About - Updates - CompareMaine

CompareMaine 12.0—March 2024

The payment data has been updated and represents average payments for the reporting period April 1, 2022 – March 31, 2023.

The Five-Star Overall Hospital Quality Rating from the Center for Medicare & Medicaid Services was added as a measure of quality care received, reported on a five-star scale. The quality data was updated to reflect the most recent reporting periods available:

Five-Star Overall Hospital Quality Rating (4/1/21 – 3/31/22)
Patient Experience Survey Results (4/1/22 – 3/31/23)
Preventing Healthcare-Associated Infections (4/1/22 – 3/31/23)
Preventing Serious Complications (7/1/20 – 6/30/22)
Preventing Falls with Injury (1/1/22 - 12/31/22)
Preventing Pressure Ulcers (1/1/22 - 12/31/22)
Unplanned Hospital-Wide Readmissions (7/1/21 – 6/30/22)

The data in the dashboards for infusion therapy, chiropractic care, and trends over time have been updated for the reporting period April 1, 2022 – March 31, 2023.

The data in the dashboard for prescription drug costs and utilization has been updated for the reporting period July 1, 2022 – June 30, 2023.

New Procedures Added to CompareMaine

In the interest of enhancing the methodology for episodes of care, new procedures were not added to CompareMaine.

Episodes of Care

These bundled payments show the payments over the course of an episode of care, instead of each service individually, and provide a more comprehensive representation of the payments associated with these procedures. Many of the surgical procedures reported on CompareMaine are for a typical 60-day episode of care and includes related medical services 30 days before and 30 days after the surgery. All services related to the surgery are included, such as anesthesia, administered medications, laboratory services, and medical and surgical supplies.

For this release, the methodology for bundling episodes has been enhanced to:

Allow for more episodes of care to be processed via Optum Symmetry’s Episode Treatment Grouper® (ETG) and considered for inclusion on the website.
Attribute a claim to a healthcare setting utilizing a Tax ID when the billing or servicing NPI is missing.
Normalize payments to one unit for units-based CPT Codes.

CompareMaine 11.0—December 2022

The payment data has been updated and represents average payments for the reporting period April 1, 2021 – March 31, 2022.

The quality data was updated to reflect the most recent reporting periods available:

Patient Experience Survey Results (10/1/20 – 9/30/21)
Preventing Healthcare-Associated Infections (10/1/20 – 9/30/21)
Preventing Serious Complications (7/1/18 – 12/31/19)
Preventing Falls with Injury (10/1/20 – 9/30/21)
Preventing Pressure Ulcers (10/1/20 – 9/30/21)
Unplanned Hospital-Wide Readmissions (7/1/20 – 6/30/21)

Except for Patient Survey results, quality data are now displayed with a three-bar icon to better visualize when performance is below, at, or above the state average. Patient Survey results continue to utilize a five-bar scale, with one bar for each star of the CMS Summary Star Rating.

For non-hospital healthcare settings where quality data is not reported at a state or national level, reference to the quality data on the CompareMaine data displays and profile pages were removed. The language indicating why a hospital may have an N/A symbol was also clarified to distinguish between when results were not available for the reporting period or there was not enough data to report versus when a hospital chose not to report.

The data in the dashboards for infusion therapy, chiropractic care, and trends over time have been updated for the reporting period April 1, 2021 – March 31, 2022.

The data in the dashboard for prescription drug costs and utilization has been updated for the reporting period July 1, 2021 – June 30, 2022.

New Procedures Added to CompareMaine

Payment estimates for the following procedures are now included on CompareMaine:

