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User Guide IBM® Watson Health™ Provider Engagement Solution Version 5.0

Proprietary notice

© Copyright IBM Corporation 2018

All company and product names mentioned are used for identification purposes only and may be trademarks of their respective owners.

Contents

What's new 1

Overview 2

Product benefits .................................................................................................................. 2 Visualization, insights, and opportunities ........................................................................... 2 How to compare .................................................................................................................. 3 Data sources ........................................................................................................................ 4 Access control ..................................................................................................................... 5 Concepts and terminology .................................................................................................. 6

Abbreviations .............................................................................................................. 6 Dashboards ................................................................................................................. 7 Diagnostic cost groups ................................................................................................ 7 Exploring data visually ................................................................................................ 7 Episodes of care .......................................................................................................... 7 Key performance indicators ........................................................................................ 7 Measures ..................................................................................................................... 7 Performance assessment ........................................................................................... 8 Primary-care medical provider ................................................................................... 8 Targets......................................................................................................................... 8 Utilization .................................................................................................................... 8

How do I? 9

Selecting dashboards or reports ......................................................................................... 9 Understanding dashboard basics ........................................................................................ 9 Finding opportunities ........................................................................................................ 10 Working with dashboards .................................................................................................. 11

KPI Performance dashboard..................................................................................... 11 KPI Trends Report ..................................................................................................... 13 My Members dashboard............................................................................................ 16 Other Program Measures dashboard ........................................................................ 18 Patient Health Record dashboard ............................................................................. 19 PCMP Directory dashboard ....................................................................................... 22

Navigating .......................................................................................................................... 23 Filtering .............................................................................................................................. 23 Data dictionary .................................................................................................................. 24

30-day Post Discharge Follow-Up Members ............................................................ 24 ER Visit Members ...................................................................................................... 28

KPI Performance dashboard..................................................................................... 31 My Members dashboard............................................................................................ 33 Postpartum Members ............................................................................................... 39 Primary Care Medical Provider (PCMP) Directory ..................................................... 42 Well-Child Check Members ....................................................................................... 45

Troubleshooting and support ............................................................................................ 48 Contacting product support ...................................................................................... 48 Performance issues or System Unavailable message .............................................. 49 Problems accessing certain dashboards .................................................................. 49 Problems with crosstab documents ......................................................................... 49 Proxy error with the My Members dashboard .......................................................... 49

Find it online 51

Exploring resources in Communities ................................................................................ 51 Connecting with IBM Sales ............................................................................................... 51 Learning through IBM Training .......................................................................................... 51

Index 53

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What's new IBM® Watson Health Provider Engagement Solution Version 5.0 introduces many new features for planners and users.

Updated data sources Provider Engagement Solution uses periodically updated data sources. By exploring the latest available data, you gain up-to-date insights on changes and trends in assessment and planning.

Improved data visualization This release includes improved dashboard reporting, with advanced, richer data visualization. Dashboards include easy to understand charts in, for example, bar chart and dot chart formats. Bar charts provide drill down support for details and insights. Dot charts display provider-level detail simply by hovering a pointer over a dot to, for instance, contrast physician performance. Tables help you identify opportunities, for example, clients eligible for more care.

Improved usability, ease of use This release includes improvements in Provider Engagement Solution usability. You can quickly access and display dashboard reports and complete assessments. Clear, more-intuitive dashboards and displays present actionable data and comparisons. Charts use color selectively to help you compare and differentiate. If your organization works with multiple customers, you can quickly switch between them.

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Overview IBM Watson Health Provider Engagement Solution communicates performance metrics (key performance indicators and other program measures) for constituencies that include primary-care medical physicians (PCMPs) and regional accountable entities (RAEs). Provider Engagement Solution helps your organization collaborate more-effectively on care delivery by providing information on individual clients and members. Information includes demographics, PCMP assignment, utilization and cost history, predictive risk scores, clinical condition summaries, and gaps-in-care opportunities.

Product benefits • Applies the most-current, nationally adopted quality measures to claims and eligibility data

to evaluate effectiveness and manage population care – resulting in higher-quality healthcare and reduced costs.

• Reports member compliance rates for specific care, identifying "gaps in care" and facilitating targeted member interventions.

• Episode-based analysis of physician performance captures all costs that are associated with a course of treatment. With such an analysis, you can more accurately evaluate the total cost that is associated with physician performance.

• Case mix risk adjustment of physician results provides a fairer comparison of physicians against their peers by accounting for both the severity of their patients' illnesses and comorbidities.

Visualization, insights, and opportunities To effectively communicate data and provide insights, Provider Engagement Solution uses data visualization. In Provider Engagement Solution dashboards, data is presented graphically, for example, use points, bars, and color. With Provider Engagement Solution charts, you can quickly grasp larger trends. Charts are easy to explore. For example, by hovering your pointer at a data point, Provider Engagement Solution displays more-detailed information.

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How to compare Example of a typical physician assessment

1. After you sign in to Provider Engagement Solution, you select the dashboard that you want to use as the basis of performance comparison and your search for opportunities. If it's the first time you use the dashboard, use the Details option for background about it.

2. Select the initial physician that you want to use, that is, to compare to other physicians in an organization.

3. In a displayed dashboard, compare the physician to others. Explore the data that Provider Engagement Solution presents visually.

4. Review dashboard information to find opportunities, for example, for performance improvement and for providing more healthcare services. Where available, drill down into dashboard data.

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Data sources Provider Engagement Solution uses consolidated, regularly updated data from various trusted sources.

Sources of data for this product Data source Description

Watson Health Data Warehouse database Regularly scheduled database updates ensure that you have the most current data available.

Enhanced patient data from US states Medicaid claims and eligibility data

Emergency room visit data

Tip

• For additional information on data sources, display the Provider Engagement Solution dashboard that you want, and then click Details.

Methodology

The key performance indicators (KPIs) are calculated for Regional Accountable Entities (RAEs) and primary-care medical providers (PCMPs) participating in the Accountable Care Collaboration (ACC) program. These indicators are based on the members’ utilization of services.

Methodology background

ACC population: One dollar of the per-member per-month (PMPM) payment to each the RAEs and PCMPs is withheld by the Department of Health Care Policy and Financing (the Department). RAEs and PCMPs are eligible to receive this one dollar by achieving performance thresholds for the KPIs including:

• Well-Child Checks (WCC) Ages 3-9 • Post-Partum Follow-up Care • Emergency Room (ER) Visits

Each KPI calculation is based on the utilization of services by the population that is enrolled in the ACC. The following sections describe the significant differences in the methodologies that are used to calculate and evaluate Emergency Room (ER) Visits, Post-Partum Visits, and Well Child Checks Ages 3-9.

Evaluation and Baseline Period

Monthly, KPI performance is calculated. Each evaluation period is 12 rolling months of data based on service/eligibility dates that allow for three months of claims runout. The baseline period is calculated to set targets for two of the three KPIs, ER Visits and WCC. The baseline is updated one time each State Fiscal Year (that is, for SFY 15-1616-17, the baseline period is July 1, 2014 through June 30, 2015, or SFY 14 - 15). The baseline period is calculated by using the same methodology and includes three months of claims runout.

