General Dashboard
This report offers a comprehensive snapshot of membership and utilization, aggregating data from a vast array of sources including Eligibility, Medical Claims, Pharmacy Claims, Dental Claims, Hospital Census, Member Registries, and Member Quality. Serving as an ideal starting point, it facilitates deep dives into nearly all available reports, streamlining your data exploration and analytical endeavors.
Report Parameters
The parameters of this report are the Core parameters defined in the General Parameters or Controls section of the Core Definitions.
Core Metrics
This section delineates key metrics providing actionable insights for the analyzed population:
Members Active - The count of members active as of the latest data update. From here you can Drill Down to the "Summary Member" report.
Top Group Level 5s - This is the amount of groups classified as Group Level 5 within the data being evaluated. Typically it will refer to the amount of Primary Medical Groups being evaluated. From here, you can drill down to the "Summary Group Level 05" report.
Top Group Level 7s - This is the amount of groups classified as Group Level 7 within the data being evaluated. Typically it will refer to the amount of Primary Care Physicians being evaluated. From here, you can drill down to the "Summary Group Level 07" report.
ALOS - Stands for the Average Length of Stay in hospitals based on Medical Claims over the preceding six months for the assessed population. Delve deeper drilling down to the Hospital Utilization subsection within the "Medical Claims Details Dashboard" report.
Currently Admitted - Denotes patients currently admitted as per the latest data update, sourced from the daily census. Drill down to a more granular view in the Hospital Admissions Details report, emphasizing currently admitted patients.
Recently Discharged - Highlights patients discharged within the past 14 days, derived from the daily census. Detailed insights can be garnered from the Hospital Admissions Details report, focusing on recently discharged patients.
Frequent users of ER - Members who have frequented the ER over three times in the last six months, as per Medical Claims. A more comprehensive view is provided drilling down to the Summary Member report, filtering by these particular members.
Special Conditions - Members affiliated with a Special Condition program within the Plan. For a more in-depth analysis, drill down to the Member Registries Details Dashboard.
Members with Encounters - Members with an encounter in the previous three months based on Medical Claims. Presented in a Gauge Chart, the green segment represents members with encounters, while the blue denotes those without in the past three months, relative to the entire population. The displayed percentage corresponds to the proportion of the population with encounters. For specific insights, drill down to the Summary Member report, filtered by the encounter status of members.
Members with Quality Gaps - Members identified with Quality Gaps based on Plan data. Displayed in a Gauge Chart, the red portion indicates members with quality gaps, and the blue represents those without, in relation to the overall population. Comprehensive details can be obtained drilling down to the Quality Measures Details Dashboard.
High Level Metrics
This section showcases the high-level metrics pertaining to the population under examination, presented over a timeline. Each row specifies a distinct metric, while the columns display the corresponding months. Only data from the most recent six months is featured. For detailed definitions of each metric, kindly refer to the 'General Metrics Definition' within the 'Core Definitions' section.
From this table, you can drill down to:
Membership Details Dashboard
Medical Claims Details Dashboard - Hospital Utilization section
Medical Claims Details
Medical Claims Births
Pharmacy Claims Details Dashboard
Pharmacy Claims Details
Preauthorization Details Dashboard
Membership Trend
This line graph depicts the membership trends for the analyzed population over a period. The vertical axis represents the Members, while the horizontal axis denotes specific months. The graph focuses on data from the most recent six months. For a deeper dive, you can drill down to the 'Eligibility Details' for any particular month.
Cost per Month
This hybrid graph illustrates the financial performance of the analyzed population by merging bars and lines for clarity. The lines chart the Revenue and Budget allocated to the population, while stacked bars represent costs associated with Medical Claims, Pharmacy Claims, Dental Claims, and Special Payments, all expressed as PMPM (Per Member Per Month). Note that this is not a full financial reconciliation; it excludes IBNR (Incurred But Not Reported) and other potential payments or adjustments.