The Patient Metrics table provides statistics on the patient population for a physician so you can gauge the physician's potential for being an influence with patients regarding home health treatment. Yearly totals are the same statistics found on the Main Table on the Physician's Page and the Physician Referral Sources table on the Home Health Agencies Page.
The quarterly numbers will not add up to the Total (Distinct Patients). The counts in each column are distinct counts, so a specific patient could be counted in multiple columns but will only be counted once in the Total column.
Patient Metrics Details
The following metrics are used throughout the Home Health Solution in many tables. In general, the definitions below are accurate with respect to the same data throughout the Solution. Where these metrics are nuanced in other tables, clarifying notes are included in the Solution and additional description will be added to the knowledge-base articles for the specific tables where the data is different.
All Medicare Patients
This the count of distinct patients who had at least one claim with the physician on this page during the reporting period (last four quarters).
This metric represents the volume of patients seen by the physician. The trend over the quarters indicates whether the Medicare portion of the physician's practice is growing or shrinking.
Home Health Patients
This is the count of distinct patients who were treated by this physician who were admitted to Home Care during the one year reporting period (last four quarters).
This is a significant number to examine in comparison to the total medicare patients treated by the physician. It is important to contrast this number to the similar metric in the Home Health Utilization table that is directly below Patient Metrics on the Physician Detail Page.
In the Physicians Main Table and in Patient Metrics, the focus is on patient flow from a physician to post-acute care, in this case Home Health Agencies. For that reason, the Home Health Patients metrics is a count of admissions for a physician who treated the patient within three months to establish a sense of connection between the physician and post-acute care.
In the Home Health Utilization table, the metric is a count of patients treated by this physician who received home health care during the reporting period, irrespective of time of admission. This count will be higher because some of the physician's patients will be counted as receiving home care even though they weren't admitted to post-acute care during the reporting period. See Physician Detail Page - Home Health Utilization.
This is the count of patients who died during the reporting period (last four quarters) who had been treated by the physician during the six month reference period prior to their death.
This count represents the number of patients where the physician on this page was listed as the following (certifying) physician on an End of Episode claim.
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 demonstrates a commitment to home care and is a prime candidate to cultivate as a partner.
Total 3 Months Prior
This count represents the number of patients who entered Home Health within the reporting period (last four quarters) for whom the physician submitted a claim within the three month reference period prior to the Home Health admission.
A physician with a high number of 3 Months Prior patients is involved with those patients during a critical time in the continuum of care. These physicians are poised at the critical time to engage patients on the course of care and even the selection of a home care facility. It is always valuable to evaluate the Home Health destinations for a physician with numerous 3 Months Prior patients to see how your facility is being utilized.
Total Last Claimed
This data enumerates the count of distinct patients who were admitted to home care during the reporting period (last four quarters) where the selected physician submitted the last claim prior to admission.
Patient Metrics Example - Ruth
Ruth was an 85 year old female diagnosed with COPD and CHF. She recently suffered a fall at home and went to the emergency room for treatment. The emergency room referred her to an Orthopedic MD for a broken wrist. After treatment, Ruth was referred to Home Health care for OT, PT and nursing. The total stay for the course of treatment included one initial episode and 1 re-certification - July 3 to October 7 - 96 days of care. During that period Ruth received an average of 8 visits per episode from nursing and 14 visits per episode for all types of therapy.
- The Orthopedic MD receives a single count as the following physician, identified on the RAP (Request for Advanced Payment) at the time of admission for Home Care.
3 Months Prior
- The Primary Care Physician and the Orthopedic MD both receive a count for 3 Months Prior because they each submitted a claim in the three month reference period before admission to Home Care.
- The PCP only receives a single count despite submitting multiple claims during the three month reference period. The counts in these columns are unduplicated counts of distinct patients.
- The Orthopedic MD receives a single count for Last Claimed for the claim submitted in June. This was the most recent claim submitted prior to admission to Home Care.
- The average visits for Nurses and Therapists provides an insight into the amount of care provided by each of the specialties. The nursing average includes visits by both RNs and LPNs. Therapist visits includes Physical Therapy, Occupational Therapy, Speech-Language Pathologists, Physical Therapy Assistants, and Occupational Therapy Assistants.