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Claims Selection Criteria

The following criteria are used to select the claims that are used to calculate the KPIs:

• Include:

Both facility and professional claims

Paid claims with three months runout

Only current records

Last claim after completing all adjustments

• Exclude

Encounters

Deleted records

Long-term care claims

Access control Access control in Provider Engagement Solution is determined by user group. User group permissions determine:

• Access to all dashboards or certain dashboards • Access to specific dashboard data

The following lists the Provider Engagement Solution user groups, and the dashboards available to those user groups.

User groups

• Health Care Policy and Financing (HCPF) • Primary-Care Medical Provider (PCMP) • Regional Accountable Entity (RAE)

Dashboards

• KPI Trends Report* • My Members • Other Program Measures** • Performance Dashboard** • Patient Health Record

* Not available for the PCMP user group

** Data-level access control

If you have questions about access control and user groups, contact your Watson Health representative.

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Concepts and terminology Learn key Provider Engagement Solution concepts and special terms that are used with the product.

Abbreviations The following are abbreviations that you might encounter as you use Provider Engagement Solution.

Common abbreviations for this product

Abbreviation Meaning

ACC Accountable Care Collaboration

ADCG Aggregated Diagnosis Cost Grouper

BHO behavioral health organization

CSV comma-separated value

DCG diagnostic cost grouper

E&M evaluation and management

FPL federal poverty level

HCPF Health Care Policy and Financing

KPI key performance indicator

MAGI Modified Adjusted Gross Income

MEG IBM Medical Episode Grouper

MMP Medicare-Medicaid Program

NPI National Provider Identifier

PCMP primary-care medical provider

PHR Patient Health Record

PIN personal identification number

PKPY per 1,000 per year

PMPM per-member per-month

RAE regional accountable entity

SFY state fiscal year

SNF skilled nursing facility

WCC well-child check

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Dashboards Provider Engagement Solution information is presented in dashboard report format. Dashboards help you visually understand changing business conditions, so you can make decisions and identify trends based on Provider Engagement Solution source data.

Dashboards display data graphically, and can include charts, tables, and metrics. These provide you with multiple views and richer insights. Provider Engagement Solution uses data from several key performance indicators (KPIs). You can download Provider Engagement Solution dashboard information to your workstation, for example, to share insights with others.

Important: Certain dashboards might not be available for your use or for your organization. For more information, see Access control.

Diagnostic cost groups Diagnostic cost group (DCG) classifications are the foundation of a family of risk-adjusted payment and analysis methodologies.

Exploring data visually With Provider Engagement Solution, you use standard, built-in charts and graphs to understand the quality and distribution of data. Powerful visuals lead you to insights and opportunities that help your organization.

Episodes of care Episodes of care are constructed by using the Medical Episode Grouper (MEG). MEG is a methodology that links inpatient, outpatient, and prescription experience into clinically relevant episodes of care. Key portions of the episode grouper are based on our Disease Staging methodology. Each admission, claim, and encounter record is assigned a disease category and severity level.

Next, these are used to group claims for the treatment of a condition into one integrated episode. Episodes are opened or initiated by a visit to a physician or admission to a hospital for a specific condition, and are closed after a clean period. A clean period is a specific time period during which the patient has no new claims for that condition during this time. (The time period varies by condition.) Prescription medications are included in episodes based on clinical relevance and proximity in time.

Key performance indicators A key performance indicator (KPI) is a measurable value that demonstrates how effectively an organization is achieving key business objectives. Organizations use KPIs at multiple levels to evaluate their success at reaching targets. Provider Engagement Solution uses data from several KPIs.

Measures Using quality measures, you can measure or quantify healthcare processes and outcomes that are associated with the ability to provide high-quality healthcare. One example of a Provider

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Engagement Solution measure is the number of emergency room visits per-thousand per-year, representing actual utilization normalized to a population of 1,000 clients.

Performance assessment Assessing healthcare output and efficacy is an important goal for any healthcare organization. While meeting patient needs, your organization must explore ways of ensuring cost-effective, high-quality service delivery. Provider Engagement Solution provides data-driven insights into costs, utilization, gaps in care, ER usage, and prescription medication usage. Using these insights, you can identify areas of improvement.

No single method of assessment is comprehensive. Using PPA with its data-based approach is an important component in your overall assessment strategy.

Primary-care medical provider A primary-care medical provider (PCMP) is a patient’s main healthcare provider. A PCMP is the patient’s “medical home,” the source of most healthcare needs. Typically, a PCMP knows the patient's health history, takes care of basic medical needs, and makes referrals as needed. As you use Provider Engagement Solution and work with PCMPs, keep in mind:

• Groupings by organization: When you use Provider Engagement Solution to make physician comparisons, you access PCMP information by the associated regional accountable entities (RAEs).

• Identification: PCMPs are identified by PCMP IDs, rather than by name. Identifying physicians this way avoids having biases of different types influence your comparisons. You can be more objective when you make decisions. When you drill down in dashboards, you see that Provider Engagement Solution identifies physicians by both PCMP ID and National Provider Identifier (NPI) ID.

Targets Targets are performance thresholds, which are used as the basis of comparisons.

Example Here is an example with a key performance indicator. If the targets are set at 1 percent and 5 percent greater than the prior year's rate, then performance needs to show 1 - 5 percent improvement to reach the 1 percent target. In addition, performance needs to be greater than or equal to 5 percent to reach the 5 percent target.

Utilization In healthcare, utilization is the quantification or description of how patients use services for:

• Preventing and curing health problems • Promoting maintenance of health and well-being • Obtaining health status and prognosis information

You can use Provider Engagement Solution for utilization and cost information on a per-patient basis.

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How do I? Learn how to complete Provider Engagement Solution tasks.

Selecting dashboards or reports After you sign in, the Provider Engagement Solution home page shows options to select from several dashboards or reports. In addition, you can browse your available dashboards and reports, and then select and display one.

Procedure

1. At the Provider Engagement Solution home page, click View all. 2. On the My Content page, locate the dashboard or report you want, then click it to open.

Understanding dashboard basics Before you explore a Provider Engagement Solution dashboard, get a better understanding of it first. When you open a dashboard, you can get a quick overview as you work interactively with the information that is displayed. By checking the basics, you understand what the dashboard is for and how it works. The result is extra insights and better decisions.

For an overview of the dashboard:

• Open the dashboard and, at the right, click Details. Provider Engagement Solution opens a Details page that provides information and background on the dashboard.

About selected details

Description: The description provides a brief overview of the dashboard report.

Helps Answer: The list includes business questions that the dashboard is intended to address. Keeping the questions in mind helps you understand dashboard information and data points.

Example Here are examples of business questions: What is my rolling 12-month KPI performance? How does my KPI performance compare to my peers? What can I do to improve my KPI performance (action list)?

Sources of data

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This includes information about the data and data sets that this dashboard uses. For more information about data sources in Provider Engagement Solution, see Data sources.

