Total Patient Cost For SNFs: Include the Inpatient Stay Pre-SNF Admission

Idea Center Question/Checklist

Responses

Is this a product enhancement/web, data adjustment, or new metric?

New metric

Name and description of metric.

The cost of the inpatient stay before the SNF admission

Who would use this (New or Current MSSPs or DCE's, physician group, health plan, specific client, etc.)?

Anyone interested in assessing SNF performance

Who's requesting this (internal idea or specific client)?

Sante - Mark Hansen

What is the client trying to solve? What is the problem they are facing?

Customer wants a more accurate segmentation of total patient costs for SNFs

Why do they need this?

INP-SNF patients will have different cost ranges than the overall INP discharged population - this data is not currently available

Do we have a form of this today (readmission rate vs risk adj, is it in Marketscape)?

Inpatient costs are included in the total patient costs

What benefits would this bring? (i.e. Enhance performance, Customer Retention/Value, New Business, New Industry/Market, Competitive Differentiator, etc.)

Customer retention

What provider types need this metric (Physicians, Hospitals, ACO's, etc.)?

SNF (other PAC explore pages could also use this metric)

Where does this data need to be reflected in the product (Explore, Analyze, etc.)?

Explore

What patient population should this be for (All FFS, Attributed to current ACO/DCE, Assigned bene's to an ACO or DCE, Attributed to new ACO/DCE, DCE population, etc.)

All FFS

What timeframe of data do they need - date range and type of data (latest complete performance year, rolling 12 months, quarterly, etc)?

rolling 12 months/FFS

Does this metric need to be risk adjusted, unadjusted, or both?

Both

Are there assumptions we should account for (i.e. For metrics that cross over years 2019 Assigned and 2020 Assigned Bene's to respective Quarters)?

N/a

Are there any exceptions (Exclude ACO's not active in 2018, providers no longer active, etc.)?

N/a

Indicate how to handle values where there is insufficient data or PHI (exclude all providers with <11 readmissions or replace all <11 with avg readmission rate)?

Standard

If going in explore, what EAV category tag should this show up under?

Currently total patient costs are under "diagnostic group" but this may be a good time to update the groupings via data clean up task

What is the impact of not doing this (client retention, lose a sale, etc.)?

Unable to allow customers a complete look during evaluating snfs

Is this a high, medium, low priority (must have, compliance requirement, etc.)?

High

Is there a defined date when this is needed by?

Not currently - but very nice to have and mentioned by Sante CEO

Additional Notes:

N/a