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 and in Marketscape CRM.

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

Let's get Oriented

Sales Spotlight comes in four 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 
• Sales Spotlight In Marketscape CRM - - click on the "Market Spotlight" button in the left navigation to open the Market Spotlight page, then for any physician or facility, when you click on the provider's name, Sales Spotlight will open.
• 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)

- For metrics found in Sales Spotlight in Marketscape CRM (MARCRM)

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

• Patient Volume - only in SS-EMail and Sales Spotlight with Conversation Starters on - a comparison statement that includes a count of hospice patients and the Annual Patient Count metric.
• Top Hospice Destinations - The top three hospices with the highest percentage of patients who were admitted to hospice within 30 days of discharge from the selected skilled nursing facility during the one-year reporting period 
• Patient Hospice Utilization (Mortalities) -The percentage of the selected physician’s patients admitted to hospice who died after admission to hospice. This metric only considers patients who were treated by the physician within six months of their death.
• Hospice ALOS - The Average number of days the selected physician's patients spent in any hospice. Counts include only discharged patients.
• CMS Payer Mix - 20XX - (MARINS4HOS only) - This tile has the most recent possible comparison metrics for patient counts in the same year for Medicare Fee for Service, Medicare Advantage, and Medicaid. Since MA metrics are not released for about two years, this comparison is generally two years old.
• Annual Patient Count (FFS) - the count of distinct Medicare FFS patients treated by the selected physician during the one year reporting period. These counts come from professional claims only. The content in this tile is displayed under "Patient Volume" with Conversation Starters on.
• Patient Risk Score - The HCC risk scores are used to adjust cost relative to other NPIs of the same provider type.
• Highest Affiliation Hospital - CRM Only - 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.
• Patient Locations - (MARCRM only) - This table includes counts and percentage of patients for the top five counties where patients lived who were treated by the selected physician.
• Chronic Conditions - (MARCRM only) - This table includes the top five chronic conditions diagnosed for patients treated by the selected physician.
• Patient Diagnostic Mix - (MARCRM only) - This table includes the top five diagnoses for patients treated by the selected physician.
• Total Patient Count - (MARCRM only) - This table includes counts of distinct home health patients by claim type.
• Place of Service - (MARCRM only) - distinct patient counts and percentages for the locations where the selected physician treated patients.

How Do I Stand Out? - These metrics are insights into your chosen hospice.

• Hospitalization Rate within 30-days of Hospice Discharge - This is the percent of your chosen agency's patients admitted to a hospital during their hospice stay or within 30 days of discharge.
• All Visits and RN Visits Last 7 and Last 3 days - These four metrics are counts of hospice visits to a patient who is actively dying. We count for All visits (RN, LPN, SW and Aide) and RN visits, each for two periods, the last three days of life and the last seven days.

Even more details

• Some of these metrics include trend information and county or state benchmarks.
• The tables identified as "CRM Only" in the menu above are summaries of complete tables that can be found in Marketscape Insights (MARINS) on the Analyze page for the selected provider under other tabs.

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.

Patient Volume

Sales Spotlight on MARINS Analyze Page (Conversation Starters on)	Sales Spotlight Email	Sales Spotlight in Marketscape CRM (Conversation Starters on)

Even though the Conversation Starter suggests that the "Physician treated 74 Hospice patients" this should not be understood to mean that the physician provided hospice care to any patients. The correct nuance is that 74 patients treated by the physician were admitted to hospice care to receive hospice services.

Using this metric

Evaluate

Patient counts are a general measure of a physician's referral potential. A physician who treats more patients has a higher likelihood of referring a patient to post-acute care.

Connections

• Look at the Hospice Destinations table under the Destinations tab for the physician to see if the 74 hospice patients are being admitted to a small number of agencies or to a larger spread of agencies. A small number of agencies might be indicative that the physician is referring those patients, which shows a commitment to hospice care in general and to a specific agency. A spread could mean that a partnership with this physician could inspire referrals to your agency.
• Next steps? Examine the patient demographics for the physician. Are the patients in locations you serve? Are the primary diagnoses of the physician's patients aligned with your initiatives and areas of strength?

Understanding the Metric

Definition

Hospice Patients - The count of distinct Medicare FFS patients who were treated by the selected physician within three months of admission to hospice care. Throughout the rest of Marketscape Insights for Hospice, this metric is called Hospice Patients: 3 Months Prior.