Ultrasound measurement of bladder capacity after voiding (CPT Code 51798)
Injection of substance into spinal canal of lower back or sacrum using imaging guidance (CPT Code 62323)
Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance, single level (CPT Code 64483)
X-ray of fingers, minimum of 2 views (CPT Code 73140)
X-ray of hip with pelvis, 2-3 views (CPT Code 73502)
X-ray of knee, 1 or 2 views (CPT Code 73560)
X-ray of knee, 4 or more views (CPT Code 73564)
X-ray of lower leg, 2 views (CPT Code 73590)
X-ray of ankle, 2 views (CPT Code 73600)
X-ray of abdomen, 1 view (CPT Code 74018)
Ultrasound behind abdominal cavity (CPT Code 76770)
Gammaglobulin (immune system protein) measurement (CPT Code 82784)
Natriuretic peptide (heart and blood vessel protein) level (CPT Code 83880)
Red blood cell sedimentation rate, to detect inflammation, automated (CPT Code 85652)
Screening test for red blood cell antibodies (CPT Code 86850)
Special stained specimen slides to examine tissue, initial procedure (CPT Code 88342)
Routine electrocardiogram (EKG) using at least 12 leads, interpretation and report only (CPT Code 93010)
Remote evaluations of single, dual, or multiple lead pacemaker system or implantable defibrillator system with technician review, support and distribution of results, up to 90 days (CPT Code 93296)
Physician services for outpatient heart rehabilitation with continuous EKG monitoring per session (CPT Code 93798)
Physician telephone patient service, 5-10 minutes of medical discussion (CPT Code 99441)
Physician telephone patient service, 11-20 minutes of medical discussion (CPT Code 99442)
Physician telephone patient service, 21-30 minutes of medical discussion (CPT Code 99443)

New Episodes of Care Added to CompareMaine

These bundled payments show the payments over the course of an episode of care, instead of each service individually, and provide a more comprehensive representation of the payments associated with these procedures. Many of the surgical procedures reported on CompareMaine are for a typical 60-day episode of care and includes related medical services 30 days before and 30 days after the surgery. All services related to the surgery are included, such as anesthesia, administered medications, laboratory services, and medical and surgical supplies.

For this release, the methodology for bundling episodes has been enhanced to represent typical episodes of care across healthcare settings. Therefore, the estimates are based on payments for a specific set of CPT and/or Revenue Codes. Each episode must have the primary CPT Code and at least one CPT or Revenue Code from each of the categories that make up a typical episode. There are instances in which healthcare claims from standalone healthcare settings, such as ambulatory surgery centers, do not include one of the typical CPT or Revenue Codes; in which case, an exception is made.

Optum Symmetry’s Episode Treatment Grouper® (ETG) was used for the following new procedure:

Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope (CPT Code 52000)

CompareMaine 10.0—February 2022

The payment data has been updated and represents average payments for the reporting period April 1, 2020 – March 31, 2021.

The quality data was updated to reflect the most recent reporting periods available:

Patient Experience Survey Results (1/1/19 – 12/31/19)
Preventing Healthcare-Associated Infections (4/1/19 – 9/30/20)
Preventing Serious Complications (7/1/18 – 12/31/19)
Preventing Falls with Injury (10/1/19 – 9/30/20)
Preventing Pressure Ulcers (10/1/19 – 9/30/20)
Unplanned Hospital-Wide Readmissions (7/1/19 – 12/1/19)

The dashboards for infusion therapy, chiropractic care, and trends over time have been updated for the reporting period April 1, 2020 – March 31, 2021.

The dashboard for prescription drug costs and utilization has been updated for the reporting period July 1, 2020 – June 30, 2021.

New Procedures Added to CompareMaine

Payment estimates for the following procedures are now included on CompareMaine:

Tangential biopsy of single skin lesion (CPT Code 11102)
Repair of wound (2.5 centimeters or less) of the scalp, neck, underarms, trunk, arms and/or legs (CPT Code 12001)
Aspiration and/or injection of large joint or joint capsule (CPT Code 20610)
Biopsy of uterine lining (CPT Code 58100)
X-ray of chest, 1 view (CPT Code 71045)
X-ray of spine of neck, 2 or 3 views (CPT Code 72040)
X-ray of middle spine, 3 views (CPT Code 72070)
X-ray of pelvis, 1 or 2 views (CPT Code 72170)
X-ray of hand, minimum of 3 views (CPT Code 73130)
Ultrasound of head and neck (CPT Code 76536)
Nuclear medicine study of vessels of heart using drugs or exercise multiple studies (CPT Code 78452)
General health panel (CPT Code 80050)
Testing for presence of drug (CPT Code 80307)
Urinalysis, manual test (CPT Code 81002)
Urine microalbumin (protein) level (CPT Code 82043)
Creatinine level to test for kidney function or muscle injury (CPT Code 82570)
Lead level (CPT Code 83655)
Troponin (protein) analysis (CPT Code 84484)
Hemoglobin measurement (CPT Code 85018)
Hepatitis B core antibody measurement (CPT Code 86704)
Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) (CPT Code 86769)
Detection test for HIV-1 and HIV-2 (CPT Code 87389)
Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) (CPT Code 87635)
Detection test for influenza virus (CPT Code 87804)
Psychotherapy, 45 minutes (CPT Code 90836)
Treatment of speech, language, voice, communication, and/or hearing processing disorder (CPT Code 92507)
Developmental screening (CPT Code 96110)

