Department of Health and Human Services 

OFFICE OF 

INSPECTOR GENERAL 

JUNE GIBBS BROWN 

Inspector General 

MARCH 1999 

OEI-03-98-00250 

Y2K READINESS OF 

MEDICARE PROVIDERS 
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 

David Tawes, Lead Analyst

Tara Schmerling

David Graf

Nancy Gross

Cynthia Hansford

Robert Katz

Erika Q. Lang

Lauren McNulty

Nancy Molyneaux

HEADQUARTERS 

Bambi Straw, Program Specialist

Stuart Wright, Program Specialist

Scott Horning, Technical Support Staff

Linda Moscoe, Technical Support Staff

Brian Ritchie, Technical Support Staff

Barbara Tedesco, Technical Support Staff

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
INTRODUCTION

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. Today’s 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 fourdigit 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 

))))))))))) 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 HCFA’s 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 provider’s 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. 

))))))))))) 4 
SUMMARY OF SURVEY RESULTS

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. 

))))))))))) 5 
FIGURE 1: PROVIDER READINESS 

Percentage Who Report Current Y2K Readiness 

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 

Rural Hospitals 

Urban Hospitals 

Rural Nursing Facilities 

Urban Nursing Facilities 

Rural Home Health 

Agencies 

Urban Home Health 

Agencies 

Rural DME Suppliers 

Urban DME Suppliers 

Rural Physicians 

Urban Physicians 

55% 

50% 

48% 

49% 

49% 

50% 

59% 

56% 

54% 

45% 

46% 

46% 

52% 

54% 

47% 

51% 

51% 

45% 

41% 

40% 

31% 

23% 

21% 

21% 

26% 

21% 

23% 

28% 

30% 

20% 

Billing Systems 

Medical Records Systems 

Biomedical Equipment 

)))))))))))

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% 

Rural Hospitals 

Urban Hospitals 

Rural Nursing Facilities 

Urban Nursing Facilities 

Rural Home Health 

Agencies 

Urban Home Health 

Agencies 

Rural DME Suppliers 

Urban DME Suppliers 

Rural Physicians 

Urban Physicians 

95% 

92% 

80% 

84% 

70% 

75% 

82% 

79% 

75% 

77% 

93% 

91% 

77% 

78% 

63% 

80% 

80% 

83% 

47% 

64% 

88% 

90% 

63% 

62% 

60% 

68% 

64% 

64% 

45% 

52% 

Billing Systems 

Medical Records Systems 

Biomedical Equipment 

Note: Percentages are based on providers who responded 

they were not currently ready. 

)))))))))))

7 
FIGURE 3: CONTINGENCY PLANNING 

Percentage Who Report Having Contingency Plans 

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 

Rural Hospitals 

Urban Hospitals 

Rural Nursing Facilities 

Urban Nursing Facilities 

Rural Home Health Agencies 

Urban Home Health Agencies 

Rural DME Suppliers 

Urban DME Suppliers 

Rural Physicians 

Urban Physicians 

42% 

51% 

32% 

32% 

34% 

42% 

32% 

29% 

32% 

29% 

))))))))))) 8 
EXTERNAL VENDORSÊ

' 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 EFFORTSÊ

' 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. 

))))))))))) 9 
CONCLUSION

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 COMMENTSÊ

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 HCFA’s and ASMB’s 

comments is presented in Appendices F and G. 

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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 
APPENDIX A

HOSPITAL SURVEY RESULTS

))))))))))) 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 

Number of 

Surveys Mailed 

Number of 

Surveys Returned 

Response 

Rate 

Rural Hospitals 

Urban Hospitals 

2,287 

3,405 

500 

500 

281 

208 

56% 

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? 

b. Lack of skilled personnel? 

c. Lack of vendor cooperation? 

d. Lack of billing service cooperation? 