Finding opportunities Opportunities are ways that your organization can improve healthcare delivery, for example to identify underperforming physicians and contact patients eligible for more follow-up care. The following includes examples of how you can use the actionable historic information Provider Engagement Solution provides and locate such opportunities.

Examples of how to find opportunities To do this... Do this...

Assess visit volume for ER providers. Use the KPI Performance dashboard to review annual numbers that are compared to a baseline. Review overall performance, then locate clients that are eligible for follow-up care.

Find options for additional services to provide an individual patient.

Use the Patient Health Record and check the gaps in care alerts.

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Working with dashboards Learn about the dashboard reports available in Provider Engagement Solution.

Important: Certain dashboards might not be available for your use or for your organization. For more information, see Access control.

KPI Performance dashboard Use the KPI Performance dashboard to review summary-level and drill down information on key performance indicators (KPIs) and emergency room visits. In addition, you can compare primary-care medical providers (PCMPs) on client (patient) volumes in areas of healthcare delivery, for example, well-child checks. In this dashboard, use information on the KPI tabs to review performance. Then, use the member tabs to review clients that are eligible for follow-up care.

Tip: For steps on how to do typical tasks (for example, how to share the information that is displayed), see How do I?

1. KPI Performance Summary by Region tab This tab charts performance by measure for the selected regional accountable entity (RAE). Dots on the chart's bars indicate the targets. Hover the pointer over a dot for details about the target.

Tip: Use your web browser's scroll bars, both horizontal and vertical, to display dashboard information.

Well-Child Check Ages 3-9: A completeness rate metric that evaluates the percentage of Well-Child Check-eligible clients ages 3 - 9 within the last 12 months.

• No action list: Eligible clients that received a well-child check • Action list: Eligible clients yet to receive well-child check

Postpartum Follow-up Care: A completeness rate metric that evaluates the percentage of clients eligible for Postpartum Check-eligible follow-up care within the last 12 months.

• No action list: Eligible clients that received a postpartum follow-up • Action list: Eligible clients yet to receive postpartum follow-up

Percentage Difference ER Visits: A completeness rate metric that evaluates the percentage of clients eligible for emergency room (ER) follow-up care within the last 12 months.

• No action list: Eligible clients that received ER care • Action list: Eligible clients yet to receive ER care

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2. KPI Performance tab

Key Performance Indicators This area charts performance by measure for the selected regional accountable entity (RAE). Dots on the chart's bars indicate the targets. To use another RAE, go to the Region Selector drop-down list box and select the one you want.


Performance Difference ER Visits This area summarizes clients who have claims for Emergency Room care in the last 12 months. To display a dashboard of ER visit members, click the graphic.

PCMP Comparison This area indicates how PCMPs in the region compare to each other on the completeness of a specific measure: Well-Child Check, Postpartum Follow-Up Care, and Emergency Room Visits. Colored lines indicate average targets per PCMP. Hover the mouse pointer over a line for details.

3. Well-Child Check Members tab This tab lists clients eligible for well-child checks. You can filter this list by various criteria, for example:

Action/No action List: List clients that are either eligible for care or yet to receive care.

Client ID: Client's Medicaid ID

PCMP NPI: National Provider Identifier for the primary-care medical provider

4. Postpartum Care Members tab This tab lists clients eligible for postpartum care. You can filter this list by various criteria, for example:

Action/No action List: List clients that are either eligible for care or yet to receive care.



5. ER Visit Members tab This tab lists clients eligible for Emergency Room care. You can filter this list by various criteria, for example:



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KPI Trends Report Use the KPI Trends report to assess how the following are performing on their key performance indicators (KPIs) during a fiscal year:

• Accountable Care Collaboration (ACC) • Regional Accountable Entities (RAEs) • Primary Care Medical Providers (PCMPs)

In this report, Provider Engagement Solution presents information both in table view and in chart view. These charts are easy to explore, with options to drill down for more detail.


Using the table view This view charts state fiscal year KPI data on a month-to-month basis. Each month represents a rolling 12-month period, ending with the last day of the month indicated.

Note: In calculations, the following members are excluded from the KPI population: Members who have Medicare coverage (dually eligible) or are enrolled in the ACC: Medicare-Medicaid Program (MMP) Members who are enrolled in any physical health Medicaid managed care plan for more than three months during the evaluation period Members with less than three months of Medicaid eligibility

ER Visits % Difference

This area charts emergency room visits for monthly reporting periods, expressed per 1,000 member months per year (PKPY). A member month is enrollment in medical coverage for any part of a month, so even one day enrollment is considered one month.

Example A member with medical coverage from January 1 to March 10, would be considered as having three member months.

The denominator for this measure includes member months for all members within the population. An ER visit is counted in the numerator if it does not result in an inpatient admission. To normalize this, the report provides it per 1,000 member months per year (PKPY). This means that the rate is multiplied by 12,000 for the evaluation period. Then, to determine whether this metric improved, the current PKPY rate is subtracted from the baseline PKPY rate to get the percentage difference. Therefore, a negative percentage difference indicates both a decrease in ER visits and improved performance.

This KPI is risk-adjusted. Healthcare cost and utilization for a specific population depend on the population's health status. When you compare the per-capita experience of various member populations at a summary level, population-based risk adjustment makes the comparison more analytically valid. It does this by considering underlying member risk, by looking at member acuity or level of severity of illness. Once the risk level of an RAE population is considered by weighting their results, comparisons can be made across different RAEs in a meaningful way.

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Diagnostic Cost Groupers (DCGs) are used in risk adjusting, population-based performance, and baselines. The DCG models are patient classification systems that evaluate and forecast healthcare utilization and costs. The models use data from a specific time frame to predict the healthcare cost of individuals. The predictions are based on the conditions and diseases for which an individual receives treatment over the past year, and the age and gender of the individual. The DCG healthcare risk assessment method is created by and licensed through Verscend, Inc.

Calculation ER Visits PKPY = # ER Visits / # Member Months *12000

Postpartum % Difference

This area charts post-partum follow-up care visits for monthly reporting periods, which are measured per delivery.

In calculating this measure, the denominator includes the number of live deliveries for members that are enrolled in the ACC as of the end of the evaluation period. Members can have multiple deliveries within the evaluation period. The evaluation period for this KPI is offset by 56 days from the current rolling 12-month period. This allows up to 56 days following the delivery for a follow-up visit to occur. In other words, the post-partum care must be delivered within 21 to 56 days after a live birth to be counted in the numerator.

Example If the evaluation period ends December 31, 2018, the delivery date range that is used is November 5, 2017 to November 11, 2018. Due to inconsistencies in coding, where prenatal visits occasionally used delivery procedure codes, we've consolidated some delivery visits. Service dates within 60 days of each other are assumed to have occurred within the same delivery. Service dates that are greater than 60 days apart are considered separate deliveries. In these cases, the first service date in the chain of claims is considered the delivery date.

