Target Audience for this Report

Chief Medical Officer, Compliance & Regulatory Department, Finance Department and CFO, Leadership Team, Medical management/Care Management Department, Physician Relations, and Utilization Management.


Business Impacts of this Report 

This report will allow target audience to compare multiple KPI data points within the platform hierarchies to their peers. Targeted strategies for areas of potential savings will be developed and priorities identified.  These KPI’s can be used to determine how groups of data are performing in relationship to their peers.


Detail and Definitions

This report can compare high level KPI’s within Level1, Level2, and Level3 hierarchies by using the Target Level drop down field at the top right of the report.  Switching this to different options will display the comparisons for the hierarchy options.

Level – Displays hierarchy values of level selected.

  • Membership – Membership (average)
  • Medical PMPM
  • Rx PMPM
  • Total PMPM
  • Admit PMPM
  • Avoidable ER PMPM

Selecting a hotlink within the Levels column of the table will display the detailed KPI’s from the KPI Details report.