Rural 281 38% 56% 6% 0% 

Urban 208 25% 68% 6% 1% 

Rural 281 40% 58% 2% 1% 

Urban 208 31% 64% 5% 0% 

Rural 281 33% 58% 9% 1% 

Urban 208 44% 48% 8% 0% 

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% 

C. COMPUTER SYSTEMS 

11. Have you made a complete inventory of your: 

a. Billing/financial systems? 

b. Clinical/medical records systems? 

c. Biomedical equipment? 

12. Have you assessed the Y2K readiness of your: 

a. Billing/financial systems? 

b. Clinical/medical records systems? 

c. Biomedical equipment? 

Urban 208 56% 35% 3% 6% 

n Yes No DK N/A 

Rural 281 93% 6% 1% 0% 

Urban 208 97% 2% 1% 0% 

Rural 281 90% 7% 1% 1% 

Urban 208 95% 3% 0% 2% 

Rural 281 89% 10% 1% 0% 

Urban 208 94% 5% 0% 1% 

Rural 281 92% 7% 1% 0% 

Urban 208 92% 6% 1% 1% 

Rural 281 88% 9% 2% 2% 

Urban 208 89% 8% 0% 3% 

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? 

b. Clinical/medical records systems? 

c. Biomedical equipment? 

14. Have you tested your new or renovated: 

a. Billing/financial systems? 2 

b. Clinical/medical records systems? 2 

c. Biomedical equipment? 2 

15. Have you begun to use your new or renovated: 

a. Billing/financial systems? 2 

b. Clinical/medical records systems? 2 

c. Biomedical equipment? 2 

16. Are the following currently Y2K ready: 

a. Billing/financial systems? 

b. Clinical/medical records systems? 

c. Biomedical equipment? 

Rural 281 58% 31% 0% 10% 

Urban 208 63% 21% 3% 14% 

Rural 281 49% 36% 1% 14% 

Urban 208 56% 26% 2% 16% 

Rural 281 40% 47% 5% 7% 

Urban 208 47% 38% 5% 10% 

Rural 164 61% 35% 0% 4% 

Urban 130 58% 38% 2% 2% 

Rural 138 58% 36% 1% 5% 

Urban 116 61% 33% 3% 3% 

Rural 113 58% 36% 1% 5% 

Urban 98 59% 32% 5% 4% 

Rural 164 71% 27% 1% 1% 

Urban 130 60% 38% 0% 2% 

Rural 138 62% 36% 1% 2% 

Urban 116 64% 34% 0% 2% 

Rural 113 68% 23% 2% 7% 

Urban 98 62% 32% 2% 4% 

Rural 281 55% 39% 5% 1% 

Urban 208 50% 38% 9% 3% 

Rural 281 46% 38% 11% 5% 

Urban 208 46% 38% 9% 7% 

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 
1

2

3

4

5

6

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: 

= Strongly Agree 

= Moderately Agree 

= Slightly Agree 

= Slightly Disagree 

= Moderately Disagree 

= 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 
1

2

3

4

5

6

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: 

= Strongly Agree 

= Moderately Agree 

= Slightly Agree 

= Slightly Disagree 

= Moderately Disagree 

= 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 
APPENDIX 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 

Number of 

Surveys Mailed 

Number of 

Surveys Returned 

Response 

Rate 

Rural Nursing Facilities 

Urban Nursing Facilities 

5,767 

10,982 

500 

500 

221 

191 

44% 

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? 

b. Lack of skilled personnel? 

c. Lack of vendor cooperation? 

d. Lack of billing service cooperation? 

Rural 221 19% 69% 10% 2% 

Urban 191 19% 73% 7% 2% 

Rural 221 23% 69% 6% 1% 

Urban 191 24% 71% 5% 1% 

Rural 221 15% 72% 10% 3% 

Urban 191 12% 78% 7% 3% 

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% 

C. COMPUTER SYSTEMS 

11. Have you made a complete inventory of your: 

a. Billing/financial systems? 

b. Clinical/medical records systems? 

c. Biomedical equipment? 

12. Have you assessed the Y2K readiness of your: 

a. Billing/financial systems? 

b. Clinical/medical records systems? 

c. Biomedical equipment? 