Calculation Post-Partum Follow-Up Care Rate (%) = # Deliveries with at Least One Post-Partum Visit / # Deliveries

Well-Child Check 3-9 Rate

The population for this measure includes children ages 3 - 9 years old as of the end of the evaluation period, who are enrolled in the ACC on the snapshot date. These children must also have at least 90 days of continuous enrollment during the measurement year. To meet the numerator, the child must have a well-child check during the measurement year.

Calculation Well-Child Check Rate (%) = # Unique Members who Received at Least One Well-Child Check / # Unique Members Eligible for a Well-Child Check Ages 3 - 9

30 Day Post Discharge Follow-Up Rate

This area charts inpatient discharges for those members that are enrolled in the ACC at the end of the evaluation period. An individual member can have multiple inpatient discharges counted

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towards the denominator. However, in the denominator, inpatient discharges that result in a readmission within either 30 days or death aren't counted. Following discharge, an evaluation and management (E&M) claim within 30 days fulfills the numerator requirement. Only one claim is needed. In the numerator, multiple follow-up E&M visits do not count multiple times.

Calculation 30-Day Inpatient Follow-Up Rate (%) = # Inpatient Discharges with 30-Day Follow-Up Visit / # Inpatient Discharges

Important

• Claims-related data doesn't include claims that were incurred but not yet paid. • Dates are always based on the dates the services were incurred, with three months runout.

Using the chart view This view shows trends in performance on key performance indicators (KPIs):

• Emergency Room Visits • Postpartum Follow-Up Care • Well-Child Checks • Post Discharge Follow-Up

Colored lines indicate average rates per primary-care medical providers (PCMPs) in the specific filtered population. Color-coding indicates whether the Tier 1 or Tier 2 targets were met. Hover the mouse pointer over a line for details.

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My Members dashboard Use the My Members dashboard to review client (patient) member information for a physician who is associated with the currently selected customer.

Examples of when you might use this dashboard

• Review a list of all members in an organization, for example, a regional accountable entity (RAE)

• Review patient procedure utilization, for example, the number of ER visits per patient • Review patient procedure eligibility, for example, whether the patient qualifies for well-child

checks • Locate patients in specific risk categories, for example, by Aggregated Diagnosis Cost

Grouper (ADCG) category, ranging from Very Low Risk to Very High Risk


Selected dashboard information The following describes selected information from the My Members client list.


ADCG Category: Identifies the patient risk based on the Aggregated Diagnosis Cost Grouper (ADCG) model. ADCG is often used to predict healthcare utilization. ADCG categorizes the raw cost risk scores into these risk categories: Very Low Risk, Low Risk, Moderate Risk, High Risk, and Very High Risk. Patients are grouped in categories based on a raw cost risk score, ranging from 0.000 to 999.000, and an ADCG per member.

Concurrent Relative Risk Score: Indicates the expected relative cost risk of the individual during the report time period that is compared to the average. A relative risk of 1 means there's no difference in risk that is compared to the average. This score is produced by the Diagnostic Cost Groupers (DCG) model, developed by Verscend®, Inc.

ER Visits: Client's number of emergency room visits

Eligible for Well-Child Check: Clients that are eligible for the well-child check performance measure

Well-Child Checks: Clients that are eligible for the well-child check performance measure

MMP Enrolled: Clients that are enrolled in the Medicare-Medicaid program population

Additional information available by downloading By default, the My Members dashboard shows core information about clients. However, you can review more-complete information that includes the following by downloading the dashboard. By doing this, you can reorder the client list for analysis and additional insights. For steps, see Downloading.

Months Medicaid Eligible: Number of months clients were on Medicaid within the past 12 months

Total Paid PMPM: Total Medicaid dollars paid Divided by total member months

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Continuous Months ACC Enrolled: Greatest number of continuously enrolled days in the Accountable Care Collaboration (ACC) program within the 12-month reporting period

Eligible for Postpartum: Identifies clients that are eligible for the post-partum check performance measure

Postpartum Visits: Number of Postpartum check claims submitted within the 12-month reporting period

Disabled: Identifies clients with disabilities

SNF Agency: Last skilled nursing facility (SNF) to render services to the client

Last SNF Service Date: The date of the latest SNF service for the client. The service must have occurred within 90 days of the report’s claims paid through date.

BHO Agency: The last behavioral health organization (BHO) to provide services to the client

BHO Last Service Date: The date of the latest BHO service for the client. The service must have occurred within one year of the report’s claims paid through date.

Waiver Agency: The last waiver organization to provide services to the client

Last Waiver Service Date: The date of the latest waiver service for the client. The service must have occurred within one year of the report’s claims paid through date.

Home Health Agency: The last home health organization to provide services to the client

Last Home Health Service Date: The date of the latest home health service for the client. The service must have occurred within one year of the report’s claims paid through date.

Expansion Eligible Indicator: Indicates whether ACC enrolled client meets the Medicaid Expansion eligibility criteria. A Y indicates that the client became eligible for the ACC due to Colorado's implementation of eligibility levels based on Modified Adjusted Gross Income (MAGI). In these eligibility levels, Federal Poverty Level (FPL) levels have been raised, which allows more people to qualify for Medicaid.

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Other Program Measures dashboard Use the Other Program Measures dashboard to find opportunities that Provider Engagement Solution identifies based on clients who did not receive additional follow-up care. This is determined per patient and per PCMP within a 30-day period after discharge.


Program Measures This area charts performance by follow-up care and identifies opportunities for providing more care. To use another RAE, go to the RAE Selector drop-down list box and select the one you want.

Program Measures - User groups other than PCMP

30 Day Post Discharge Follow-up: This evaluates the percentage of inpatient clients eligible for 30-day post-discharge follow-up and who also had 30-day discharge follow-up within the last 12 months.

• No action list: Eligible inpatient clients that received discharge follow-up • Action list: Eligible inpatient clients yet to receive discharge follow-up

Program Measures - PCMP user group only

30 Day Post Discharge Follow-up: This evaluates the percentage of clients eligible for 30-day post-discharge follow-up and who also had 30-day post-discharge follow-up within the last 12 months.

• No action list: Eligible clients that received discharge follow-up • Action list: Eligible clients yet to receive discharge follow-up


PCMP Directory This area lists providers within a specified RAE.

Important

• This dashboard section isn't available to the PCMP user group. For more information, see Access control.

PCMP Comparison This area indicates how PCMPs in the region compare to each other on the completeness of a specific measure: Well-Child Check, Postpartum Follow-Up Care, and Emergency Room Visits. Colored lines indicate average targets per PCMP. Hover the mouse pointer over a line for details.

User groups other than PCMP: This area includes the Percentage Difference ER Visits chart.

PCMP user group only: This area includes the Clients with ER Visits chart.

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Patient Health Record dashboard Use the Patient Health Record dashboard to review a care summary for a selected patient. The summary provides fast access to patient-level cost, utilization, and clinical detail information. This dashboard includes:

• Quick View: Summarizes service utilization, ER services, and gaps in care. • Utilization and Cost Summary: Includes demographic information, costs per procedural

category (for example, outpatient procedures), and ranked prescription medication supply. • Episode of Care: Charts episodes of healthcare delivery for the most-recent 24-month

period, including the associated costs, care category, and prescribed medications.


