In many locations throughout the Trella Health Solutions, there are total counts that don't equal what seems to be the counts of all parts. The most simple example would be when the counts for four quarters don't equal the count of the entire year. The answer is below, but this article will break down a few examples to help make sense of what we see.
The quarters don't equal the total
Question - In this case, we expect the counts in the four quarters to add up to the total column. But, when we add the numbers in the rectangle, the total is 3,669 Medicare Patients.
Explanation - The reason is that all of these counts include distinct patients. If a patient was admitted into hospice care in more than one quarter, each admission would be counted in the relative quarter, but only once in the Total column.
Observation - The size of the difference between the totaled columns and the total (Distinct Patients) is interesting. All columns reflect one patient population. The difference between the two totals is indicative of a physician who is seeing a larger percentage of patients multiple times. If this percentage of visits outstrips other physicians in the same specialty, that could suggest potential discovery through digging deeper.
If you take the time to add up the other rows in the same way, you will discover that the same distinct patient count issue is found with all of the claim types. However, the Mortalities counts will always match, because, of course, a patient death can only ever be counted once.
For counts over a time period, it is better to not think of the first column as a total, which implies that you are combining the four columns. It is better to think of them as an annual metric and quaterly metrics.
Claims don't add up
Question - The patient counts that are tied to each claim count look like divisions of the total. Why don't the three claim types add up to the total (Hospice) Patients? In this example, the three claim types add up to 862, not 619.
Explanation - Although the counts in each of the claim type columns does represent distinct patients, for a given physician/patient pair, some claims could represent more than one claim type or there could be more than one claim. For example, a claim that was the last one prior to admission that was within 90 days of admission would be counted in both columns; Patient 3 Months Prior and Last Claimed Patients.
Observation - There is a lot that we can glean from comparing the three claim types represented in many of these tables. For more detail, see "Additional Strategies" in Physician Targeting Strategies - Hospice.