 
Urban  93  Largest Response Categories: Paper Claims (87%), N/A (4%) 
8 Non-responses were not used in the analysis of these questions. 
Durable Medical Equipment Suppliers, Page D - 11  A P P E N D I X  E

PHYSICIAN SURVEY RESULTS

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E - 1
 KEY: 
n = number of responses 
Yes = percentage of n answering "Yes". 
No = percentage of n answering "No". 
DK = percentage of n answering "Don't Know". 
N/A = percentage of n answering "Not Applicable" or providing no response. 
All percentages may not total 100 percent due to rounding. 
Applicable footnotes appear at the bottom of each page. 
SURVEY RESPONSE RATES: 
Total  Number of  Number of  Response 
Number  Surveys Mailed  Surveys Returned  Rate 
Rural Physicians  101,843  500  124  25% 
Urban Physicians  649,897  500  95  19% 
Total  751,740  1000  219  22% 
Physicians, Page E - 2  A. BACKGROUND

n  Yes  No  DK  N/A 
1.  Do you contract with an external vendor for claims submission and payment activities?  Rural  124  28%  69%  2%  2% 
Urban  95  39%  53%  1%  7% 
2.	 Is an external vendor or contractor assisting in your effort to solve Y2K-related computer problems?  Rural  124  35%  42%  5%  18% 
Urban  95  47%  34%  5%  14% 
3.	 Have you contacted an external vendor or contractor to assist you in completing this survey?  Rural  124  7%  83%  0%  10% 
Urban  95  3%  87%  0%  9% 
B. Y2K AWARENESS AND PLANNING 
n  Yes  No  DK  N/A 
4.	 Have you thought about how Y2K problems could affect your practice?  Rural  124  91%  6%  1%  2% 
Urban  95  86%  7%  2%  4% 
5.  Have you developed a strategy for dealing with potential Y2K problems associated with your: 
a. 	Billing/financial systems?  Rural  124  73%  15%  2%  10% 
Urban  95  72%  15%  7%  6% 
b. 	Clinical/medical records systems?  Rural  124  51%  15%  3%  31% 
Urban  95  53%  11%  6%  31% 
c. 	Biomedical equipment?  Rural  124  41%  16%  6%  37% 
Urban  95  29%  11%  12%  49% 
6.  Are you facing any of the following obstacles in identifying or fixing potential Y2K problems: 
a. Lack of financial resources?  Rural  124  17%  71%  4%  8% 
Urban  95  12%  76%  6%  6% 
b. Lack of skilled personnel?  Rural  124  24%  63%  3%  10% 
Urban  95  16%  72%  4%  9% 
c. Lack of vendor cooperation?  Rural  124  8%  73%  7%  12% 
Urban  95  6%  71%  13%  11% 
d. Lack of billing service cooperation?  Rural  124  2%  72%  4%  22% 
Urban  95  3%  63%  7%  26% 
7.  Have you thought about the impact to your practice if all systems are not Y2K ready?  Rural  124  84%  9%  3%  4% 
Urban  95  88%  4%  3%  4% 
Physicians, Page E - 3  B. Y2K AWARENESS AND PLANNING (cont.) 
n  Yes  No  DK  N/A 
8.  Have you developed contingency plans in case your practice experiences Y2K-related failures?  Rural  124  32%  55%  5%  8% 
Urban  95  29%  51%  12%  8% 
9.	 If you have not developed contingency plans, do you plan to do so? 1  Rural  68  57%  21%  21%  1% 