Quick View This tab gives you an overview of patient demographic and utilization information, along with alerts about gaps in the patient's care.

Important


Summary

This displays patient demographic information. Projected future costs are based on a DCG risk score which might be available in your database.

Time Period

This indicates the start date and end date of the source data from the database.

ER Summary

This summarizes emergency room services that are provided for this patient. The services are summarized by service date and three-digit diagnosis, with the most recent services first. By default, it includes information for any ER services that are paid during the most recent 24 months available in the database.

Gaps in Care Alerts

This displays care-related alerts, that is, a listing of recommended services according to evidence-based guidelines, where the status of the service is either overdue or missing. These guidelines are based on age, gender, and clinical condition.

Note: Provider Engagement Solution uses the most-recent data available to generate Gaps in Care alerts.

Services: These are recommended services for this patient, where the status of the service is either overdue or missing.

Utilization Details

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This displays a tick chart, showing the patient's utilization history by place of service for the most-recent 24 months available in the database. Each color-coded tick mark on the chart represents one day on which the patient received services.

Note: Dates are always based on the dates the services were incurred.

Utilization and Cost Summary This tab includes patient-specific utilization and cost summaries, as well as information about a patient's most frequently prescribed medications.

Important


Utilization Summary

This charts the patient's utilization history by place of service for the most recent 24 months available in the database. Each bar depicts the number of visits in each service category.

Cost Summary

This displays the allowed amount that is paid for this patient by place of service. By default, the cost summary includes information for all claims that are paid during the most recent 24 months available in the database. The pie chart depicts paid claims that are sliced by category.

Important


Top Drugs

This lists prescription medications for this patient, ranked by days supply. The bar graph includes product names by days supply, in descending order. By default, this information includes prescription claims that are paid during the most recent 24 months available in the database.

Tip: To reverse the sort order for medications, click the icon next to Days Supply.

Episode of Care This dashboard section includes charts of a patient's episodes, with associated information on types of care and prescriptions. These charts are easy to explore, with options to drill down for more detail. For information about episodes and related methodologies, see Episodes of care.

Important


Episodes chart

This bar chart displays one row for each of this patient's episodes of care, which are sorted alphabetically by episode. You can quickly recognize the episode time duration by checking a bar's size, since Provider Engagement Solution plots each episode against time. Each bar is labeled with the amount that is paid for the episode. This view is enhanced with a 24-month look back period.

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Tip: To reverse the sort order for episodes, hover a pointer over the table, then click the icon that appears.

Procedure

• In the chart, click the episode that you want. Provider Engagement Solution displays episode details.

Episode details

Following the episodes chart, the Episode of Care tab displays additional information about a selected episode.

Medical Details area

This information is restricted to only those claims that are associated with the selected episode, for example, the episode group, the high disease stage code, and the start and end dates. For more details, hover a pointer over the chart bar.

Drug Details area

This information is restricted to only those prescription claims that are associated with the selected episode. By default, the table shows all the medication claims for that patient during the entire time period available in the database. For more details, hover a pointer over the chart bar.

22

PCMP Directory dashboard Use the PCMP Directory dashboard to review a listing of primary care medical providers (PCMPs)associated with the currently selected customer.

Examples of when you might use this dashboard

• Review a list of all member PCMPs in an organization, for example, a regional accountable entity (RAE)

• Review a list of all member PCMPs with attributions in a region


Selected dashboard information The following describes selected information from the PCMP Directory.


Number of Attributions: Number of Accountable Care Collaboration members attributed to the provider in the selected region

23

Navigating As you use Provider Engagement Solution, do the following to navigate it for best results:

• To navigate Provider Engagement Solution and switch between dashboards, you can click the tabs or use the menu options.

Note: Navigate by using the icons and links on Provider Engagement Solution pages. Don't use your web browser's controls, for example, the forward and back buttons. If any tab is disabled, Provider Engagement Solution has no detailed information of that type for that physician.

Navigating charts

Here are examples of how you can explore Provider Engagement Solution charts and the information that they contain.

How to navigate charts To do this... Do this...

Bar charts

Display details Hover the pointer over a bar.

Drill down Click a bar.

Dot charts

Display details on a physician Hover the pointer over a dot.

Highlight a physician, dim others Click a dot.

Zoom in Either press Shift+Ctrl+Click, or double-click a dot.

Zoom out Hold the Shift key and double-click the chart.

Revert to the original display Click the chart's home icon.

Filtering You can filter Provider Engagement Solution lists, such as a claims list, to list items you specify.

Procedure

1. Go to the appropriate list. 2. Specify the items that you want. For example, to list items by gender, select your choice from

the Client Gender drop-down list box. Provider Engagement Solution lists matching items.

24

Data dictionary These topics provide a reference to data fields used in Provider Engagement Solution dashboards.

30-day Post Discharge Follow-Up Members Note: The description is not displayed in the dashboard.

Data displayed in the dashboard Field Description HCPF CA REGION PCMP

1 Client ID Client’s Medicaid Identification Number

Y Y Y Y

2 Client Name Client’s Name Y Y Y Y

3 Client Phone Number

Client’s Phone Number Y Y Y Y

4 Client DOB Client’s Date of Birth Y Y Y Y

5 Client Gender

Client’s Gender Y Y Y Y

6 REGION Name

Regional Care Collaborative Organization Name

Y Y Y Y

7 PCMP ID Primary Care Medical Provider Identification Number

Y Y Y Y

8 PCMP NPI PCMP National Provider Identifier

Y Y Y Y

9 PCMP Name Primary Care Medical Provider Name

Y Y Y Y

10 PCMP Address

Primary Care Medical Provider Address

Y Y Y Y

11 PCMP City PCMP City Y Y Y Y

12 PCMP Zip Code

PCMP Zip Code Y Y Y Y

13 PCMP PCMP Phone Number Y Y Y Y

25

Field Description HCPF CA REGION PCMP

Phone Number

14 Discharge Date

Date of hospital discharge Y Y Y Y

15 Primary DX for Hospital Admission

Primary diagnosis for hospital discharge

Y Y Y Y

Data displayed in the dashboard Filter/Search By HCPF CA REGION PCMP

1 Action/No Action List (Drop down) Y Y Y Y

2

Client ID (Wildcard Match) Y Y Y Y

3 Client Name (Wildcard Match) Y Y Y Y

4 Client Gender (Drop down) Y Y Y Y

5 REGION Name (Drop down) Y Y Y Y

6 PCMP ID (Drop down) Y Y Y Y

7 PCMP Name (Drop down) Y Y Y Y

8 PCMP Address (Wildcard Match) Y Y Y Y

9 PCMP City (Drop down) Y Y Y Y

10 PCMP Zip Code (Wildcard Match) Y Y Y Y

11 PCMP Phone Number (Wildcard Match) Y Y Y Y

12 Discharge Date (Range of Dates) Y Y Y Y

13 Primary DX for Hospital Admission (Wildcard Match)

Y Y Y Y

Note: The description is not exported.

