Detailed report of admissions which includes key metrics for evaluation, comparison, and trending.  Graphs offer quick reference points for users and presentations to external and internal stakeholders.  The arrows in all panels provide a rapid assessment of positive (green) and negative (red) trends.  Additional detail can be obtained by filtering the hospital, PCP and members.

 

 

Target Audience for this Report

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

 

Business Processes Impacted by this Report

This detailed cost and utilization data supports comparison analysis of hospitals and provider referral patterns.  

 

Header provides a snapshot of admission information for tracking, trending and comparisons – Admissions, Days/1000, Admits/1000, ALOS, and Paid/Admit.

 

Supports the evaluation of the health and compliance of members to determine care management and disease management program development and effectiveness.

 

This hospital utilization information provides insight regarding member preferences for facilities.   Hospitalizations represent the major cost driver and reduction of this cost requires analysis of current admission data.  

 

Detail and Definitions

Header

  • Admissions
  • Days/1000
  • Admits/1000
  • ALOS
  • Paid/Admit

Admissions by Facility

  • Facility Name
  • Place of Service
  • Admits
  • Total Paid
  • Paid/Admit
  • ALOS
  • Member Risk

PCP Admissions

  • PCPID
  • PCP Name
  • Admits
  • Member Risk
  • Total Paid
  • ALOS
  • Paid/Admit

Admissions by Member

  • Member Number
  • Member Name
  • Admits
  • Total Paid
  • Paid/Admit
  • ALOS
  • Member Risk

Admissions by Diagnosis (Top 100 by Admits

  • Diagnosis
  • Admits
  • ALOS
  • Total Paid
  • Patients
  • Member Risk
  • Paid/Admit

Trending Graphs

Accessed by clicking on the graph icon in the upper right of the report.

Period by Period Trends (Graph)

Displays the trends of Admits/1000, ALOS, and Paid/Admit trends by the selected period; year, quarter, or month.  The graph changes with applied filters found in the header.   This snapshot of the three indicators provides significant information regarding Admissions and the graphical display provides quick reference points to guide a deeper analysis.

 

Period Over Period Trends (Graph)

Displays the selected time period trends of Admits/1000, ALOS, and Paid/Admit in percentages over the previous period.  The graph changes with the applied filters found in the header.  By describing period over period in this manner the user can easily determine progress or decline in the indicators.