13. If necessary, have you renovated or replaced your: 

a. Billing/financial systems? 

b. Clinical/medical records systems? 

c. Biomedical equipment? 

1

 Only analyzed if respondent answered "No" to question 8. 

Urban 191 27% 63% 9% 2% 

n Yes No DK N/A 

Rural 221 76% 16% 3% 5% 

Urban 191 84% 10% 3% 3% 

Rural 221 75% 16% 4% 6% 

Urban 191 83% 10% 4% 4% 

Rural 221 47% 19% 10% 24% 

Urban 191 45% 22% 12% 21% 

Rural 221 76% 15% 3% 5% 

Urban 191 83% 11% 4% 2% 

Rural 221 78% 14% 3% 6% 

Urban 191 80% 13% 3% 4% 

Rural 221 44% 21% 9% 26% 

Urban 191 45% 22% 12% 21% 

Rural 221 49% 32% 3% 16% 

Urban 191 54% 31% 3% 11% 

Rural 221 48% 33% 3% 17% 

Urban 191 50% 31% 3% 15% 

Rural 221 19% 36% 10% 35% 

Urban 191 22% 37% 13% 28% 

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 

b. Clinical/medical records systems? 2 

c. Biomedical equipment? 2 

15. Have you begun to use your new or renovated: 

a. Billing/financial systems? 2 

b. Clinical/medical records systems? 2 

c. Biomedical equipment? 2 

16. Are the following currently Y2K ready: 

a. Billing/financial systems? 

b. Clinical/medical records systems? 

c. Biomedical equipment? 

17. Will the following be Y2K ready by December 31, 1999: 

a. Billing/financial systems? 3 

b. Clinical/medical records systems? 3 

c. Biomedical equipment? 3 

Rural 109 50% 36% 3% 11% 

Urban 104 56% 36% 1% 8% 

Rural 105 52% 34% 3% 10% 

Urban 96 56% 32% 3% 8% 

Rural 42 36% 36% 7% 21% 

Urban 42 50% 29% 2% 19% 

Rural 109 59% 39% 2% 1% 

Urban 104 62% 38% 0% 0% 

Rural 105 67% 30% 1% 2% 

Urban 96 65% 35% 0% 0% 

Rural 42 48% 48% 2% 2% 

Urban 42 50% 45% 2% 2% 

Rural 221 48% 37% 11% 5% 

Urban 191 49% 39% 9% 3% 

Rural 221 52% 32% 10% 5% 

Urban 191 54% 30% 10% 6% 

Rural 221 21% 25% 23% 31% 

Urban 191 21% 28% 25% 27% 

Rural 105 80% 2% 18% 0% 

Urban 92 84% 0% 16% 0% 

Rural 93 77% 2% 20% 0% 

Urban 77 78% 1% 21% 0% 

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 
1

2

3

4

5

6

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: 

= Strongly Agree 

= Moderately Agree 

= Slightly Agree 

= Slightly Disagree 

= Moderately Disagree 

= 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 
1

2

3

4

5

6

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: 

= Strongly Agree 

= Moderately Agree 

= Slightly Agree 

= Slightly Disagree 

= Moderately Disagree 

= 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 
APPENDIX 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 

Number of 

Surveys Mailed 

Number of 

Surveys Returned 

Response 

Rate 

Rural Home Health Agencies 

Urban Home Health Agencies 

2,905 

6,193 

500 

500 

136 

133 

27% 

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? 

b. Lack of skilled personnel? 

c. Lack of vendor cooperation? 

d. Lack of billing service cooperation? 

Rural 136 36% 57% 7% 0% 

Urban 133 39% 50% 6% 5% 

Rural 136 29% 67% 4% 0% 

Urban 133 32% 62% 5% 2% 

Rural 136 13% 77% 6% 4% 

Urban 133 11% 76% 9% 5% 

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% 

C. COMPUTER SYSTEMS 

11. Have you made a complete inventory of your: 

a. Billing/financial systems? 

b. Clinical/medical records systems? 

c. Biomedical equipment? 

