Overview

The purpose of this article is to help you understand the metrics in Sales Spotlight and know how to use them effectively. In this article we take a deep dive into each metric; definition, calculation, usage, and where to find each metric in Marketscape Insights.

To jump directly to a list of specific metrics in this article -

 

Let's get Oriented

Sales Spotlight comes in three flavors and the differences between the flavors is where you will find each version and the metrics available in each. 

• Sales Spotlight In Marketscape Insights - - on Physician or Facility Analyze pages, Sales Spotlight is the content in the first tab. 
• Sales Spotlight Email - - on Physician or Facility Analyze pages, under the Sales Spotlight tab, you can send yourself or any of your colleagues the Sales Spotlight email. Look for this button 
• Conversation Starters - In the case of both Sales Spotlight in Marketscape Insights and Sales Spotlight in Marketscape CRM, there is a "view" of the content called Conversation Starters. The metrics in Conversation Starters are different in that they are presented in a sentence that compares two metrics. The metrics in the Sales Spotlight email are all presented in this sentence format.

 

Signposts in this article

So that you can quickly determine which metric is included in which version of Sales Spotlight, at the top of the section where each metric is described below, we will display the following icons:

    - For metrics included in Sales Spotlight in Marketscape Insights (MARINS)

- For metrics included in the Sales Spotlight email (SSEmail)

Relevant details about Conversation Starters will be included under each metric in which they appear.

 

 In this article

Content summary

This article contains the definition, calculation and usage information for each metric tile in the Sales Spotlight tab. You can certainly browse the entire article, or, you can use the following list of metrics in order to find a specific metric of interest and navigate to that section of the article using the link.

Sales Spotlight and the Sales Spotlight email have two sections of metrics:

• Get to Know this Physician - metrics that help you to evaluate the selected physician.
• How Do I Stand Out? - metrics that help you to create a story about your chosen "My Agency."

Click on the metric name to immediately navigate to the details for that metric.

• Get to Know this Physician - there are 5 metrics that might be visible in this section.
  • Skilled Nursing Patients: Last Claimed - Count of distinct patients for which the physician submitted the last professional claim prior to the patient's SNF Admission during the one year reporting period.
  • Patient SNF Utilization - 3 Months Prior - Percentage of this physician's patients who received skilled nursing services during the one year reporting period and who were treated by the selected physician within three months of SNF admission.
  • Highest Affiliation Hospital - The facility where the highest percentage of the physicians patients were treated by the physician in an inpatient or outpatient setting during the one year reporting period.
  • Patient Risk Score - The HCC risk scores are used to adjust cost relative to other NPIs of the same provider type.
  • Top SNF Destinations - The three (or four) skilled nursing facilities that admitted the largest number of the selected physician's patients.
  • CMS Payer Mix - 20XX - 
  • Patient Volume - Only SS Email - Counts of SNF patients and all Medicare Part B patients for the selected physician.
• Our Agency Relationship - There are only three metrics included. However, these metrics could be shown for different Diagnostic Groupings.
  • Total Patient Cost Following SNF (12-month Risk-Adjusted) - Average total risk-adjusted Medicare spend for patients during the six month period after SNF discharge.
  • 30-Day Readmission Rate - Your agency's readmission rates for patients with the listed diagnosis.
  • Average Medicare Days per Stay - The average number of days patients with a primary diagnosis in the named category were cared for by your SNF.

Some of these metrics include trend information and county or state benchmarks.

 

 

Get to Know this Physician

Evaluate

This section of Sales Spotlight or the Sales Spotlight email includes the most helpful and insightful metrics you can use to evaluate the selected physician.

 

Skilled Nursing Patients: Last Claimed

 

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	Not shown on Analyze page

 

Usage

When a physician submits the last professional claim prior to SNF admission, it indicates an opportunity to be involved in the selection of specific SNF for care subsequent to the professional visit. A physician with a larger number of Last Claimed patients has a greater opportunity to make a referral to SNF. 

 

Definition

Last Claimed Patients - This is the count of distinct patients for which the selected physician submitted the last professional for that patient prior to SNF admission. 

To the left of the main metric, you will find an arrow pointing up or down that indicates whether this metric has increased or decreased for the selected physician since the prior year count. The number in the top row indicates the change.

 

Calculation

This metric is a count drawn directly from the selected physician's professional claims.

Reporting Period - This metric is calculated from a one-year reporting period.

 

Where can I find this metric?

In addition to the Sales Spotlight tab, you can find these metrics:

• On the Explore page, in the row for the selected physician, although the metric is called Last Claimed Patients.
• On the Analyze page, under the Patient Population tab in the Patient Volume table under the name SNF Patients: Last Claimed.