Medicare FFS Patients - This is the count of distinct Medicare FFS patients treated by the physician during the one-year reporting period (where the physician was listed as the performing physician on a professional claim).

Metrics Calculation

Both metrics listed above are counts based on the claims and are from a one-year reporting period.

  Where can I find this metric?

Marketscape Insights

• In MARINS, on the Physician Explore page, the metrics are called Annual Patient Count (FFS) and Hospice Patients: 3 Months Prior.
• In MARINS, on the Analyze page, under the Patient Population tab in the Patient Volume table in the rows for Medicare FFS Patients and Hospice Patients: 3 Months Prior. This table also provides 8 quarters of trended patient counts for the selected physician.
• In MARINS, on the Analyze page for the selected physician, under the Destinations tab, in the table Hospice Destinations, at the bottom of the column for Hospice Patients 3 Months Prior in the row for Distinct Patient Count.

Marketscape CRM

• In Marketscape CRM, under the Market Spotlight tab for hospice, in the row for the selected physician, the Medicare FFS Patients metric is displayed as Annual Patient Count. The Hospice Patients count is not displayed on this page.

Hospice Utilization (Mortalities)

Sales Spotlight on MARINS Analyze Page	Sales Spotlight Email	Sales Spotlight in Marketscape CRM
		This metric is not shown in Sales Spotlight in Marketscape CRM

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 hospice care.

Understanding the Metric

Definition

This metric is a percentage that shows the selected physicians patient's usage of hospice. We tie this closely to the need for hospice by taking the percentage from the set of patients who died during the year. Of patients treated by the selected physician within 6 months of death, this metric is the percent of deceased patients who were receiving hospice care at the time of death.

Metrics Calculation

 This image shows how we count the patients in this metric. For a patient to be counted, they must have died during the one year reporting period, and they must have been treated by the selected physician within 6 months of their death. The only difference is whether the patient was on hospice care. If the above limitations apply, we have the following: For patients who were treated by the selected physician within 6 months of their death:

Numerator - count of physician's patients on hospice who died.

Denominator - count of physician's patients admitted to hospice.

Where can I find this metric?

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

Marketscape Insights

• On the Physician Explore page in the row for the selected physician.
• A quarterly version of this metric can be found on the Analyze page for the selected physician under the Utilization tab in the table, Hospice Utilization (Mortalities)

Marketscape CRM

• This metric is displayed in the table on the Market Spotlight page.

Annual Patient Count FFS

Sales Spotlight on MARINS Analyze Page	Sales Spotlight Email	Sales Spotlight in Marketscape CRM
	This metric is included in the Conversation Starter in the Patient Volume metric.

Using this metric

Evaluate

Patient counts are a general measure of a physician's referral potential. A physician who treats more patients has a higher likelihood of referring a patient to post-acute care.

Understanding the Metric

Definition

This metric is a distinct count of Medicare FFS patients for which the selected physician submitted a claim during the one year reporting period.

Calculation

The metric is a simple count of distinct patients from claims submitted during the reporting period.

Details

To the left of the main metric is a number and an arrow. The number is the difference between the current patient count and the count from the previous year. An arrow indicates whether the current number of patients is lower than the previous year or higher. Red arrows indicate that the trend is unfavorable. Green arrows indicate positive growth.

Ponder this - We provide these metrics as a comparison indicating a trend, and we choose to assign a color indicating that the change is good or bad (green or red). Keep in mind that there might be any number of reasons why the selected physician had more or fewer patients between different years. The colors are indicators of referral potential, not an evaluation of the physician's performance.

  Where can I find this metric?

Marketscape Insights

• In MARINS, on the Physician Explore page, in the row for the selected physician, see Annual Patient Count (FFS).
• In MARINS, on the Analyze page for the selected physician, under the Patient Population tab in the Patient Volume table in the rows for Medicare FFS Patients. This table also provides 8 quarters of trended patient counts for the selected physician.

Marketscape CRM

• Annual Patient Care can be found on the Market Spotlight page in the row for the selected physician.

Top Hospice Destinations

Sales Spotlight on MARINS Analyze Page	Sales Spotlight Email	Sales Spotlight in Marketscape CRM

Using this metric

   Compare

At a glance you can see if your agency is in the top three (or five in MARCRM) agencies admitting patients treated by the selected physician. If you are in the top agencies, you can also see where you stand against local competitors.