12. Have you assessed the Y2K readiness of your: 

a. Billing/financial systems? 

b. Clinical/medical records systems? 

c. Biomedical equipment? 

13. If necessary, have you renovated or replaced your: 

a. Billing/financial systems? 

b. Clinical/medical records systems? 

c. Biomedical equipment? 

1

 Only analyzed if respondent answered "No" to question 8. 

Urban 133 24% 66% 8% 2% 

n Yes No DK N/A 

Rural 136 84% 12% 3% 1% 

Urban 133 83% 14% 2% 0% 

Rural 136 79% 13% 3% 6% 

Urban 133 78% 14% 2% 5% 

Rural 136 49% 10% 2% 39% 

Urban 133 48% 14% 5% 34% 

Rural 136 82% 13% 4% 0% 

Urban 133 90% 8% 2% 0% 

Rural 136 76% 13% 3% 7% 

Urban 133 80% 14% 2% 5% 

Rural 136 43% 13% 4% 40% 

Urban 133 43% 17% 5% 35% 

Rural 136 38% 46% 4% 13% 

Urban 133 48% 37% 2% 14% 

Rural 136 30% 44% 4% 22% 

Urban 133 42% 35% 1% 22% 

Rural 136 16% 35% 3% 46% 

Urban 133 19% 32% 5% 44% 

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 

b. Clinical/medical records systems? 2 

c. Biomedical equipment? 2 

15. Have you begun to use your new or renovated: 

a. Billing/financial systems? 2 

b. Clinical/medical records systems? 2 

c. Biomedical equipment? 2 

16. Are the following currently Y2K ready: 

a. Billing/financial systems? 

b. Clinical/medical records systems? 

c. Biomedical equipment? 

17. Will the following be Y2K ready by December 31, 1999: 

a. Billing/financial systems? 3 

b. Clinical/medical records systems? 3 

c. Biomedical equipment? 3 

Rural 51 63% 31% 2% 4% 

Urban 64 59% 36% 2% 3% 

Rural 41 71% 22% 2% 5% 

Urban 56 61% 36% 2% 2% 

Rural 22 59% 27% 5% 9% 

Urban 25 64% 24% 8% 4% 

Rural 51 61% 31% 2% 6% 

Urban 64 66% 31% 2% 2% 

Rural 41 66% 32% 0% 2% 

Urban 56 63% 34% 2% 2% 

Rural 22 68% 23% 0% 9% 

Urban 25 64% 28% 0% 8% 

Rural 136 49% 38% 12% 2% 

Urban 133 50% 37% 11% 3% 

Rural 136 47% 32% 10% 11% 

Urban 133 51% 29% 8% 11% 

Rural 136 26% 23% 10% 41% 

Urban 133 21% 26% 14% 39% 

Rural 67 70% 6% 24% 0% 

Urban 63 75% 3% 22% 0% 

Rural 57 63% 5% 30% 2% 

Urban 50 80% 2% 18% 0% 

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 
1

2

3

4

5

6

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: 

= Strongly Agree 

= Moderately Agree 

= Slightly Agree 

= Slightly Disagree 

= Moderately Disagree 

= 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 
1

2

3

4

5

6

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: 

= Strongly Agree 

= Moderately Agree 

= Slightly Agree 

= Slightly Disagree 

= Moderately Disagree 

= 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 
APPENDIX 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 

Number of 

Surveys Mailed 

Number of 

Surveys Returned 

Response 

Rate 

Rural DME Suppliers 

Urban DME Suppliers 

24,612 

84,817 

500 

500 

145 

117 

29% 

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? 

b. Lack of skilled personnel? 

c. Lack of vendor cooperation? 

d. Lack of billing service cooperation? 

Rural 145 16% 71% 7% 6% 

Urban 117 13% 74% 5% 9% 

Rural 145 21% 69% 5% 5% 

Urban 117 16% 73% 3% 8% 

Rural 145 8% 77% 10% 5% 

Urban 117 3% 81% 7% 9% 

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% 

C. COMPUTER SYSTEMS 

11. Have you made a complete inventory of your: 

a. Billing/financial systems? 

b. Clinical/medical records systems? 

c. Biomedical equipment? 