26

Data fields available on export Field Description HCPF CA REGION PCMP


Y Y Y Y





5 Client Gender


6 REGION Name


Y Y Y Y


Y Y Y Y


Y Y Y Y


Y Y Y Y

10 PCMP Address


Y Y Y Y


12 PCMP Zip Code


13 PCMP Phone Number

PCMP Phone Number Y Y Y Y

14 Discharge Date

Date of hospital discharge

Y Y Y Y

15 Primary DX for Hospital Admission

Primary diagnosis for hospital discharge

Y Y Y Y

27


16 Action/No Action List

Action/No Action List Y Y Y Y

28

ER Visit Members Note: The description is not displayed in the dashboard.



Y

Y

Y Y

2 Client Name

Client’s Name Y Y Y Y



4 Client DOB

Client’s Date of Birth Y Y Y Y

5 Client Gender


6 REGION Name


Y Y Y Y


Y Y Y Y

8 PCMP NPI

PCMP National Provider Identifier

Y Y Y Y

9 PCMP Name

Primary Care Medical Provider Name

Y Y Y Y

10 PCMP Address


Y Y Y Y

11 PCMP City

PCMP City Y Y Y Y

12 PCMP Zip Code




29


14 Last ER Visit Date

Most recent ER visit date Y Y Y Y

15 Primary DX for ER Visit

Primary ER visit diagnosis Y Y Y Y

16 ER Visit Count

Total ER visits in the evaluation period

Y Y Y Y

Note: The description is not displayed in the dashboard.


1 Client ID (Wildcard Match) Y Y Y Y




5 PCMP ID (Drop Down) Y Y Y Y

6 PCMP NPI (Drop down) Y Y Y Y






12 Primary DX for ER Visit (Wildcard Match) Y Y Y Y

13 ER Visit Count (Wildcard Exact Match) Y Y Y Y


30



Y Y Y Y

2 Client Name





5 Client Gender


6 REGION Name


Y Y Y Y


Y Y Y Y


Y Y Y Y

9 PCMP Name


Y Y Y Y

10 PCMP Address


Y Y Y Y


12 PCMP Zip Code




14 Last ER Visit Date

Most recent ER visit date Y Y Y Y

15 Primary DX for ER

Primary ER visit diagnosis Y Y Y Y

31


Visit

16 ER Visit Count

Total ER visits in the evaluation period

Y Y Y Y

KPI Performance dashboard Note: The description is not displayed in the dashboard.

Data displayed in the dashboard Field Description


2 Client Name Client’s Name

3 Client Phone Number Client’s Phone Number

4 Client DOB Client’s Date of Birth

5 Client Gender Client’s Gender

6 REGION Name Regional Care Collaborative Organization Name




10 PCMP Address Primary Care Medical Provider Address

11 PCMP City PCMP City

12 PCMP Zip Code PCMP Zip Code

13 PCMP Phone Number PCMP Phone Number

14 Date of Last WCC Most recent Well Child Check date


Data fields available on export

32

Field Description


2 Client Name Client’s Name

3 Client Phone Number Client’s Phone Number

4 Client DOB Client’s Date of Birth

5 Client Gender Client’s Gender

6 REGION Name Regional Care Collaborative Organization Name




10 PCMP Address Primary Care Medical Provider Address

11 PCMP City PCMP City

12 PCMP Zip Code PCMP Zip Code

13 PCMP Phone Number PCMP Phone Number

14 Date of Last WCC Most recent Well Child Check date

33

My Members dashboard Note: The description is not displayed in the dashboard.

Data fields for the My Members dashboard Field Description HCPF CA REGION PCMP

1 Client ID Clients' Medicaid Identification Number

Y

Y

Y Y

2 Client Name

Clients' Name Y Y Y Y

3 REGION ID Regional Care Collaborative Organization ID

Y Y Y Y


Y Y Y Y

5 PCMP Name


Y Y Y Y


Y Y Y Y

7 Client DOB Clients' Date of Birth Y Y Y Y

8 Client Gender

Clients' Gender Y Y Y Y

9 Client County

County of Client's Residence

Y Y Y Y

10 Client Zip Zip code of Client's Residence

Y Y Y Y

11 ADCG Category

Aggregated Diagnosis Cost Grouper Categories (Very Low, Low, Moderate, Moderate High, High)

Y Y Y Y

12 Concurrent Relative Risk Score

Assigned to an individual that indicates the expected relative cost risk of the individual during the report time period compared to the average. A relative risk

Y Y Y Y

34


of 1 means there is no difference in risk compared to the average. This score is produced by the DCG (developed by Verisk Health®) model

13 ER Visits Number of Emergency Room Visits

Y Y Y Y

14 Eligible for Well-Child Check

Identifies clients that are eligible for the well-child check performance measure

Y Y Y Y

15 Well-Child Checks

Number of well-child check claims submitted within the 12 month reporting period

Y Y Y Y

16 MMP Enrolled

Identifies clients enrolled in the MMP population

Y Y Y Y

Data fields for the My Members dashboard Filter/Search By HCPF CA REGION PCMP



3 REGION ID (Drop down) Y Y Y Y

4 PCMP ID (Multi-select Drop down) Y Y Y Y

5 PCMP Name (Multi-select Drop down) Y Y Y Y


7 Client County (Drop down) Y Y Y Y

8 ADCG Category (Drop down) Y Y Y Y

Data fields available on export

35


1 Client ID Clients' Medicaid Identification Number

Y

Y

Y Y

2 Client Name

Clients' Name Y Y Y Y

3 REGION ID Regional Care Collaborative Organization

Y Y Y Y

4

PCMP ID Primary Care Medical Provider Identification Number / Billing ID

Y Y Y Y

5 PCMP Name


Y Y Y Y

6 PCMP NPI National Provider Identifier Y Y Y Y

7 Client DOB Clients' Date Of Birth Y Y Y Y

8 Client Gender

Clients' Gender Y Y Y Y

9 Client County

County of Client's Residence

Y Y Y Y

10 Client Zip Zipcode of Client's Residence

Y Y Y Y

11

ADCG Category

Aggregated Diagnosis Cost Grouper Categories (Very Low, Low, Moderate, Moderate High, High)

Y Y Y Y

12 Concurrent Relative Risk Score

Assigned to an individual that indicates the expected relative cost risk of the individual during the report time period compared to the average. A relative risk of 1 means there is no difference in risk compared to the average. This score is produced by the DCG (developed by Verisk

Y Y Y Y

36


Health®) model

13 ER Visits Number of Emergency Room Visits

Y Y Y Y

14 Eligible for Well-Child Check

Identifies clients that are eligible for the well-child check performance measure

Y Y Y Y

15 Well-Child Checks

Number of Well-Child check claims submitted within the 12 months reporting period