New Episodes of Care Added to CompareMaine

These bundled payments show the cost over the course of an episode of care, instead of each service individually, and provide a more comprehensive representation of the costs associated with these procedures. Optum Symmetry’s Episode Treatment Grouper® (ETG) was used for the following new procedures:

Biopsy of prostate gland (CPT Code 55700)
Catheter insertion of stents in major coronary artery or branch, accessed through the skin (CPT Code 92928)
Insertion of catheter for imaging of heart blood vessels or grafts (CPT Code 93454)

CPT Codes

The following CPT Codes were retired by the American Medical Association in January 2021, and no substitution codes were identified:

New patient office visit (CPT Code 99201)
Low dose CT scan for lung cancer screening (CPT Code G0297)

CompareMaine 9.0—December 2020

The payment data has been updated and represents average payments for the reporting period April 1, 2019 – March 31, 2020.

The quality data was updated to reflect the most recent reporting periods available:

Patient Experience Survey Results (10/1/18 – 9/30/19)
Preventing Healthcare-Associated Infections (10/1/18 – 9/30/19)
Preventing Serious Complications (7/1/17 – 6/30/19)
Preventing Falls with Injury (10/1/18 – 9/30/19)
Preventing Pressure Ulcers (10/1/18 – 9/30/19)
Unplanned Hospital-Wide Readmissions (7/1/18 – 6/30/19)

The dashboards for infusion therapy, chiropractic care and trends over time have been updated for the reporting period April 1, 2019 – March 31, 2020.

The dashboard for prescription drug costs and utilization has been updated for the reporting period July 1, 2019 – June 30, 2020.

New Procedures Added to CompareMaine

A new category for Emergency Department Visits is included on CompareMaine, along with estimates for the following 25 procedures:

CT scan of blood vessel of head, with contrast (CPT Code 70496)
CT scan of blood vessels in chest, with contrast (CPT Code 71275)
X-ray of lower back, minimum four views (CPT Code 72110)
MRI scan of pelvis, with and without contrast (CPT Code 72197)
MRI scan of abdomen, with and without contrast (CPT Code 74183)
Abdominal ultrasound of pregnant uterus, less than 14 weeks, single or first fetus (CPT Code 76801)
Abdominal ultrasound of pregnant uterus, greater than or equal to 14 weeks, single or first fetus (CPT Code 76805)
Ultrasound of pregnant uterus, 1 or more fetus (CPT Code 76815)
Vaginal ultrasound of pregnant uterus (CPT Code 76817)
Ultrasound of fetus (CPT Code 76819)
Screening digital tomography of both breasts (CPT Code 77063)
Blood test, basic group of blood chemicals (CPT Code 80048)
Obstetric blood panel (CPT Code 80055)
Blood test for coagulation assessment (CPT Code 85730)
Electrocardiogram (ECG or EKG), with interpretation and report (CPT Code 93000)
Cardiovascular stress test (CPT Code 93017)
Ultrasound of veins in arm or leg (CPT Code 93971)
Sleep monitoring (CPT Code 95810)
Sleep monitoring, with continued pressured respiratory assistance (CPT Code 95811)
Emergency department visit, very minor (CPT Code 99281)
Emergency department visit, low complexity (CPT Code 99282)
Emergency department visit, moderate severity (CPT Code 99283)
Emergency department visit, problem of high severity (CPT Code 99284)
Emergency department visit, problem with significant threat to life or function (CPT Code 99285)
Fentanyl Citrate injection (CPT Code J3010)

New Episodes of Care Added to CompareMaine

These bundled payments show the payments over the entire course of an episode of care, instead of each service individually, and provide a more accurate representation of healthcare payments a patient may incur. Optum Symmetry’s Episode Treatment Grouper® (ETG) was used for the following new procedures:

Removal of tonsils and adenoid glands patient younger than age 12 (CPT Code 42820)
Colonoscopy with removal of polyps or growths using an endoscope (CPT Code 45385)
Repair of groin hernia patient age 5 years or older (CPT Code 49505)

New Healthcare Settings Added to CompareMaine

Added 70 new healthcare settings, including 5 that currently exist within CompareMaine healthcare setting groups.