12. Have you assessed the Y2K readiness of your: 

a. Billing/financial systems? 

b. Clinical/medical records systems? 

c. Biomedical equipment? 

13. If necessary, have you renovated or replaced your: 

a. Billing/financial systems? 

b. Clinical/medical records systems? 

c. Biomedical equipment? 

1

 Only analyzed if respondent answered "No" to question 8. 

Urban 117 27% 64% 4% 5% 

n Yes No DK N/A 

Rural 145 72% 16% 5% 8% 

Urban 117 68% 22% 2% 9% 

Rural 145 68% 12% 4% 16% 

Urban 117 58% 21% 2% 20% 

Rural 145 35% 19% 9% 37% 

Urban 117 38% 17% 5% 39% 

Rural 145 81% 10% 3% 6% 

Urban 117 73% 18% 1% 9% 

Rural 145 71% 12% 3% 14% 

Urban 117 62% 15% 2% 22% 

Rural 145 37% 17% 7% 39% 

Urban 117 36% 17% 5% 42% 

Rural 145 49% 29% 3% 19% 

Urban 117 39% 30% 3% 28% 

Rural 145 43% 26% 3% 29% 

Urban 117 25% 35% 3% 38% 

Rural 145 17% 28% 6% 50% 

Urban 117 13% 28% 5% 54% 

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 

b. Clinical/medical records systems? 2 

c. Biomedical equipment? 2 

15. Have you begun to use your new or renovated: 

a. Billing/financial systems? 2 

b. Clinical/medical records systems? 2 

c. Biomedical equipment? 2 

16. Are the following currently Y2K ready: 

a. Billing/financial systems? 

b. Clinical/medical records systems? 

c. Biomedical equipment? 

17. Will the following be Y2K ready by December 31, 1999: 

a. Billing/financial systems? 3 

b. Clinical/medical records systems? 3 

c. Biomedical equipment? 3 

Rural 71 61% 37% 0% 3% 

Urban 46 80% 20% 0% 0% 

Rural 62 58% 37% 2% 3% 

Urban 29 86% 14% 0% 0% 

Rural 24 54% 42% 4% 0% 

Urban 15 80% 20% 0% 0% 

Rural 71 72% 25% 0% 3% 

Urban 46 76% 22% 0% 2% 

Rural 62 60% 35% 2% 3% 

Urban 29 79% 21% 0% 0% 

Rural 24 67% 25% 4% 4% 

Urban 15 73% 27% 0% 0% 

Rural 145 59% 26% 8% 8% 

Urban 117 56% 28% 4% 11% 

Rural 145 51% 22% 10% 17% 

Urban 117 45% 22% 8% 25% 

Rural 145 23% 17% 16% 44% 

Urban 117 28% 14% 15% 44% 

Rural 49 82% 0% 18% 0% 

Urban 38 79% 5% 11% 5% 

Rural 46 80% 2% 17% 0% 

Urban 35 83% 6% 9% 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 
1

2

3

4

5

6

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: 

= Strongly Agree 

= Moderately Agree 

= Slightly Agree 

= Slightly Disagree 

= Moderately Disagree 

= 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 
1

2

3

4

5

6

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: 

= Strongly Agree 

= Moderately Agree 

= Slightly Agree 

= Slightly Disagree 

= Moderately Disagree 

= 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 
APPENDIX E

PHYSICIAN SURVEY RESULTS

))))))))))) 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 

Number of 

Surveys Mailed 

Number of 

Surveys Returned 

Response 

Rate 

Rural Physicians 

Urban Physicians 

101,843 

649,897 

500 

500 

124 

95 

25% 

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? 

b. Lack of skilled personnel? 

c. Lack of vendor cooperation? 

d. Lack of billing service cooperation? 