Urban  48  50%  17%  33%  0% 
10. Do you feel that your ability to provide quality care could be compromised by Y2K-related failures?  Rural  124  21%  68%  8%  3% 
Urban  95  22%  63%  8%  6% 
C. COMPUTER SYSTEMS 
n  Yes  No  DK  N/A 
11. Have you made a complete inventory of your: 
a. Billing/financial systems?  Rural  124  68%  22%  3%  7% 
Urban  95  63%  19%  7%  11% 
b. Clinical/medical records systems?  Rural  124  52%  20%  4%  24% 
Urban  95  45%  17%  5%  33% 
c. Biomedical equipment?  Rural  124  46%  18%  6%  31% 
Urban  95  22%  18%  9%  51% 
12. Have you assessed the Y2K readiness of your: 
a. Billing/financial systems?  Rural  124  77%  14%  1%  8% 
Urban  95  66%  17%  7%  9% 
b. Clinical/medical records systems?  Rural  124  50%  16%  2%  31% 
Urban  95  47%  12%  4%  37% 
c. Biomedical equipment?  Rural  124  41%  19%  4%  36% 
Urban  95  23%  17%  7%  53% 
13.  If necessary, have you renovated or replaced your: 
a. Billing/financial systems?  Rural  124  45%  35%  1%  19% 
Urban  95  43%  32%  3%  22% 
b. Clinical/medical records systems?  Rural  124  23%  34%  3%  40% 
Urban  95  21%  26%  3%  49% 
c. Biomedical equipment?  Rural  124  21%  35%  5%  40% 
Urban  95  14%  19%  8%  59% 
1 Only analyzed if respondent answered "No" to question 8.  Physicians, Page E - 4  C. COMPUTER SYSTEMS (cont.) 
n  Yes  No  DK  N/A 
14.  Have you tested your new or renovated: 
a. Billing/financial systems? 2  Rural  56  66%  32%  0%  2% 
Urban  41  61%  37%  2%  0% 
b. Clinical/medical records systems? 2  Rural  28  68%  29%  0%  4% 
Urban  20  70%  30%  0%  0% 
c. Biomedical equipment? 2  Rural  26  62%  31%  0%  8% 
Urban  13  69%  23%  8%  0% 
15. Have you begun to use your new or renovated: 
a. Billing/financial systems? 2  Rural  56  71%  25%  2%  2% 
Urban  41  68%  24%  2%  5% 
b. Clinical/medical records systems? 2  Rural  28  71%  25%  0%  4% 
Urban  20  65%  25%  5%  5% 
c. Biomedical equipment? 2  Rural  26  73%  19%  0%  8% 
Urban  13  77%  15%  0%  8% 
16. Are the following currently Y2K ready: 
a. Billing/financial systems?  Rural  124  54%  33%  5%  8% 
Urban  95  45%  25%  20%  9% 
b. Clinical/medical records systems?  Rural  124  41%  19%  10%  30% 
Urban  95  40%  15%  12%  34% 
c. Biomedical equipment?  Rural  124  30%  19%  15%  36% 
Urban  95  20%  12%  17%  52% 
17. Will the following be Y2K ready by December 31, 1999: 
a. Billing/financial systems? 3  Rural  47  75%  9%  17%  0% 
Urban  43  77%  7%  16%  0% 
b. Clinical/medical records systems? 3  Rural  36  47%  14%  39%  0% 
Urban  25  64%  8%  24%  4% 
c. Biomedical equipment? 3  Rural  42  45%  7%  45%  2% 
Urban  27  52%  15%  30%  4% 
2 Only analyzed if respondent answered "Yes" to question 13a, 13b, or 13c, respectively. 
3 Only analyzed if respondent answered "No" or "Don't Know" to question 16a, 16,b, or 16c, respectively. 
Physicians, Page E - 5  D. MEDICARE CLAIM FILING