Connections

In Marketscape Insights, whether you are in the top three agencies for the selected physician or not, you will want to navigate to the Destinations tab for the selected physician and see the complete Hospice Destinations table to see all agencies who admitted the physician's patients for hospice care. In Marketscape CRM, there is no table of all destinations.

Understanding the Metric

Definition

 This summary table includes the three agencies that admitted the highest number of patients treated by the selected physician.

Details

The summary table includes 4 columns

• Rank - based on the volume of patients admitted to the listed hospice, Trella Health assigns a numerical order for comparison.
• Hospice - The name of the hospice for which the metrics in the row apply
• Patients - the count of patients treated by the selected physician who were admitted to the listed hospice
• Affiliation - (Should be Affiliation %) - the percentage of all patients admitted to hospice who were admitted to the listed hospice.

  Where can I find this metric?

Marketscape Insights

• In MARINS4HOS, on the Analyze page for the selected physician, under the Destinations tab, see the table Hospice Destinations, which includes all hospices that admitted patients treated by the selected physician.

Marketscape CRM

• In Marketscape CRM there are no insights for additional hospices.

Hospice ALOS (Average Length of Stay)

Sales Spotlight on MARINS Analyze Page	Sales Spotlight Email	Sales Spotlight in Marketscape CRM

Understanding the Metric

Definition

The average number of days the selected physician's patients spent in any hospice, for patients discharged from Hospice during the one-year reporting period and treated by the physician within 3 months prior to hospice admission.

Metrics Calculation

For patients discharged during the reporting period and who were treated by the selected physician within 3 months of admission to hospice, we count the number of days in each stay (going back up to 2 years prior to the most recent quarter of data) then divide by the number of patients for whom the metric applies.

For lotsa details on ALOS, see Average Length of Stay.

Details

To the right of the main metric, we provide the average for all physicians with the same specialty in the same state.

Where can I find this metric?

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

Marketscape Insights

• On the Physician Explore page in the row for the selected physician in the column for Hospice ALOS.
• On the Analyze page for the selected physician, under the Utilization tab, in the Hospice Length of Stay and Mortalities table, there is a more focused version of this metric, called Hospice ALOS (Mortalities).

Marketscape CRM

• There are no additional length of stay metrics in Marketscape CRM.

CMS Payer Mix - 20XX

Sales Spotlight on MARINS Analyze Page	Sales Spotlight Email	Sales Spotlight in Marketscape CRM
	This content is not included in the Sales Spotlight email	This content is not available in Marketscape CRM

Using this metric

Evaluate - As a user, this table allows you to view the payer mix for a physician or hospital at-a-glance in Sales Spotlight so you can identify whether the provider is a good fit for your organization. For example, if you want to target FFS patients, you can qualify a referral source by viewing their payer mix here.

The table includes counts of distinct patients treated by the selected provider during the one-year reporting period for three different payers:

• FFS - Medicare Fee for Service
• MA - Medicare Advantage
• Medicaid

In order to provide a meaningful comparison between the three different payers, we display counts from the most recent year for which all three payers have complete counts available. Since Medicare Advantage data is delayed by two years, we use two year old data to make counts of FFS and Medicaid patients.

This means that the Medicare FFS counts on this tile will not match any other metrics in Marketscape Insights.

Patient Risk Score

Sales Spotlight on MARINS Analyze Page	Sales Spotlight Email	Sales Spotlight in Marketscape CRM
	Risk Scores are not included in the Sales Spotlight email.

Using this metric

Evaluate & Compare

Risk Scores provide insight into the level of care required for a provider's patient population, and the score provides a frame of reference to evaluate a provider’s performance relative to its peers. Based on the score for each provider, we assign a risk category, which is included under the number. 

Example: when we compare two similar providers using performance metrics, like patient costs or length of stay, we expect a provider with a higher risk score to have higher costs or longer lengths of stay. For your messaging, therefore, you want to account for the level of care required for a provider's patients, and the Risk Score provides this insight.

Connections

When you compare two providers and notice a higher risk score for one over the other, it is helpful to investigate further to see the details that explain why one provider has a higher score. For example, on the Analyze page for a provider, you can click on the "Patient Population" tab to investigate patient diagnoses and chronic conditions to see more about the provider's patients.

Understanding the Metric

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 Sales Spotlight, you can find this metric:

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

For more information, see Risk Scores and HCC.