Y Y Y Y

16 MMP Enrolled

Identifies clients enrolled in the MMP population

Y Y Y Y

17 Client Age Client's Age Y Y Y Y

18 Months Medicaid Eligible

Number of months clients were on Medicaid within the past 12 months

Y Y Y Y

19 Total Paid Total Medicaid Dollars Paid Y Y Y Y

20 Total Paid PMPM

Total Medicaid Dollars Paid Divided by Total Member Months

Y Y Y Y

21 IP Admits Number of Inpatient Admissions

Y Y Y Y

22 Continuous Months ACC Enrolled

Greatest number of continuously enrolled days in the ACC program within the 12 month reporting period

Y Y Y Y

23 Eligible for Postpartum

Identifies clients that are eligible for the Postpartum check performance measure

Y Y Y Y

24 Postpartum Number of Postpartum Y Y Y Y

37


Visits check claims submitted within the 12 month reporting period

25 Disabled Identifies disabled clients Y Y Y Y

26 SNF Agency

Last skilled nursing facility (SNF) to render services to the client

Y Y Y Y

27 Last SNF Service Date

Date which latest SNF service was rendered to the client. Service must have been rendered within 90 days of the report’s claims paid through date

Y Y Y Y

28 BHO Agency

Last Behavioral Health Organization (BHO) to render services to the client

Y Y Y Y

29 BHO Last Service Date

Date which latest BHO service was rendered to the client. Service must have been rendered within one year of the report’s claims paid through date

Y Y Y Y

30 Waiver Agency

Last waiver organization to render services to the client

Y Y Y Y

31 Last Waiver Service Date

Date which latest waiver service was rendered to the client. Service must have been rendered within one year of the report’s claims paid through date

Y Y Y Y

32 Home Health Agency

Last home health organization to render services to the client

Y Y Y Y

33 Last Home Date which latest home Y Y Y Y

38


Health Service Date

health service was rendered to the client. Service must have been rendered within one year of the report’s claims paid through date

34 Expansion Eligible Indicator

Indicates whether ACC enrolled client meets the Medicaid Expansion eligibility criteria. A "Y" indicates client became eligible for the ACC due to CO's implementation of Modified Adjusted Gross Income (MAGI) – based eligibility levels, where Federal Poverty Level (FPL) levels have been raised which allowed more people to qualify for Medicaid.

Y Y Y Y

39

Postpartum Members Note: The description is not displayed in the dashboard.



Y Y Y Y





5 Client Gender


6 REGION Name


Y Y Y Y


Y Y Y Y


Y Y Y Y

9 PCMP Name Primary Care Medical Provider Name (Prefer DBA)

Y Y Y Y

10 PCMP Address


Y Y Y Y


12 PCMP Zip Code




40


14 Date of Postpartum Visit

Date of Postpartum Visit

Y Y Y Y

15 Date of Child Birth

Date of Child Birth Y Y Y Y














13 Date of Child Birth (Range of Dates) Y Y Y Y




Y Y Y Y

41




Client’s Phone Number

Y Y Y Y


5 Client Gender Client’s Gender Y Y Y Y

6 REGION Name


Y Y Y Y


Y Y Y Y


Y Y Y Y

9 PCMP Name Primary Care Medical Provider Name (Prefer DBA)

Y Y Y Y

10 PCMP Address


Y Y Y Y


12 PCMP Zip Code




14 Date of Postpartum Visit

Date of Postpartum Visit

Y Y Y Y

15 Date of Child Birth

Date of Child Birth Y Y Y Y



42

Primary Care Medical Provider (PCMP) Directory Note: The description is not displayed in the dashboard.

Data displayed in the dashboard Field Description HCPF CA REGION

1 PCMP ID PCMP Number Y Y Y

2 PCMP Name PCMP Name Y Y Y

3 PCMP Doing-Business-As Name

PCMP Doing-Business-As Name

Y Y Y


Y Y Y

5 PCMP Address PCMP’s Address Y Y Y

6 PCMP City PCMP’s City Y Y Y

7 PCMP State PCMP’s State Y Y Y

8 PCMP Zip Code PCMP’s Zip Code Y Y Y

9 PCMP Phone Number

PCMP Phone Number Y Y Y

10 PCMP Type Description

PCMP’s Type Description

Y Y Y

11 PCMP Specialty Description

PCMP’s Primary Specialty Description

Y Y Y


Y Y Y

13 Number of Attributions

Number of ACC Members Attributed to Provider in the selected region

Y Y Y

43

Data displayed in the dashboard Filter/Search By HCPF CA REGION

1 PCMP ID (Drop down) Y Y Y

2 PCMP Name (Drop down) Y Y Y

3 REGION ID (Drop down) Y Y Y

3 PCMP Doing-Business-As Name (Wildcard Match)

Y Y Y

4 PCMP NPI (Drop down) Y Y Y

5 PCMP Address (Wildcard Match) Y Y Y

6 PCMP City (Multi-Values Drop down) Y Y Y

7 PCMP Zip Code (Wildcard Match) Y Y Y

8 PCMP Phone Number (Wildcard Match) Y Y Y

9 PCMP Type Description (Wildcard Match) Y Y Y

10 PCMP Specialty Description (Wildcard Match) Y Y Y

Note: The description is not displayed in the dashboard.

Data fields available on export Field Description HCPF CA REGION

1 PCMP ID PCMP Number Y Y Y

2 PCMP Name PCMP Name Y Y Y

3 PCMP Doing-Business-As Name

PCMP Doing-Business-As Name

Y Y Y


Y Y Y

5 PCMP Address PCMP’s Address Y Y Y

6 PCMP City PCMP’s City Y Y Y

44

Field Description HCPF CA REGION

7 PCMP State PCMP’s State Y Y Y

8 PCMP Zip Code PCMP’s Zip Code Y Y Y

9 PCMP Phone Number

PCMP Phone Number Y Y Y

10 PCMP Type Description

PCMP’s Type Description

Y Y Y

11 PCMP Specialty Description

PCMP’s Primary Specialty Description

Y Y Y


Y Y Y

13 Number of Attributions

Number of ACC Members Attributed to Provider

Y Y Y

45

Well-Child Check Members Note: The description is not displayed in the dashboard.



Y Y Y Y

2 Client Name





5 Client Gender


6 REGION Name


Y Y Y Y


Y Y Y Y


Y Y Y Y

9 PCMP Name


Y Y Y Y

10 PCMP Address


Y Y Y Y


12 PCMP Zip Code


13 PCMP Phone


46


Number

14 Date of Last WCC

Most recent Well Child Check date

Y Y Y Y

















Y Y Y Y


47





5 Client Gender


6 REGION Name


Y Y Y Y


Y Y Y Y


Y Y Y Y


Y Y Y Y

10 PCMP Address


Y Y Y Y


12 PCMP Zip Code




14 Date of Last WCC

Most recent Well Child Check date

Y Y Y Y



48

Troubleshooting and support You can resolve many issues with Provider Engagement Solution by trying troubleshooting procedures.

Tip: Refer to the topics in this section before you contact Product Support. For support information, see Contacting product support.