Rural 124 17% 71% 4% 8% 

Urban 95 12% 76% 6% 6% 

Rural 124 24% 63% 3% 10% 

Urban 95 16% 72% 4% 9% 

Rural 124 8% 73% 7% 12% 

Urban 95 6% 71% 13% 11% 

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% 

C. COMPUTER SYSTEMS 

11. Have you made a complete inventory of your: 

a. Billing/financial systems? 

b. Clinical/medical records systems? 

c. Biomedical equipment? 

12. Have you assessed the Y2K readiness of your: 

a. Billing/financial systems? 

b. Clinical/medical records systems? 

c. Biomedical equipment? 

13. If necessary, have you renovated or replaced your: 

a. Billing/financial systems? 

b. Clinical/medical records systems? 

c. Biomedical equipment? 

1

 Only analyzed if respondent answered "No" to question 8. 

Urban 95 22% 63% 8% 6% 

n Yes No DK N/A 

Rural 124 68% 22% 3% 7% 

Urban 95 63% 19% 7% 11% 

Rural 124 52% 20% 4% 24% 

Urban 95 45% 17% 5% 33% 

Rural 124 46% 18% 6% 31% 

Urban 95 22% 18% 9% 51% 

Rural 124 77% 14% 1% 8% 

Urban 95 66% 17% 7% 9% 

Rural 124 50% 16% 2% 31% 

Urban 95 47% 12% 4% 37% 

Rural 124 41% 19% 4% 36% 

Urban 95 23% 17% 7% 53% 

Rural 124 45% 35% 1% 19% 

Urban 95 43% 32% 3% 22% 

Rural 124 23% 34% 3% 40% 

Urban 95 21% 26% 3% 49% 

Rural 124 21% 35% 5% 40% 

Urban 95 14% 19% 8% 59% 

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 

b. Clinical/medical records systems? 2 

c. Biomedical equipment? 2 

15. Have you begun to use your new or renovated: 

a. Billing/financial systems? 2 

b. Clinical/medical records systems? 2 

c. Biomedical equipment? 2 

16. Are the following currently Y2K ready: 

a. Billing/financial systems? 

b. Clinical/medical records systems? 

c. Biomedical equipment? 

17. Will the following be Y2K ready by December 31, 1999: 

a. Billing/financial systems? 3 

b. Clinical/medical records systems? 3 

c. Biomedical equipment? 3 

Rural 56 66% 32% 0% 2% 

Urban 41 61% 37% 2% 0% 

Rural 28 68% 29% 0% 4% 

Urban 20 70% 30% 0% 0% 

Rural 26 62% 31% 0% 8% 

Urban 13 69% 23% 8% 0% 

Rural 56 71% 25% 2% 2% 

Urban 41 68% 24% 2% 5% 

Rural 28 71% 25% 0% 4% 

Urban 20 65% 25% 5% 5% 

Rural 26 73% 19% 0% 8% 

Urban 13 77% 15% 0% 8% 

Rural 124 54% 33% 5% 8% 

Urban 95 45% 25% 20% 9% 

Rural 124 41% 19% 10% 30% 

Urban 95 40% 15% 12% 34% 

Rural 124 30% 19% 15% 36% 

Urban 95 20% 12% 17% 52% 

Rural 47 75% 9% 17% 0% 

Urban 43 77% 7% 16% 0% 

Rural 36 47% 14% 39% 0% 

Urban 25 64% 8% 24% 4% 

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 
1

2

3

4

5

6

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: 

= Strongly Agree 

= Moderately Agree 

= Slightly Agree 

= Slightly Disagree 

= Moderately Disagree 

= 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 
1

2

3

4

5

6

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: 

= Strongly Agree 

= Moderately Agree 

= Slightly Agree 

= Slightly Disagree 

= Moderately Disagree 

= 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 
APPENDIX F

HEALTH CARE FINANCING ADMINISTRATION COMMENTS

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APPENDIX G

ASSISTANT SECRETARY FOR MANAGEMENT AND BUDGET COMMENTS

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