Highest Affiliation Hospital

Sales Spotlight on MARINS Analyze Page	Sales Spotlight Email	Sales Spotlight in Marketscape CRM
This metric is not available in Sales Spotlight for Marketscape Insights	This metric is not available in Sales Spotlight email

Understanding the Metric

Definition

This tile identifies the hospital with the highest percentage of patients who were treated by the physician at the facility (inpatient or outpatient setting) during the one year reporting period. It also shows the percentage of the physician's patients treated at the affiliated hospital.

Calculation

The percentage is the count of the physician's patients who were treated at the listed hospital (both inpatient and outpatient). (See formula below)

  Where can I find this metric?

Marketscape Insights

• In Marketscape Insights for Hospice, although this metric is not visible in Sales Spotlight, the hospital and affiliation percentage can be found on the Explore page in the columns Highest Affiliation Hospital and Highest Hospital Affiliation %.

Marketscape CRM

• This metric is not displayed in any other location.

Patient Locations - MARCRM only

Sales Spotlight on MARINS Analyze Page	Sales Spotlight Email	Sales Spotlight in Marketscape CRM
Although this content is not available in Sales Spotlight, the complete table can be can be viewed in Marketscape Insights for Hospice on the Analyze page for the selected physician under the Patient Population tab, in the table, Patient Locations - County.	This content is not available in the Sales Spotlight email.

Using this metric

Evaluate

Use this table as a quick evaluation tool for the selected physician. Simply put, does the physician treat patients who live in the service area for your agency?

Understanding the Metric

Definition

This table contains the top five counties where the most patients live who were treated by the selected physician during the one year reporting period.

Counties with less than eleven (<11) patients residing therein are aggregated together into a count and reported as "Other" in the table. When this category is displayed in the table, what you are really seeing is the top four counties for patients of the listed physician. There is no way to display the breakdown of the counties with <11 patients because of the privacy suppression requirements.

Calculation

From the physician's professional claims, we count the number of distinct patients who reside in each county listed.

Details

This table includes three columns:

• County - The county where the patients live.
• State - The state where the patients reside. In cases where a physician lives near a state border, you will sometimes see counties from multiple state displayed in this table.
• Percentage - The percentage of the physician's total distinct patients that live in each county listed.

It is possible that not all counties show up in this table. If that is the case, the percentages will not add up to 100%.

  Where can I find this metric?

In addition to the table in Sales Spotlight in Marketscape CRM, you can find these metrics:

Marketscape Insights

• In the Physicians Analyze page, under the Patient Population tab.
• On the Reports page, the Market Share report is a powerful tool to show patient location by state or county.

Marketscape CRM

• Patient location metrics are not displayed anywhere else.

Chronic Conditions - MARCRM only

Sales Spotlight on MARINS Analyze Page	Sales Spotlight Email	Sales Spotlight in Marketscape CRM
Although this content is not available in Sales Spotlight, the complete table can be can be viewed in Marketscape Insights for Hospice on the Analyze page for the selected physician under the Patient Population tab, in the table, Chronic Conditions.	This content is not available in the Sales Spotlight email.

Using this metric

Evaluate

This table displays the top five chronic conditions for patients treated by the selected physician during the one year reporting period. The value of this table is that it allows you to identify areas of care where your agency's expertise aligns with the patients of the selected physician. In addition, the counts of patients with chronic conditions will also help you to evaluate the level of care required for the physician's patients.

Understanding the Metric

Definition

The table has three columns:

• Chronic Condition - the patients counted in the row were treated for the listed diagnosis.
• Annual Patient Count -  this is the count of distinct patients treated by the selected physician during the one-year reporting period who met the criteria for the listed chronic condition.
• Percentage of patients - the percentage of the selected physician's patients who met the criteria for the listed condition.

Calculation

In short, we count the number of patients who met the criteria for the listed chronic condition.

What is the criteria?

We follow the CCW chronic condition algorithm that searches the CMS administrative claims data for the specific diagnosis codes, MS-DRG codes, or procedure codes for each chronic condition. For each patient that matches one of the specific criteria, we count that patient for the identified chronic condition.

For those of you who want all of the details, see Lotsa Chronic Conditions Details. This is the source we use for aligning patients to chronic conditions.

Details

About the percentages

• These percentages will probably never add up to 100%. Patients with multiple chronic conditions in their diagnoses will be counted when calculating the percentages in each row. That is, lots of patients impact multiple rows.
• If you are interested, this is one of the metrics that you can see how we calculated the percentage. One of our previous metrics, Annual Patient Count (FFS) shows that our selected physician treated 571 patients. If we look at the count in the first row of the Chronic Conditions table, we see that 456 patients were diagnosed with hypertension. 456/571 = .798 or 79.8% which we round up to 80%, as the table shows.

