Whose ounce of prevention is worth the pound of cure? With the Total Cost of Care Report you can compare agencies by the average Medicare spend for patients in the six months or year following a home health admission. Lower average overall costs indicate that an agency’s service is bending the cost curve for patients. Sometimes creating a better long-term outcome requires a bigger upfront investment!
Using this information, you can promote your impact on the cost of providing care for a patient population and position yourself as a compelling partner for health systems that are focused on reducing overall costs within their patient population.
This report page includes a table and a graph that contain average Medicare expenditures for patients receiving treatment by the home health agencies that you select for examination. You can view these averages for a 6 month or 12 month period starting at the start of care for the home health agency. In addition, you can limit which claims data are used to calculate the averages by patient acuity, age, or by specific Major Diagnostic Category.
How To Use this Page
Initial Set up Summary
In order to populate the table and graph, you will need to perform some configuration. (Refer to Screenshot)
- 1) Add/Edit Competitors - Click on the "+" to add agencies. (Specific steps below)
- 2) Select a Filter - The default is to include All claims in calculating the table and graph. You can also limit the claims by acuity, age or MDC. (Details below)
- 3) Choose the Follow up Period - Click on the radio button for either 6 or 12 months. (Explanation below)
Step 1: Add/Edit Competitors
Up to five home health agencies can be displayed in the table and graph at one time. Follow the steps below in order to add home health agencies to the report.
To expedite this process, have the NPI numbers for the agencies you want to examine available. A best practice would be to have agencies of interest selected as favorites so they will show up in the "My Home Health Agencies" tab of the "My Dashboard" page. Then, if you open the Total Cost of Care page in one tab and "My Dashboard" in another tab of your browser, it will be simple to copy and paste NPIs or names.
- Click on the "+" next to "Add/Edit Competitors. The following window will open up:
- In the first field, enter the NPI or name of the agency to be included in the table. You can also add a county or ZIP code. (If you use a county, it will populate the results from every matching county for all states to which your company has access.)
- Scroll through the results and click on the agency you want to add. The agency will move from the left to the right. (The image above shows the agency in both locations as an example; no agency will appear in both locations in actual use.)
- Click "Apply" to add your selected agencies to the page.
You can select home health agencies from any Market that you can access in the Solution. That is, you are not limited to a specific state when selecting the agencies to include in this report.
Step 2: Select a filter
Filters for Acuity, Age, and "Major Diagnostic Category" limit the data set so metrics shown on the page only reflect claims that match the selection. For more information the Acuity and Diagnostic grouping options, see Trella Health Patient Acuity and Trella Health Diagnostic Groupings.
Clicking on the filter field will open the selection of three filters you can apply to the data as shown in the following image:
Step 3: Choose a Follow-up period
Choose the radio button for the follow up period length you want to evaluate. Claims for each patient are summed from either a 6 month or 12 month follow up period which are then used to calculate the average for all patients admitted to the home health agency during the reporting period (blue boxes in image below.)
In order to provide the necessary period of time from Admit to the end of the most recent quarter of data, we offset the one year reporting period to provide a full year of admissions.
Understanding the Metrics
|Home Health Agency Name/NPI/ZIP code||These three columns show identify the chosen Home Health Agency by name, NPI, and ZIP Code|
|Average Total Cost of Care||This metric is the average amount Medicare spent (in dollars) for patients during the selected follow up period after admission to home health care. This includes all Part A & B claims, lab claims, and durable medical equipment costs (DME).|
|Admit Count||This is the count of home health stays used to produce the follow-up metrics.|
|Follow Up Metrics||Average Inpatient Admits||
This is the average number of inpatient admits during the selected follow-up period (Includes LTACH & IRF).
|Average ER/Obs Visits||This metric is the average number of emergency department and observation visits that started during the selected follow-up period.|
|Average SNF Visits||The average number of SNF claims submitted during the selected follow-up period.|
|Average HHA Admits||This is the average number of home health billing episodes started during the selected follow-up period.|
|Mortality Rate||The percentage of patients who died out of all patients included in the follow up metrics during the selected follow-up period.|
Total Cost of Care Chart:
The report includes an interactive chart. Hovering over a bar in the graph shows the amount Medicare spent broken out by claim type.