Contacting product support Product Support website

(http://truvenhealth.com/support/portal)

This self-service option for healthcare solutions is available seven days a week, 24 hours a day. Check this site periodically for the latest product and support information. If you cannot find what you are looking for in this document, you can request assistance directly from this site. If you are not currently registered to access this site, contact Product Support for an ID and a password.

Email ([email protected])

Email to Product Support is monitored during standard business hours. Provide the following information in the subject line: the product name and the priority level that is assigned to the problem. If the message concerns a previous contact with Product Support, provide the incident number.

Standard Business Hours

Standard business hours are 8:00 AM to 8:00 PM EST, Monday through Friday, excluding holidays.

Use the Customer Support links on http://truvenhealth.com to request access to the Product Support Portal. Use the Portal to:

• Submit product support issues or questions. • Review and update the status of support issues. • Communicate more effectively with Product Support. • Find product information and updates. • Find solutions to common product issues by using the Knowledge Base. • Maintain your personal contact information such as phone number, mailing address, and

email address. • Access time-sensitive information in Product Bulletins.

http://truvenhealth.com/support/portal

mailto:[email protected]

http://truvenhealth.com/

49

Performance issues or System Unavailable message Problems can occur with product performance when you're working with the My Members dashboard.

Symptoms These can include unusually slow loading (for example, greater than 60 seconds), or the display of a System Unavailable message.

Resolving the problem Try loading the dashboard again and allow Provider Engagement Solution adequate time to generate and display the dashboard.

Problems accessing certain dashboards Problems can occur when some dashboards are accessible, but other dashboards aren't.

Symptoms The product home page does not include an option to access and open a specific dashboard. Some users in your organization might be able to access all dashboards, while other users might access only certain dashboards.

Causes Access to dashboards and product data is controlled by user group.

Resolving the problem This might not be a problem, but result from your permissions. If you have questions, contact your Watson Health representative.

Problems with crosstab documents Problems can occur with downloaded documents in crosstab (CSV) format from the My Members dashboard.

Symptoms When you open the crosstab document, you find that cells in the file include only the text "Back".

Resolving the problem Click the report spreadsheet to make sure that the focus is in the correct location.

Proxy error with the My Members dashboard Problems can occur when you try to download the My Members dashboard as a PDF or an image.

Symptoms A Proxy Error message appears when you try to download the dashboard. This can occur when the dashboard contains a large volume of data.

50

Resolving the problem Try these steps:

• Apply a filter to the large My Members listing, to reduce the data volume. • Download the dashboard in crosstab (CSV) format to get the full listing.

51

Find it online You can find additional IBM Watson Health resources online.

Exploring resources in Communities Provider Engagement Solution provides various resources for customers that use online communities. Information you'll find includes product information, expert forums, an events calendar, and more.

Communities are for registered Provider Engagement Solution users. This site is not open to the general public. The first time that you visit the communities, click Register, and follow the instructions on screen to register.

Tip: Take a moment and set up your Communities profile. Benefits include receiving notifications about events or blog updates, and identifying yourself to other product and Communities users.

Procedure

1. From any Provider Engagement Solution page, in the menu bar, click the icon next to your organization name.

2. Click My Communities. 3. On the Welcome page, sign in using your Communities user name and password. 4. On the Communities home page, access the resources that you want. 5. When you're done using Communities for now, click Logout.

Connecting with IBM Sales The Provider Engagement Solution site supports a wide variety of healthcare products, by using quality data from diverse data sources. Expand your strategic insights and understanding by using additional IBM Provider Engagement Solution products and services. If you have questions, including product licensing, subscriptions, and data use agreements, contact IBM Sales.

Sales Support and Inquiries (https://truvenhealth.com/Contact/Sales)

Connect with an IBM representative (https://www.ibm.com/connect/ibm/us-en/?lnk=fcw)

Learning through IBM Training Education through IBM Training helps you get the most out of your organization's IBM Provider Engagement Solution products. Our training empowers healthcare professionals to find answers, gain insights, be more successful in delivering better quality care.

For information about learning through IBM Training:

1. At the bottom of any page on the Provider Engagement Solution site, click Training.

https://truvenhealth.com/Contact/Sales

https://www.ibm.com/connect/ibm/us-en/?lnk=fcw

52

2. Follow the instructions on-screen.

53

Index

A

ACC, Accountable Care Collaboration, 6

access control, 5

Accountable Care Collaboration (ACC), 6

ADCG, Aggregated Diagnosis Cost Grouper, 6

Aggregated Diagnosis Cost Grouper (ADCG), 6

alerts, 19

assessing organization performance, 8

attributions, 22

B

behavioral health organization, 6

business questions, 9

C

comma-separated value, 6

common tasks, 1, 9

Communities, 51

concepts, 6

copyrights, 2

crosstab documents, 49

CSV, comma-separated value, 6

D

dashboards, 6, 7

access to, 49

selecting, 9

visual data, 7

data dictionary, 24

data sources, 4

details

medical, 19

Performance Dashboard, 9

diagnostic cost group, 6

diagnostic cost groups, 7

documentation, 23

E

episodes of care

overview, 7

Physician Health Record, 19

evaluation and management, 6

exploring data, 7

F

federal poverty level, 6

filtering

lists, 23

troubleshooting, 49

forums, 51

H

HCPF, Health Care Policy and Financing, 6

Health Care Policy and Financing (HCPF), 6

Help, 23

K

key performance indicators (KPI), 6, 7, 13

KPI Performance dashboard

54

details, 9

overview, 11

KPI Trends Report, 13

KPIs, key performance indicators, 6, 7, 13

L

legal, 2

M

measures, 7

Medical Episode Grouper (MEG), 7

Medicare-Medicaid Program, 6

MEG, Medical Episode Grouper, 7

methodology, 4

Modified Adjusted Gross Income, 6

My Members dashboard, 16

N

National Provider Identifier, NPI, 6

NPI, National Provider Identifier, 6

number of attributions, 22

O

opportunities, 10

Other Program Measures

measures, 7

overview, 11, 18

P

Patient Health Record, 6, 19

PCMP Directory dashboard, 22

PCMP, primary care medical provider, 6, 8

per thousand per year (PKPY), 6

performance

key performance indicators, 7

performance assessment, 8

system issues, 49

targets, 8

per-member per-month, 6

permissions, 5

personal identification number, 6

PKPY, per thousand per year, 6

primary care medical provider (PCMP), 6, 8, 22

product benefits, 2

product overview, 2, 3

product support, 48, 51

proxy error, 49

R

RAE, regional accountable entity, 6

references

data dictionary, 24

terminology, 6

regional accountable entity (RAE), 6

reports

dashboards, 7

selecting, 9

visual data, 7

resources, 51

user forums, 51

S

Sales at IBM, 51

skilled nursing facility, 6

state fiscal year, 6

55

support, 51

System Unavailable message, 49

T

targets, 8

technical support, 48

terminology, 6

training, 51

troubleshooting, 48

U

user forums, 51

user groups, 5

user levels, 5

utilization, 8

W

well-child checks, 6

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