 

Patient Volume

 

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Not shown on Analyze page

 

Usage

Simply, a physician who treats more patients has a greater potential as a source of new and ongoing referrals.

 

Definition

Skilled Nursing Patients - This is the count of distinct patients treated by a SNF during the most recent year who were counted for the selected physician as a 3 month prior, last claimed, or attended patient. For more on physician claim types, see Patient Counts and Claim Types.

Medicare Part B patients - This metric is called Annual Patient Count (FFS) everywhere else in Marketscape. This is the count of distinct Medicare FFS patients treated by the selected physician during the one year reporting period.

 

Metrics Calculation

These are both unique counts, although the Skilled Nursing Patients is also a union of three other counts, Attended Patients, Patients 3 Months Prior, and Last Claimed Patients.

Reporting Period - Both of these counts are from a one-year reporting period.

 

Where can I find this metric?

In addition to Conversation Starters on the Analyze page, you can find these metrics:

• On the Explore page. In the table, the metrics are called Physician SNF Patients, and Annual Patient Count (FFS).
• On the Analyze page, under the Patient Population tab in the Patient Volume table under the names Medicare FFS Patients, and SNF Patients (Overall).
• The SNF Patients count can be found under the Destinations tab as the "Distinct Patient Total, at the bottom of the SNF Destinations table.

 

SNF Utilization - 3 Months Prior

 

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Usage

Utilization is a broad indicator of the referral potential of the selected physician. A physician with a high utilization number has a larger number of patients being admitted to SNF care.

Understanding the Metric

Definition

This metric is the percentage of the Physician's Medicare Patients (Annual Patient Count (FFS)) who were treated by the physician within three months of admission to a SNF.

 

Calculation

We calculate this metric from two other metrics. In general;

If you want to calculate the metric yourself, navigate to the Explore page for your selected physician and look at two metrics:

And use them in this equation:

 

Where can I find this metric?

This metric doesn't exist elsewhere in Marketscape. You can find quarterly utilization metrics on the Analyze page, under the Utilization tab in the Skilled Nursing Utilization table

 

Highest Affiliation Facility

 

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	Not shown on Analyze page

 

Definition

This is the facility where the highest percent of the selected physician's patients were treated by the physician in an inpatient or outpatient setting during the one year reporting period. The highest affiliated facility is named and the patient percentage is included below the name.

 

Calculation

This metric is the percentage of the selected physician's distinct Medicare patients who were treated at the listed Facility.

 

Where can I find this metric?

In addition to the Sales Spotlight tab, you can find these metrics:

•  On the Explore page in the row for your selected physician.

 

Patient Risk Score

 

Off	On
	Not shown on Analyze page

 

Usage

In general, Risk Scores provide insight into the amount of care that can be expected for a patient population, and it helps calibrate a provider’s performance relative to its peers. The Risk score is an index number used for comparison. Based on the score for each provider, we assign a risk category, which is included under the number. 

 

Definition

The HCC risk scores are used to adjust cost relative to other NPIs of the same provider type. Adjusted costs allow for better comparison across NPIs with different risk scores because it accounts for the increased cost of patients with chronic conditions.

 

Calculation

Trella Health uses CMS’s Hierarchical Condition Category (HCC) model to calculate Risk Scores.

 

Where can I find this metric?

In addition to the Sales Spotlight email, you can find these metrics:

•  On the Explore page in the row for your selected physician.

For more information, see Risk Scores and HCC.

 

Top SNF Destinations

 

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Usage

This table shows you up to the top three SNF destinations for your selected physician's patients. At a glance you can see if your agency is in the top three agencies receiving patients treated by the selected physician.

 

Where can I find this metric?

The complete table of all SNFs that admitted patients treated by the selected physician can be found under the Destinations tab on the Analyze page for the selected physician.

 

 

Section 2 - Our Agency Relationship

Overview

To orient you to the content in this section of the Sales Spotlight tab there are four critical features you must know. After we present these four, we will analyze the metrics.

My  Agency - In order to provide the most meaningful metrics, you will need to select your "My Agency" from the dropdown selector at the top of Sales Spotlight.

 

 Diagnoses - The metrics in this section are based on different patient populations distinguished by diagnoses. In the image below, the blue boxes surround the metrics related to these different populations. The top box contains metrics for patients with all diagnoses, that is, all patients. The middle box contains metrics only for Circulatory System Patients. The bottom box, Injury and Poisoning.

All diagnoses will be included for every physician, other diagnoses will be included if that diagnosis represents greater than 15% of the physician's patients

For more information, see Trella Health Diagnostic Groupings.