  Where can I find this metric?

Marketscape Insights

• The complete table of chronic conditions for all patients can be found in Marketscape Insights, under the "Patient Population" tab in the "Chronic Conditions" table

Marketscape CRM

• In Marketscape CRM, there are no additional metrics of this type available.

Patient Diagnostic Mix - MARCRM only

Sales Spotlight on MARINS Analyze Page	Sales Spotlight Email	Sales Spotlight in Marketscape CRM
Although this content is not available in Sales Spotlight, the complete table can be can be viewed in Marketscape Insights for Hospice on the Analyze page for the selected physician under the Patient Population tab, in the table, Patient Diagnostic Mix.	This content is not available in the Sales Spotlight email.

Using this metric

Evaluate

This table displays the top five Trella Health diagnostic groups  for patients treated by the selected physician during the one year reporting period. The value of this table is that it allows you to identify areas of care where your agency's expertise aligns with the patients of the selected physician. 

For more details, see Trella Health Diagnostic Groupings.

Understanding the Metric

Definition

 The table includes three columns:

• Trella (Health) Diagnostic Group - the patients counted in this row have a primary diagnosis that is included in the Trella Health diagnostic group listed in the row
• Top Diagnoses - this column contains the top three diagnoses (based on the primary ICD-10 diagnosis codes) for patients treated by the selected physician that fall within the listed Trella Health diagnostic group
• Annual Patient Count - the count of distinct patients treated by the physician with a primary diagnosis code included in the listed Trella Health diagnostic group

Calculation

The connection between diagnosis codes and the Trella Health diagnostic groupings is described in detail in the article: Trella Health Diagnostic Groupings. We identify the primary diagnosis for each patient treated by the selected physician and count the number of distinct patients that align with each diagnostic group. The diagnostic groups with the highest counts are included in the table.

  Where can I find this metric?

Marketscape Insights

• The complete table of metrics for the Trella Health Diagnostic Groupings for all patients can be found on the Marketscape Insights Analyze page for the selected physician, under the "Patient Population" tab in the "Patient Diagnostic Mix" table.

Marketscape CRM

• In Marketscape CRM, there are no additional metrics of this type available.

Total Patient Count - MARCRM only

Sales Spotlight on MARINS Analyze Page	Sales Spotlight Email	Sales Spotlight in Marketscape CRM
Although this content is not available in Sales Spotlight, the complete table can be can be viewed in Marketscape Insights for Hospice on the Analyze page for the selected physician under the Patient Population tab, in the table, Total Patient Count.	This content is not available in the Sales Spotlight email.

For a complete introduction to the metrics in this table, see Patient Counts and Claim Types.

Understanding the Metrics

Definitions 

These three metrics are probably the most important metrics in Marketscape Insights for identifying referral potential for a prospective physician. It is not too much to say that you should probably start your assessment of any physician by looking at this table.

Medicare claims do not contain any referral information. However, we can infer "referral potential" by looking at details and connections between claims. Trella Health uses three categories of claims to identify a physician's potential as a referral source.

• Attended - This is the count of distinct patients who were admitted to hospice services during the reporting period where the named physician is identified as the attending physician on the hospice claim. If the physician is the attending for many patients at a specific hospice, it is likely that the physician is a medical director for that hospice. A physician who follows a larger number of patients is clearly committed to hospice care, however, that physician is also already aligned .
• 3 Months Prior - This is the count of all patients treated by the selected physician during the one year reporting period who were admitted to hospice care within 3 months of being treated by the selected physician. Since we are looking for referral potential, a physician who treats patients shortly prior to admission to hospice care are more likely to have the opportunity to identify the need for hospice care and advise the patient. A physician with a high number of 3 month prior patients is worth closer evaluation as a referral source.
• Last Claimed - This is the count of patients for whom the selected physician submitted the most recent professional claim prior to hospice admission. This is an even more focused connection between the physician and patient with regard to hospice admission. Imagine a physician who treats 100 patients right before hospice admission. That physician either advised the patient to seek out hospice care, or should have advised the patient to do so. We know that since the patient was admitted to hospice care. Either way, that physician is a prime referral contact.