CPT Codes

The following CPT Codes were added as replacements for expired codes:

CPT Code 77047 (MRI scan of both breasts, without contrast) and CPT Code 77049 (MRI scan of both breasts, without and with contrast) for CPT Code 77059 (MRI scan of both breasts, without and/or with contrast). CPT Code 77047 does not have enough volume to be displayed at this time.
CPT Code 96156 (Health and behavior assessment) for CPT Code 96150 (Health and behavior assessment for 15-minute session).
CPT Code 96158 (Health and behavior intervention for 30-minute session) for CPT Code 96152 (Health and behavior intervention for one person for 15-minute session).

CompareMaine 8.0—December 2019

The payment data has been updated and represents average payments for the reporting period April 1, 2018 – March 31, 2019.

The quality data was updated to reflect the most recent reporting periods available:

Patient Experience Survey Results (10/1/17 – 9/30/18)
Preventing Healthcare-Associated Infections (10/1/17 – 9/30/18)
Preventing Serious Complications (7/1/16 – 6/30/18)
Preventing Falls with Injury (1/1/18 – 12/31/18)
Preventing Pressure Ulcers (1/1/18 – 12/31/18)
Unplanned Hospital-Wide Readmissions (7/1/17 – 6/30/18)

New Procedures Added to CompareMaine

Estimates for the following procedures are now included on CompareMaine:

Cervical biopsy (Colposcopy) (CPT Code 57454)
CT scan of neck, with contrast (CPT Code 70491)
Electrocardiogram (ECG or EKG) (CPT Code 93005)
Electrocardiogram (EGC or EKG) monitoring (CPT Code 93270)
MRI scan of lower spinal canal, before and after contrast (CPT Code 72158)
Ultrasound of heart (Echocardiogram) (CPT Code 93306)
Upper gastrointestinal (GI) endoscopy without biopsy (CPT Code 43235)
Upper gastrointestinal (GI) endoscopy with biopsy (CPT Code 43239)

CompareMaine 7.0—May 2019

The payment data has been updated and represents average payments for the reporting period July 1, 2017 – June 30, 2018.

Three new quality measures were added, in addition updating the quality data to reflect the most recent reporting periods available:

Patient Experience Survey Results (1/1/17 – 12/31/17)
Preventing Healthcare-Associated Infections (1/1/17 – 12/31/17)
Preventing Serious Complications (10/1/15 – 6/30/17)
Preventing Falls with Injury (7/1/17 – 6/30/18) *new*
Preventing Pressure Ulcers (7/1/17 – 6/30/18) *new*
Unplanned Hospital-Wide Readmissions (7/1/16 – 6/30/17) *new*

New Episode Grouping Software

MHDO transitioned to Optum Symmetry’s Episode Treatment Grouper® (ETG) to group episodes of care. These bundled payments show the payments over the entire course of an episode of care, instead of each service individually, and provide a more accurate representation of healthcare payments a patient may incur. The ETG is used for the following procedures:

Colonoscopy with biopsy for noncancerous growth
Colonoscopy without biopsy for encounter for preventative health services
C-section (Cesarean delivery)
Vaginal delivery
Carpal tunnel release surgery
Gallbladder removal
Hip replacement
Knee replacement
Surgical arthroscopy of knee
Surgical arthroscopy of shoulder

Once the episodes are created, MHDO uses custom logic to produce payment estimates. Health care services performed at the same time but are not associated with the same diagnosis code are not grouped into a given episode.

New Procedure Added to CompareMaine

Estimates for Comprehensive Metabolic Panel (CPT Code 80053) are now included on the website.

