Class Summary:
Today's session focused on various updates and discussions related to performance metrics and updates, primarily in the area of managed care, specifically pertaining to Medicare Advantage (MA) populations. Key topics included performance reports overviewing risk captures and patient visit statistics, updates on risk engine delays, discussion on benchmarking with ARCadia, and preliminary evaluations of new data integrations and tool implementations in patient care strategies.
Notes:
Agenda Review:
- Presentation of performance reports for March.
- Update on HCC benchmarking and solutions.
- Light agenda aiming for a shorter meeting duration.
Performance Reporting from Maddie:
- Performance overviews comparing year-end 2023 to year-to-date 2024 for MA populations.
- Overall Performance: Discussed the overall risk scores and risk capture percentages.
- Risk Capture Performance:
- Enterprise: 52%
- Ohio: 51%
- Florida: 60%
- PCP Activation and Visits: Florida showing more completed and upcoming visits compared to Ohio.
Updates on Refresh Cycles:
- Appointment data up until March 13 indicated refreshing delays, impacting completed visit numbers. Ongoing tracking was discussed to ensure timely data representation.
Trend Analysis:
- Month-over-month performance for risk capture showing an expectation of growth once data is more complete.
- New visuals and charts presented to aid in understanding trend impacts and potential outcomes.
Discussion on Regional Performance:
- Noted differences in engagement and risk capture between Florida and Ohio, with Florida usually performing better in comparison to Ohio.
- Specific discussions focused on high-performing and low-performing providers, considering roles (Physician vs. APP) and their impact on risk capture rates.
ARCadia Benchmarking Update:
- ARCadia Data Use: Discussion on utilizing ARCadia for accessing broader benchmarking data.
- Costs and Decision Making: Additional costs associated with deeper data dives were discussed, contemplating their justification.
- Benchmark Relevance: Points raised about the relevance and comparison points of benchmarking, whether regional or among similar sized providers.
Implementation of New Data Tools in Practice:
- Introduction of OSCAR-related updates reflected on new slide displays.
- Integration issues and implementation of new workflows involving data from OSCAR, like pre-visit and post-visit work cues.
Next Steps:
- Continuous monitoring and updating of risk capture statistics.
- Discussions to potentially adjust and improve current strategies and data practices.
Further discussions appear to be geared towards optimizing the accuracy of data collection and interpretation, improving benchmarking techniques to enhance performance monitoring, and better integration of tools for patient management within various contracts and health plans. There was a consistent emphasis on assessing data reliability, ensuring timely refreshes, and working collaboratively across teams to address discrepancies and improve overall care efficiency.