Calculation

For Attended patient counts we simply count the number of distinct patients for which the selected physician is named as the attending physician from the hospice claim (institutional claim.)

For 3 Months Prior and Last Claimed patient counts, we look for a hospice claim identifying a patient admission to hospice. We then look back to identify every physician who treated that patient within the previous 3 months and the one physician who submitted the most recent claim prior to hospice admission. We then add up the counts from all patients - for all applicable physicians - including the selected physician. In short, each of these counts require a connection between two claims.

Using these metrics

Evaluate

 Use these metrics to evaluate the selected physician to determine the referral potential before talking to the physician. As described immediately below, counts for each of the claim types is already indicative of referral potential. These metrics are also insightful when viewed in connection to each other. 

Questions

• What does it mean when a physician has a high number of Attended patients, but very low 3 Months Prior, and Last Claimed? This suggests that the selected physician is closely connected to a hospice but does not treat patients near to their admission. We can conclude that the selected physician is committed to hospice care, but is not a likely source of referrals. Our experience with other customers shows that physicians with high counts of attended patients are good candidates if you need to hire a medical director. 
• What about a physician who has a lot of 3 Months Prior patients, but no Attended? Or who has a lot of Last Claimed, but no Attended? Metrics like this are indicative of a physician with good referral potential. This physician is in a place to identify conditions requiring hospice in the immediate future along with advising the patient to seek appropriate care.
• And what about a physician with high patient counts in all three? Clearly that physician is involved and committed to hospice. The next step is to dig deeper.

Connections

As always, identifying potential is one step in the process. Once you identify a physician as having high referral potential, the next step is to view their Analyze page to investigate patient demographics under the Patient Population tab, or hospice destinations under the Destinations tab. As it turns out, many of the other metrics in Sales Spotlight already assist with getting this additional helpful information once you have identified the physician as a good referral source for hospice patients.

Marketscape Insights

• These metrics can be found on the Explore page in the row for the selected physician.
• On the Analyze page for the selected physician, under the Patient Population tab, these metrics can be found in the Patient Volume tab.

Marketscape CRM

• In Marketscape CRM, the Hospice Patients: Attended metric is shown on the Market Spotlight table in the row for the selected physician.

Place of Service - MARCRM only

Sales Spotlight on MARINS Analyze Page	Sales Spotlight Email	Sales Spotlight in Marketscape CRM
Although this content is not available in Sales Spotlight, the complete table can be can be viewed in Marketscape Insights for Hospice on the Analyze page for the selected physician under the Practice Details tab, in the table, Place of Service.	This content is not available in the Sales Spotlight email.

Using this metric

Evaluate

This table shows us where the selected physician is having visits with patients. By looking at the different venues, it is easy to see, for example, the relative number of hospice patients seen by the physician in the private practice office, or in the hospital.

Understanding the Metric

Definition 

There are five different locations that we identify for each physician:

• Hospital - This could include both inpatient or outpatient claims.
• Office - Reflects patient visits in the physician's office.
• SNF - Visits by the Physician in a Skilled Nursing Facility
• Other - These could include patient's homes, nursing homes, clinics, etc.
• Telehealth - The location where health services and health related services are provided or received, through telecommunication technology. 

Calculation

On all professional claims submitted by the selected physician, we identify the place of service and count how many of each visit occurs in each location.

Details

• This table only includes professional claims, not institutional claims. 
• If a claim includes multiple settings, we include the count for that claim in the top option in this order of priority: Hospital, Office, SNF.

Place of Service Codes

All of the Place of Service metrics are taken from the Part B (Professional) claims submitted under the Physician's NPI. The place of service code is entered into box 24b of form 1500. The existing codes are 01 through 99, (not all used). This table generates metrics based on the following codes:

• Hospital - code 21 or 22
• SNF - 31
• Office - code 11
• Telehealth - code 02 and 10 (02 is used when the patient is not at home, 10 is used when the patient is in their home.)
• Other - any other code. This is why there may be a large count of visits linked to this category

  Where can I find this metric?

Marketscape Insights

• The identical table can be found on the selected physician's Analyze page, under the "Practice Details" tab in the "Place of Service" table.

Marketscape CRM

• In Marketscape CRM, there are no additional metrics of this type available.

Section 2 - How Do I Stand Out?

Overview

Once we start looking at the How Do I Stand Out? section of Sales Spotlight, we have switched from metrics about the selected physician to metrics about your agency.