Infusion Therapy Services Added

Added four high cost, high utilization infusion therapy services:

J1569: Gammagard Liquid Injection (500 mg) (Brand Name: Gammagard Liquid®)
J1745: Infliximab Injection (Brand Name: Remicade®)
J7120: Ringers Lactate Infusion (up to 1000 cc)
J9310: Rituximab Injection (100 mg) (Brand Name: Rituxan®)

CPT Codes

The following CPT Codes were added as replacements for expired codes:

CPT Code 97763 (Orthotic management and training and prosthetic training) for CPT Code 97762 (Evaluation of orthotic or prosthetic use)
CPT Code 71046 (X-ray of chest, 2 views) for CPT Code 71020 (X-ray of chest, 2 views, front and side)

CompareMaine 6.0—September 2018

The payment data has been updated and represents average payments for the reporting period January 1, 2017 – December 31, 2017. The payment estimates for the 10 surgical procedures listed below have not been updated for this release, and their payments remain reflective of the July 1, 2016 – June 30, 2017 reporting period due to a transition to a new episode grouping tool. MHDO hopes to complete this transition in early 2019 and will provide more information when it becomes available as to the impact of the estimates on CompareMaine.

Carpal Tunnel Surgery
Colonoscopy with biopsy for noncancerous growth
Colonoscopy without biopsy for encounter for preventative health services
C-section Delivery
Gallbladder Removal
Hip Replacement
Knee Arthroscopy
Knee Replacement
Shoulder Arthroscopy
Vaginal Delivery

The quality data have been updated to reflect the most recent information and reporting periods available:

Patient Experience Survey Results (10/1/2016-9/30/2017)
Preventing Healthcare-Associated Infections (10/1/2016-9/30/2017)
Preventing Serious Complications (10/1/2015-6/30/2017)

Status of the Clinician & Group CAHPS and Patient-Centered Medical Homes CAHPS Patient Experience Data: Due to outdated data, the inability to locate another consistent data source, or establish an alternate collection method, the 2014 Clinician & Group CAHPS and Patient-Centered Medical Homes CAHPS Patient Experience Data previously reported on CompareMaine for free-standing primary care and specialty practices has been removed in this update and will be reported as Not Available. Hospital CAHPS (H-CAHPS) patient experience will continue to be shown for associated hospital-based primary care and specialty practices.

New Procedures Added to CompareMaine

Estimates for the following procedures are now included on CompareMaine:

Diagnostic Mammogram, one breast, with computer-aided detection (CPT Code 77065)
Diagnostic Mammogram, both breasts, with computer-aided detection (CPT Code 77066)
Screening Mammogram, both breasts, with computer-aided detection (CPT Code 77067)
Physical Therapy Evaluation, Low Complexity (CPT Code 97161)
Physical Therapy Evaluation, Moderate Complexity (CPT Code 97162)
Physical Therapy Evaluation, High Complexity (CPT Code 97163)
Physical Therapy Re-Evaluation (CPT Code 97164)
Occupational Therapy Evaluation, Low Complexity (CPT Code 97165)
Occupational Therapy Evaluation, Moderate Complexity (CPT Code 97166)
Occupational Therapy Evaluation, High Complexity (CPT Code 97167)
Low Dose CT Scan for Lung Cancer Screening (CPT Code G0297)
Health and behavior re-assessment for 15-minute session (CPT Code 96151)

Procedure Volume Added to the Data Display

The number of times a healthcare setting has performed a service or procedure annually for covered individuals reported in MHDO’s All-Payer Claims Database (includes private and public payors) has been added to the data display, underneath the average total payment and cost breakdown.

Added Average Payment Data for Chiropractic Procedures

Chiropractic payments and volume data for the four procedures listed below displayed by county, is available on CompareMaine.

Chiropractic treatment, 1+ non-spinal regions (98943)
Chiropractic treatment, 1-2 spinal regions (98940)
Chiropractic treatment, 3-4 spinal regions (989410)
Chiropractic treatment, 5 spinal regions (98942)

CompareMaine Trends Over Time

An interactive report allows users to compare the average total payments for hundreds of healthcare procedures at different healthcare settings across the state of Maine, as reported on CompareMaine over time.

CompareMaine 5.0—March 2018

The MHDO is pleased to release CompareMaine 5.0. Below is a summary of the updates included in this release:

The payment data has been updated and represents average payments for the reporting period July 1, 2016 – June 30, 2017.

