The Insights section of any analyze page will contain the most relevant metrics for the selected provider. These metrics will allow you to make a quick evaluation of the selected physician to determine whether to dig deeper or move to another physician.
Understanding the Metrics
Physician total followed patients
This is the count of distinct patients who were admitted to home health services during the reporting period where the named physician is identified as the certifying physician on the RAP (Request for Advanced Payment).
The following physician certifies that the patient needs home care services and determines the course of care. A physician who follows a larger number of patients is clearly committed to home care and is a prime candidate to cultivate as a partner. Look for physicians whose patients are spread over a number of home health agencies and discuss with that physician areas of strength that you have shown with shared patients.
This metric can be found on the Explore page in the row for this physician. It is also found in the Patient Volume Table in the Patient Population tab on the Analyze page directly below the Insights.
This metric is the percentage of the selected physician's patients who were admitted to home health services during the one year reporting period and who were treated by the physician within 3 months prior to admission to home health.
In sum, this metric is the percentage of the named physician's recent patients who were admitted to home health care.
The equation in the graphic above shows how two metrics from the Home Health Utilization table (screenshot above) are used to calculate this utilization percent.
Home health utilization is an indicator that reveals the physician's commitment to home health care. With a physician who has a high utilization rate, it is useful to identify which facilities treat the patients (Home Health Destinations) to discover your share of the physician's patients.
This metric can be found on the Explore page in the row for this physician.
Top facility affiliation
This is the top facility affiliation for this physician. This is the facility through which the selected physician presented the highest volume of their claims. Calculating the percentages for a physician's affiliation includes both inpatient and outpatient claims.
The table that has a list of the highest affiliations can be found below Insights in the Facility Affiliation table in the Practice Details tab. For our selected physician, you can see how the Insight aligns with the highest affiliated facility
Be careful not to confuse this with the Highest Affiliation Agency for this physician from the Explore page. That metric is the home health agency receiving the highest share of the selected physician's home health patients from all claims submitted by the physician within the 3 months prior to the patient's home health admission.
This Highest Affiliation Agency can also be found at the top of the Home Health Destinations table in the Destinations tab on the Analyze page.
Patient Risk Score
Average Hierarchical Condition Category (HCC) Patient Risk Score for the selected physician. The High/Medium/Low beneath the number is the Risk Category, which is the categorization of this physician's Patient Risk Score in comparison to all Physicians with the same specialty.
For more information on Risk Scores, click here.