Compare and Create -  The purpose of this section of Sales Spotlight is to help you create a winning story about your agency. To that end, the metrics in this section are specifically about your agency in comparison to the top agencies (competitors) and state and county benchmarks.

To orient you to the content in this section of the Sales Spotlight tab there are five critical features of which you must be aware. After we present these five items, 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.

In Marketscape CRM, the dropdown selector is down in the second section, directly above the metrics impacted by the selection. In this dropdown selection you will find both hospices and home health agencies.

If you choose a hospice when viewing Sales Spotlight for home health, or vice versa, you will not see any content in the How Do I Stand Out? section.

Diagnoses - The metrics in this section are calculated for different patient populations distinguished by diagnoses. Because of the nature of hospice care and the numbers of patients (smaller), it is highly likely that you will not see any diagnoses other than All Trella Diagnostic Groups.

The "All Diagnoses" category will be included in Sales Spotlight for every physician, other diagnoses will be included if that diagnosis represents greater than 15% of the physician's patients. Only the top three diagnoses that meet this 15% criteria will be displayed in the "How Do I Stand Out?" section of Sales Spotlight.

For more information, see Trella Health Diagnostic Groupings.

Metrics - There are five metrics included for each diagnosis set:

• All Visits Last 3 Days
• All Visits Last 7 Days
• Hospitalization Rate: Stay + 30 Days
• RN Visits Last 3 Days
• RN Visits Last 7 Days

All five 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

Compare to: By default, we show metrics that tell the best story about your agency. To this end, we present comparisons for your agency in the following order:

• Against the top competing agency - we show when your agency performs better against one of the top three recipients of patients treated by the selected physician. (As seen in the Top HHA Destinations table.)
• Against the state or county benchmark - If your agency doesn't outperform against a competitor, the comparison is made against the state or county benchmark.
• If your agency doesn't outperform the state or county benchmark, we will still show how your agency stacks up against the state average.

Using the "Compare to:" dropdown, you can choose to compare your agency to the top three home health destination agencies, or against the state or county benchmarks. If you choose an option from this dropdown, all comparisons in the section will be shown against your selection.

Understanding the Metrics

Hospitalization Rate: Stay + 30 Days

Sales Spotlight on MARINS Analyze Page	Sales Spotlight Email	Sales Spotlight in Marketscape CRM

For Sales Spotlight in Marketscape Insights and Marketscape CRM, with Conversation Starters on, the content is the same as the Sales Spotlight email.

Usage

   Compare

Hospitalization rates show your agency's success rate at keeping hospice patients out of the hospital.

Two additional metrics are included in this tile.

• To the left of the main metric (1.79%) is the competitive advantage. In this case the arrow, pointing down, shows that your agency's metric is 5.99% lower than the listed competitor.
• Beneath the main metric (4.61%) is the metric for your competitor along with their name.

All of the details are written out as a sentence in the Sales Spotlight email or when Conversation Starters are on.

Understanding the Metric

Definition

This is our broadest view of hospitalization in Marketscape Insights. For an event to be a hospitalization, the patient would need to be admitted to inpatient care during a post-acute stay or in the 30 days following post-acute discharge.

Any Length of Stay - We calculate this metric on a stay of any length in part to distinguish this metric from readmission rates that have a fixed 30 day period. Other issues to consider:

• In many cases, an admission to inpatient care from post-acute care triggers/requires a discharge from the post-acute stay. The exception is a home health transfer where the episode/stay continues. When a discharge does occur, we count the event as a hospitalization, and the 30 days post discharge don't apply.
• In the case of a patient who is discharged from post-acute care, we then consider that stay/event a hospitalization if the patient is admitted to inpatient care within 30 days of post-acute discharge.

See Hospitalization for more information.

Metrics Calculation

Hospitalization is the number of patients hospitalized during a post-acute stay or within 30 days after discharge divided by the total number of patients admitted to the post-acute agency, times 100%.

The equation looks like this:

Where can I find this metric?

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

Marketscape Insights

• On the Hospice Explore page in the row for your agency in the column for Hospitalization Rate: Stay + 30 Days.
• On the Analyze page for your agency, under the Quality and Operational tab, in the table Trended LOS. There is a breakdown of length of stay metrics in this table.

Marketscape CRM

• This metric is not available in any other location.

End of Life Visits

Overview

There are four additional metric tiles that are displayed in the bottom section of Sales Spotlight. As you can see from the image below, the two differences between the tiles are whose visits are being counted and the period for the counting. 