The quality data have been updated to reflect the most recent information and reporting periods available:

Patient Experience Survey Results (1/1/16-12/31/16)
Preventing Healthcare-Associated Infections (1/1/16-12/31/16)
Preventing Serious Complications (7/1/14-9/30/15)

The MHDO is currently exploring options for updating the CG CAHPS patient experience data for a future release.

New Procedures Added to CompareMaine

Estimates for the following procedures are now included on CompareMaine:

Heart vessel study using drugs or exercise, single study (CPT Code 78451)
Negative or vacuum pressure wound therapy (CPT Code 97606)
Psychotherapy for crisis, each additional 30 minutes (CPT Code 90840)

Disclaimer

Added an interactive disclaimer to remind users that the average cost estimates for specific healthcare procedures represent an average payment to facilitate comparison between providers and health insurance companies and do not reflect what an individual’s out of pocket costs may be.

CompareMaine 4.0—October 2017

The payment data has been updated and represents the average payments for the reporting period October 1, 2015 – December 31, 2016. The average total payment also breaks down to show payments paid to the healthcare setting and professional(s) providing services, if applicable.

The quality data have been updated to reflect the most recent information and reporting periods available:

Patient Experience Survey Results (7/1/15-6/30/16)
Preventing Healthcare-Associated Infections (7/1/15-6/30/16)

CPT Codes

CPT Code 72082 (X-ray of entire spine, thoracic and lumbar) replaced CPT Code 72010 (X-ray of entire spine).

New Procedures Added to CompareMaine

Estimates for skin lesions (CPT Codes 17000 and 17110) are now included on CompareMaine.

Healthcare Settings

We have updated our healthcare setting listing as described below:

Community Clinical Services

B Street Health Center
CCS Family Health Center
CCS Psychiatry at Central Maine Family Practice
Second Street Health Center

Penobscot Community Health Care

Brewer Medical Center
Capehart Community Clinic
Helen Hunt Health Center
Jackman Community Health Center
Pediatrics
Penobscot Community Health Center
Seaport Community Health Center
Specialty Clinic
Summer St. Community Clinic
Winterport Community Health Center

Pines Health Services

Kimball Community Health Center
Pines Caribou Health Center
Presque Isle Health Center
St. John Valley Health Center
Washburn Health Center
Women and Children’s Center

Portland Community Health Center

Portland Community Health Center (PCHC)
PCHC at Brickhill
PCHC at Franklin Towers
PCHC at Preble St.
PCHC at Riverton Park

HOMETOWN Health Center (Formerly Sebasticook Family Doctors)

Canaan
Dexter
Dover-Foxcroft
Newport
Pittsfield

CompareMaine 3.0—December 2016

The quality data were updated to reflect the most recent information and reporting periods available:

Patient Experience Survey Results (10/1/2014-9/30/2015)
Preventing Serious Complications (7/1/2013-6/30/2015)
Preventing Healthcare-Associated Infections (10/1/2014-9/30/2015)

Also, in July 2016, the Centers for Medicare & Medicaid (CMS) added an "Overall Hospital Quality Star Rating" to their Care Compare website, formerly Hospital Compare. The new overall hospital quality star rating comprises of 64 quality measures and will allow you to compare hospitals quality using one metric. First Release of the Overall Hospital Quality Star Rating on Hospital Compare.

CompareMaine 2.0—June 2016

Based on feedback we received since launching the site in the fall of 2015, we have added colonoscopies, digital mammograms and 28 other new procedures to this release. We also added eight new healthcare settings and made several enhancements to the site. The payment data has been updated for the reporting period October 1, 2014 – September 30, 2015. The quality data have been updated to the most recent reporting periods available. For more detail, see below.

Site Enhancements:

Alphabetized procedure categories and procedures on "Compare Costs and Quality";
Enhanced the search function within the site;
Improved Search Engine Optimization to make it easier for users to find the site;
Added a Methodology section and moved information there from the About section;
Added "Choose a Topic" header on the individual healthcare settings pages to make it clearer that users can view different procedures.

Procedure Changes: This document contains a list of procedures that were added and removed in this release.

Healthcare Setting Changes: This document contains a list of healthcare settings that were added and removed in this release.