 

 Metrics - There are three metrics included for each diagnosis set: (Green boxes from image below.)

• 12-month Risk Adjusted Total Cost of Care following SNF (The image shows 6-month, but this has been updated.)
• 30-Day Readmission Rate
• Average Medicare Days per Stay

All three metrics are displayed for each diagnosis displayed.

 

 Conversation Starter Toggle - There are two modes for presenting the included metrics. In sum, with the Conversation Starters toggle off, you can see the featured metric with trends and comparisons. With the Conversation Starters toggle on, the comparison is stated in a sentence.

 

Conversation Starters Off	Conversations Starters On
At a glance metrics	Comparisons turned into a sentence

 

 Comparisons - All comparisons are made between the top three agencies for the selected physician. If there is not a favorable comparison for My Agency, a comparison will be made with the state/county benchmarks.

 

Understanding the Metrics

 

Twelve-Month Risk Adjusted Total Cost of Care following SNF

Conversation Starters Off	Conversations Starters On

Definitions

This metric is an average cost of care for medical expenses for patients after discharge from my chosen agency. The three different diagnostic groups showcase the following:

• Each different diagnosis set has its own metric for a total cost of care.
• Trends - to the left of each cost is a colored arrow that shows the percentage of cost difference against the listed competitor or average. 
  • For "All Diagnoses" My Agency has costs 13.47 percent lower than the listed competitor, Normandie Ridge.
  • For circulatory patients, My Agency's costs are 4.65 percent lower than the competitor Manorcare. These advantageous metrics are indicated with a green arrow, pointing down.
• Conversation Starters - With the toggle on, these comparisons are presented in a sentence format.

 

Calculation

The following details will help clarify how we calculate the metrics in this column:

• We calculate the total cost of care for all patients who were discharged from "My Agency" who were treated by the selected physician within the three months prior to SNF admission. We then create an average for this body of patients.
• The discharge must occur during the one year reporting period. This reporting period is pushed back one year prior to the current data set in order to allow time from the discharge to calculate subsequent expenses.
• The total cost for each patient is drawn from all claims submitted in the 6 month period subsequent to SNF discharge. The included costs are included in the image below under Where can I find this metric?
• We use Risk adjusted metrics to make the comparisons meaningful.

Where can I find this metric?

The Total Patient Costs Report table in the Reports section of Marketscape will allow you to compare post home health care costs agency by agency. That table allows you to slice the metrics in numerous ways.

 

30-Day Readmission Rate

Conversation Starters Off	Conversations Starters On

 

Definition

This metric is the rate at which "My Agency's" patients were discharged from an inpatient setting, were newly admitted to "My Agency", and were subsequently readmitted to any hospital within 30 days of the first inpatient discharge.

To the left of the metric is an arrow that indicates my agencies performance against the county average. In this case, all of the performance metrics are unfavorable and are indicated by a red arrow and the percentage difference from the county average.

If this metric is not favorable against a competitor or against the state average, this is a call to action for your agency.

If the metric was favorable, this would be indicated by a down arrow to the left of the main metric and a comparison below.

 

Calculation

This is the percentage of all patients discharged from an Inpatient stay and admitted to home health within 30 days who were admitted back to inpatient care within 30 days of the initial discharge.

Numerator - count of patients discharged from inpatient care who entered the chosen home health agency and who were re-admitted to inpatient care within 30 days of initial discharge

Denominator - count of patients discharged from inpatient care who entered the chosen home health agency within 30 days

 

Where can I find this metric?

In addition to the Sales Spotlight email, you can find this metric:

• On the Explore page, in the row for My Agency, under the header Readmission Rate: 30-days.
• On the Analyze page for My Agency, under the Insights tab.
• On the Analyze page for My Agency, under the Operational tab in the table, SNF Agency's Summary. The metric is Readmission Rate: 30-days
• On the Analyze page for My Agency, under the Quality tab in the table, Readmission Rate table in the All row at the bottom under All Acuities - This SNF.

For more information, see Readmission Rates.

 

Average Medicare Days per Stay

Conversation Starters Off	Conversations Starters On

 

Definition

This metric is the average count of patient days spent at "My Agency."

• Each different diagnosis set has its own metric for the count of patient days.
• Trends - to the left of each cost is a colored arrow that shows the percentage of cost difference against the listed competitor or average. 
  • For "All Diagnoses" My Agency has an average patient days of 25.62, which is 15.70 percent lower than the listed competitor - Rest Haven.
  • For circulatory patients, My Agency has an average patient days of 24.28, which is 8.62 percent lower than the listed competitor - Rest Haven.
• Conversation Starters - With the toggle on, these comparisons are presented in a sentence format.

For more information, see Length of Stay.