• count of RN visits vs. count of all visits
• visits in the last 7 days vs. visits in the last 3 days

Sales Spotlight on MARINS Analyze Page	Sales Spotlight Email	Sales Spotlight in Marketscape CRM

With Conversation Starters on, the physician Sales Spotlight tiles in Marketscape Insights for HOS and Marketscape CRM will display the same content as the Sales Spotlight email.

Using this metric

   Compare

The "How Do I Stand Out?" section is designed to show how your agency outshines your competitors through specific performance metrics connected to patient care. The focus of these metrics is to show how well your agency performed providing care during the last 7 and 3 days of life for your patients. Being able to prove through visit counts that your agency excels in providing better care is a powerful message to anyone concerned about their patients.

There are four counts featured in the Sales Spotlight for your hospice that focus on counts of care provided to patients during the last week of life. The following table shows the four metrics.

Visits Last 7 Days

Usage

The last seven days of a patient's life is that period where the patient is actively dying, and the type and frequency of care should change to reflect the different patient and family requirements. Although there is no numeric standard, CMS considers that excellent service in this period would include an increase of total visits and also a larger ratio of visits by RN's to keep pace with changes in care requirements.

	Counts of Visits Last Seven Days
	Sales Spotlight on MARINS Analyze Page	Sales Spotlight Email	Sales Spotlight in Marketscape CRM
RN Visits
All Visits - RN, LPN, SW, and Aides

For the last 7 days of visits we have two metrics for your agency; an average count of RN visits and an average count of visits by all staff. RNs are counted in each count.

Two additional metrics are included in this Spotlight.

• To the left of the main metric is a percentage that shows how much better your agency is doing against the listed competitor. In this case the arrow, pointing up, shows that your agency's performance is better than the listed competitor.
• Beneath the main metric is the metric for your competitor and their name.

All of the details are written out as a sentence in the Sales Spotlight email or when Conversation Starters are on.

Definition

• RN Visits - This metric is the average count of visits by an RN during the last 7 days of life for patients treated by your agency.
• All Visits - This metric is the average count of visits by all staff during the last 7 days of life for patients treated by your agency. This includes visits by registered nurses, social workers, licensed practical nurses, and aides.

Metrics Calculation

The average is calculated by counting the number of patients who died while on service at your agency and counting up visits in the last 7 days to all of those patients and dividing by the number of patients. 

Where can I find this metric?

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

• The All Visits - Last 7 Days, can be found on the Hospice Explore page in the row for your agency.
• All of the Last 3 day and Last 7 day metrics can be found on the Anlayze page for your agency under the Quality and Operational tab, in the tables, Visit Type - Last Seven Days, and Visit Type - Last Three Days.

Visits Last 3 Days

	Counts of Visits Last Seven Days
	Sales Spotlight on MARINS Analyze Page	Sales Spotlight Email	Sales Spotlight in Marketscape CRM
RN Visits
All Visits - RN, LPN, SW, and Aides

For the last 3 days of visits we have two metrics for your agency; an average count of RN visits and an average count of visits by all staff. RNs are counted in each count.

Two additional metrics are included in this Spotlight.

• To the left of the main metric is a percentage that shows how much better your agency is doing against the listed competitor. In this case the arrow, pointing up, shows that your agency's performance is better than the listed competitor.
• Beneath the main metric is the metric for your competitor and their name.

- Be careful! - Because the period for this count (3 days) is so small, the counts themselves will be very small, generally between 1.5 and 2.5 visits. As a result, you will sometimes see a huge competitive difference in the percentage. Keep this percentage in perspective. That huge percentage, in these cases, represents a small difference in visit counts in the average.

All of the details are written out as a sentence in the Sales Spotlight email or when Conversation Starters are on.

Definition

• RN Visits - This metric is the average count of visits by an RN during the last 3 days of life for patients treated by your agency.
• All Visits - This metric is the average count of visits by all staff during the last 3 days of life for patients treated by your agency. This includes visits by registered nurses, social workers, licensed practical nurses, and aides.

Metrics Calculation

The average is calculated by counting the number of patients who died while on service at your agency and counting up visits in the last 3 days to all of those patients and dividing by the number of patients. 

Where can I find this metric?

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

• All of the Last 3 day and Last 7 day metrics can be found on the Anlayze page for your agency under the Quality and Operational tab, in the tables, Visit Type - Last Seven Days, and Visit Type - Last Three Days.