Patient Engagement Performance

Overview

The Patient Engagement Performance dashboard provides deep insight into rosters, patient engagement and patient profiles in Florida and Tennessee. Metrics can be observed by many attributes such as location, market segment, insurance product, clinical line of business and patient demographics.

Metric Definitions

  • Inclusion Criteria: Include all rosters, all payers and all states

  • Unique Consumers: Number of unique people in the rosters. If the roster has a member with 2+ member IDs, it only counts once

  • Unique Members: Number of unique members based on the master member ID. The master member ID comes from the roster member ID and any other elements that need to be concatenated (e.g., -01) to develop a unique member ID

  • Qualifying Visits: Primary Care (which includes Telehealth visits) + Urgent Care visits as defined in the cohort_appt_type_definitions (primary care visit, telehealth phone, telehealth video and urgent care visit). You can contact the Sanitas data team to get the latest appointment types managed table.

  • Seen Status (priority order):

    • Seen This Calendar Year - a consumer who has a Qualifying Visit in the current calendar year

    • Future Visit Scheduled - a consumer who has NOT been Seen This Calendar Year AND has a future Qualifying Visit scheduled this calendar year

    • Seen Prior Calendar Year - a consumer who has NOT been seen This Calendar Year AND does NOT have a Future Visit Scheduled AND has a Qualifying Visit in the prior calendar year

    • Inactives - a consumer who has NOT been seen This Calendar Year AND does NOT have a Future Visit Scheduled AND has a Qualifying Visit before the prior calendar year

    • Not Seen - a consumer who does NOT qualify for any of the above conditions and therefore has not had a Qualifying Visit

  • Roster Adds: patients who are new to a roster in a given month

  • Roster Deletes - patients who fell off the roster from one month to the next

  • Roster Retained - patients who stayed on the roster from month to month (historical trends)

  • Tenure: How many months the member has been in a roster. For example: 13-24 months.

Tabs Overview

Active Roster

Shows current roster seen rates in general, by market segment, age groups and tenure. Ability to filter state, payer name, market segment, plan name and tenure.

Metrics included are:

  • Active Roster Patients

  • Roster Type

  • Seen Rate - Active Roster Patients

  • Year over Year Seen Rate Trend

  • Relationship

  • Performance by Relationship

  • Seen Rate Trend by Relationship

  • Market Segment

  • Performance by Market Segment

  • Seen Rate Trend by Market Segment

  • Assigned Region

  • Performance by Assigned Region

  • Health Status

  • Performance by Health Status

  • Seen Rate Trend by Health Status

Patient Profile

Metrics included are:

  • Active Roster Patients

  • Seen Rate - Active Roster Patients

  • Age

  • Gender

  • Performance by Age and Gender

  • Language Preference

  • Performance by Language Preference

  • Ethnicity

  • Performance by Ethnicity

  • Tenure

  • Performance by Tenure

Leap Assignment

Metrics included are:

  • Active Roster Patients

  • Seen Rate - Active Roster Patients

  • Assigned Roster Patients

  • Unassigned Roster Patients

  • Performance by Panel

  • Performance by Region

  • Performance by Facility

  • Performance by Provider

  • Assignment Drilldown

YTD Roster

Shows roster adds (new members), deletes (left roster) and retained trend for the last 12 months by state, market segment and age groups

Shows contact information stats provided in the payer rosters as well as capture in the EMR. The more contact information we have (email, text message opt-in, phone for calls), the better the engagement rates.

Metrics included are:

  • Unique Roster Patients YTD

  • YTD Seen Rate

  • Year over Year Roster Volumes

  • Roster Volume Trend

  • Roster Net Gain

  • Roster Volume Trend by Market Segment

  • Roster Net Gain by Market Segment

  • Roster Volume Trend by Health Status

  • Roster Net Gain by Health Status

  • YTD Roster Patient Details

Florida Blue QAPX

Metrics included are:

  • Florida Blue Commercial QAPX Cohort

  • Florida Blue Commercial QAPX Product Category

  • Performance by Florida Blue Commercial QAPX Cohort

  • Performance by Florida Blue Commercial QAPX Product Category

FAQs

What does "Payer Hierarchy Crosswalk Incomplete" mean?

When rosters are ingested, they are conformed to standards for market segment (Individual, Employer, Medicare, Medicaid), payer, plan, network, and other key data elements that tend to be very different from roster to roster. This process (recoding new values) is managed by the data governance team.

If you see Payer Hierarchy Crosswalk Incomplete in the the controls (filters) for state, it means recoding is needed.

What does "Unknown" mean?

After recoding the roster is completed, there are values that are unknown based on the information provided. For example, we may know it is a Medicare Advantage roster but we may not know if the network is PPO vs HMO from the data provided. Unknown values are managed by the data governance team in partnership with a data steward that can help research the answer.

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