n  Yes  No  DK  N/A 
18. Are you aware that several fields on HCFA claim forms now require or will soon require 8-digit dates?  Rural  124  79%  15%  4%  2% 
Urban  95  68%  18%  7%  6% 
19.	 Can you enter 8-digit dates in the required fields of the paper HCFA Form 1500?  Rural  124  75%  9%  14%  2% 
Urban  95  61%  13%  21%  5% 
20.	 Can you enter 8-digit dates in the required fields of the electronic HCFA Form 1500 (NSF/X12 837)?  Rural  124  52%  10%  19%  18% 
Urban  95  50%  8%  26%  16% 
21.	 Will you be able to enter 8-digit dates in these fields in the next six months? 4  Rural  37  27%  19%  51%  3% 
Urban  33  30%  3%  67%  0% 
E. MEDICARE CONTRACTOR EFFORTS 
n  Yes  No  DK  N/A 
22.	 Has your Medicare contractor sent you information on Y2K or offered assistance with Y2K issues?  Rural  124  51%  25%  10%  15% 
Urban  95  27%  37%  22%  14% 
23.	 Have efforts from your Medicare contractor increased your Y2K awareness?  Rural  124  48%  31%  6%  15% 
Urban  95  20%  51%  14%  16% 
24.	 Are you aware that Medicare contractors have free Y2K-ready billing software available for use?  Rural  124  27%  56%  3%  14% 
Urban  95  16%  60%  14%  11% 
25.	 Have you requested Y2K-ready software from your Medicare contractor?  Rural  124  10%  69%  4%  18% 
Urban  95  12%  65%  7%  16% 
26.	 Have you received Y2K-ready software from your Medicare contractor? 5  Rural  124  12%  61%  7%  19% 
Urban  95  7%  61%  11%  21% 
27.	 Have you installed the Y2K-ready software provided by your Medicare contractor? 6  Rural  15  87%  13%  0%  0% 
Urban  7  100%  0%  0%  0% 
28.	 Have you submitted any claims using the Y2K-ready software provided by your Medicare contractor? 6  Rural  15  67%  20%  7%  7% 
Urban  7  86%  14%  0%  0% 
29.	 Does your Medicare contractor's Y2K-ready software function properly? 6  Rural  15  67%  13%  13%  7% 
Urban  7  86%  0%  14%  0% 
4 Only analyzed if respondent answered "No" or "Don't Know" to question 20.

5 Rural Phys: 7 of 12 who requested software received it. Urban Phys: 7 of 11 who requested software received it.

6 Only analyzed if respondent answered "Yes" to question 26.  Physicians, Page E - 6  F.  VENDORS AND CONTRACTORS

n  Yes  No  DK  N/A 
30. Have you identified all external vendors and contractors with whom you conduct business?  Rural  124  41%  36%  9%  14% 
Urban  95  55%  20%  11%  15% 
31. Have you discussed Y2K issues with your vendors and contractors?  Rural  124  40%  44%  5%  12% 
Urban  95  45%  35%  4%  16% 
32.	 Have you received certification from vendors and contractors that their systems will be Y2K ready?  Rural  124  26%  53%  7%  14% 
Urban  95  31%  45%  6%  18% 
33.	 Do your contracts with vendors and contractors guarantee Y2K readiness?  Rural  124  23%  36%  23%  18% 
Urban  95  21%  31%  26%  22% 
34.	 Have you tested Y2K data exchange between your systems and your vendors and contractors?  Rural  124  14%  60%  6%  21% 
Urban  95  11%  56%  11%  23% 
Physicians, Page E - 7  G.  OVERALL ASSESSMENT

Strongly  Strongly 
Agree.................................................................Disagree 
n 1 2 3 4 5 6 
35.  I have an excellent understanding of Y2K issues:  Rural  124  14%  23%  32%  18%  6%  5% 
Urban  95  19%  17%  32%  16%  5%  4% 
36.	 I am very concerned about Y2K issues:  Rural  124  18%  23%  31%  10%  11%  3% 
Urban  95  21%  23%  25%  12%  5%  6% 
37.	 My practice is currently Y2K ready:  Rural  124  16%  29%  15%  11%  9%  12% 
Urban  95  14%  22%  18%  18%  11%  8% 
38.	 My practice will be Y2K ready by December 31, 1999:  Rural  124  41%  31%  8%  4%  2%  4% 
Urban  95  47%  29%  8%  4%  0%  0% 
39.	 My Medicare patients' access to quality care will not be affected by Y2K problems:  Rural  124  56%  20%  11%  3%  3%  1% 
Urban  95  56%  24%  4%  6%  0%  1% 
40.	 My Medicare contractor has been very helpful in providing Y2K information/support:  Rural  124  10%  10%  21%  16%  6%  12% 
Urban  95  11%  6%  14%  19%  16%  11% 
41.	 My vendors have been very helpful in providing Y2K information/support:  Rural  124  14%  16%  26%  12%  7%  6% 
Urban  95  15%  16%  20%  17%  7%  5% 
KEY: 
1 = Strongly Agree 
2 = Moderately Agree 
3 = Slightly Agree 
4 = Slightly Disagree 
5 = Moderately Disagree 
6 = Strongly Disagree 
N/A = No Response or Not Applicable 
Physicians, Page E - 8  N/A 
2% 
7% 
4% 
7% 
8% 
9% 
10% 
11% 
5% 
8% 
25% 
24% 
19% 
20% 
Physicians, Page E - 9  G.  OVERALL ASSESSMENT (cont.)

