PHP Performance - FL

Overview

Metrics Definitions

Category
Metric
Data Source(s)

NPS

Measures the patient’s experience through Net Promoter Score (NPS) surveys, with the goal of optimizing patient satisfaction and loyalty.

  • Numerator: Total NPS scores of survey responses from patients seen by the provider

  • Denominator: Total number of survey responses from patients seen

Tabs Overview

Executive Summary

Metrics are broken down by the three sub-tabs: Member Counts, Allowed Amounts, and Claims by Service Category. Member Counts and Allowed Amounts can be separated by the following dimensions:

  • Financial Region

  • Attributed Facility

  • PHP Cohort

  • PHP Care Continuum

  • PHP Chronic Ind

  • Member Type

  • FLBL Seen Status

  • Sanitas Seen Status

Member Counts metrics included are:

  • Average Members by Month and Dimension

  • Average Members Ranked by Dimension

  • Average Members Trend by Dimension

Allowed Amounts metrics include:

  • Average Allowed Amount by Month and Dimension

  • Average Allowed Amount Ranked by Dimension

  • Average Allowed Amount Trend by Dimension

  • Average Allowed Amount (Capped) Ranked by Dimension

  • Average Allowed Amount (Capped) Trend by Dimension

Claims by Service Category include:

  • Average Claims PMPM by Month and Service Category

  • Average Claims PMPM Trend by Service Category

  • Claims per Thousand by Month and Service Category

  • Claims per Thousand Trend by Month and Service Category

ER Claims

Metrics are filtered by these dimensions:

  • Financial Region

  • Attributed Facility

  • PHP Cohort

  • PHP Care Continuum

  • PHP Chronic Ind

  • Member Type

  • FLBL Seen Status

  • Sanitas Seen Status

Metrics included are:

  • ER Claim Details by Month

  • ER Claims Trend

  • ER Claim Details by Month and Dimension

  • ER Claims PMPM Ranked by Dimension

  • ER Claims Trend by Dimension

  • ER Claims per Thousand Ranked by Dimension

  • ER Claims per Thousand Trend by Dimension

Inpatient Claims

Metrics included are:

  • Inpatient Claim Details by Month

  • Inpatient Claims Trend

  • Inpatient Claim Details by Month and Dimension

  • Inpatient Claims PMPM Ranked by Dimension

  • Inpatient Claims PMPM Trend by Dimension

  • Inpatient Other Claims PMPM per Thousand Ranked by Dimension

  • Inpatient Other Claims PMPM per Thousand Trend by Dimension

  • Inpatient Claims per Thousand Ranked by Dimension

  • Inpatient Claims per Thousand Trend by Dimension

  • Inpatient Other Claims per Thousand Ranked by Dimension

  • Inpatient Other Claims per Thousand Trend by Dimension

Outpatient Claims

Metrics included are:

  • Outpatient Claim Details by Month

  • Outpatient Claims Trend

  • Outpatient Claim Details by Month and Dimension

  • Outpatient Claims PMPM Ranked by Dimension

  • Outpatient Claims PMPM Trend by Dimension

  • Outpatient Other Claims per Thousand Ranked by Dimension

  • Outpatient Other Claims per Thousand Trend by Dimension

Rx Claims

Metrics included are:

  • Rx Claim Details by Month

  • Rx Claims Trend

  • Rx Claim Details by Month and Dimension

  • Brand Rx Claims PMPM Ranked by Dimension

  • Brand Rx Claims PMPM Trend by Dimension

  • Generic Rx Claims PMPM Ranked by Dimension

  • Generic Rx Claims PMPM Trend by Dimension

  • Special Rx Claims PMPM Ranked by Dimension

  • Special Rx Claims PMPM Trend by Dimension

  • Brand Rx Claims per Thousand Ranked by Dimension

  • Brand Rx Claims per Thousand Trend by Dimension

  • Generic Rx Claims per Thousand Ranked by Dimension

  • Generic Rx Claims per Thousand Trend by Dimension

  • Special Rx Claims per Thousand Ranked by Dimension

  • Special Rx Claims per Thousand Trend by Dimension

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