n  mean7  median7  mode7 
35.  I have an excellent understanding of Y2K issues:  Rural  121  2.95  3  3

Urban  88  2.83  3  3

36.	 I am very concerned about Y2K issues:  Rural  119  2.83  3  3

Urban  88  2.74  3  3

37.	 My practice is currently Y2K ready:  Rural  114  3.04  3  2

Urban  86  3.16  3  2

38.	 My practice will be Y2K ready by December 31, 1999:  Rural  111  1.95  2  1

Urban  85  1.66  1  1

39.	 My Medicare patients' access to quality care will not be affected by Y2K problems:  Rural  118  1.73  1  1

Urban  87  1.62  1  1

40.	 My Medicare contractor has been very helpful in providing Y2K information/support:  Rural  93  3.45  3  3

Urban  72  3.72  4  4

41.	 My vendors have been very helpful in providing Y2K information/support:  Rural  101  3.03  3  3

Urban  76  3.03  3  3

KEY: 
1 = Strongly Agree 
2 = Moderately Agree 
3 = Slightly Agree 
4 = Slightly Disagree 
5 = Moderately Disagree 
6 = Strongly Disagree 
N/A = No Response or Not Applicable 
7 N/A responses were not used to calculate the mean, median, and mode. 
Physicians, Page E - 10
 H.  INFORMATION ABOUT YOUR BUSINESS 
n 
42.	 If your practice is not currently Y2K ready, by what date do you expect to be Y2K ready?8  Rural  55  Largest Response Categories: 12/31/99 (35%), 6/1/99 (9%), 6/30/99 (7%) 
Urban  41  Largest Response Categories: 12/31/99 (22%), 6/1/99 (12%), 6/30/99 (10%) 
43.	 What percentage of your business is represented by Medicare?8  Rural  116  Approx. 3/4 answered less than 40 percent. Median: 30 percent 
Urban  87  Approx. 3/4 answered less than 40 percent. Median: 25 percent 
44.	 Approximately how many patients do you see per year?8  Rural  99  Approx. 3/4 answered 8000 or less. Median: 4500 
Urban  69  Approx. 3/4 answered 5000 or less. Median: 2100 
n  Yes  No  N/A 
45.	 Are you a member of a group practice?  Rural  124  44%  52%  3% 
Urban  95  51%  43%  6% 
46.	 Are you a provider for a managed care organization?  Rural  124  59%  36%  5% 
Urban  95  66%  28%  5% 
47.	 Do you provide services for Medicaid patients?  Rural  124  90%  10%  1% 
Urban  95  65%  29%  5% 
48.	 How long could you continue to serve Medicare patients if payments were delayed?8  Rural  106  Largest Response Categories: 1-2 months (26%), 3-6 months (26%) 
Urban  66  Largest Response Categories: 1-2 months (24%), 3-6 months (27%) 
49.	 If you couldn't submit electronically due to Y2K problems, how would you submit claims?8  Rural  104  Largest Response Categories: Paper Claims (87%), N/A (8%) 
Urban  70  Largest Response Categories: Paper Claims (86%), Don't Know (9%) 
8 Non-responses were not used in the analysis of these questions. 
Physicians, Page E - 11  A P P E N D I X  F

HEALTH CARE FINANCING ADMINISTRATION COMMENTS

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 A P P E N D I X  G

ASSISTANT SECRETARY FOR MANAGEMENT AND BUDGET COMMENTS

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