Achieving the Outcome We Deserve – How to Navigate and use Data Effectively PRESENTED BY: MARY BUCKLER, LAUREN MCGUIRK & LISA SANDERS

KPCA has contracted with Precision Healthcare Delivery to support a Quality Improvement Initiative focused around the 2016 value based MCO contracts. Please welcome two of Precision’s QI Specialists, Lauren McGuirk and Lisa Sanders, here today to speak on the initiative and the data they provide.

Tableau Download & FTP Reporting Mechanism

Downloading Tableau

Finding & Opening Your Packaged Workbook

What is Included?

How to Navigate?

FTP Reporting Mechanism

What Can I Do With This Report?

How Do I Move to Another Report?

How Do I Download To Excel?

How Do I Print?

Plan-Do-Study-Act (PDSA) Worksheet and Example HOW TO IMPLEMENT CHANGE BY FOLLOWING 4 SIMPLE STEPS

What is being implemented?

PLAN:

DO:

STUDY:

ACT:

Example: PLAN

Example: DO

Example: STUDY

Example: ACT

Clinic Feud

Question #1 ON WHICH PRECISION REPORT CAN YOU FIND WELLCARE AND AETNA CARE GAPS?

Answer #1 DASHBOARD REPORTS

Question #2 HOW DO YOU KNOW WHEN THERE ARE NEW REPORTS FOR YOU TO ACCESS ON YOUR FTP SITE?

Answer #2 ANNOUNCEMENT SENT BY KELLIE DOLIGALE AFTER DROPS

Question #3 WHAT DOES PDSA STAND FOR?

Answer #3 PLAN, DO, STUDY, ACT

Question #4 WHERE ON THE FTP SITE WOULD YOU FIND THE DASHBOARD REPORT?

Answer #4 QUALITY REPORTS FOLDER

Question #5 ON THE NEW FTP REPORTING MECHANISM, THE HOME PAGE/MAIN MENU HAS 5 LARGE REPORT (BLUE) BUTTONS. YOU CAN CLICK ON THESE BUTTONS TO ACCESS REPORTS. NAME ONE OF THE REPORTS.

Answer #5 PANEL REPORTS – LIST OF ASSIGNED PATIENTS BY HEALTH PLAN. THERE IS AN INDICATOR OF WHETHER OR NOT THE PATIENT HAS BEEN SEEN BY A PROVIDER IN YOUR PRACTICE. ER REPORTS - ALSO CALLED “PROVIDER OVERVIEW” THIS REPORT WAS FORMERLY “PATIENTS NOT SEEN” THIS REPORT IS BROKEN DOWN BY PROVIDERS WITHIN THE PRACTICE, WHETHER ACTIVE OR TERMED, AND THEIR PERCENTAGE OF PATIENTS WHO WENT TO THE ER WITHIN THE DESIGNATED 12-MONTH PERIOD BUT WERE NOT SEEN BY THEIR PCP. ER PATIENT INFORMATION - LIST OF PATIENTS WHO HAVE VISITED THE ER WITHIN THE DESIGNATED 12 MONTH PERIOD, HOWEVER, HAVE NOT HAD A VISIT AT THEIR PCP’S OFFICE. INPATIENT REPORT ALL PATIENTS/ALL CLAIMS - THIS WILL EXECUTE A QUERY OF ALL ASSIGNED PATIENTS AND THEIR CLAIMS FOR THE 12-MONTH PERIOD

Question #6 ON THE NEW FTP REPORTING MECHANISM, CERTAIN REPORTS CAN BE EXPORTED TO EXCEL. HOW DO YOU KNOW WHICH REPORTS HAVE THAT CAPABILITY?

Answer #6 TABS WITH GREEN UNDERLINE CAN BE EXPORTED TO EXCEL

Question #7 WHICH BROWSER DO YOU USE TO ACCESS THE FTP SITE?

Answer #7 INTERNET EXPLORER

Question #8 WHERE ON THE ER/INPATIENT UTILIZATION REPORTS WOULD YOU ULTIMATELY WANT TO SEE YOUR CLINIC?

Answer #8 THE BOTTOM SINCE THIS MEANS UTILIZATION IS LOWER.

Question #9 WHERE ON THE FTP SITE WOULD YOU FIND THE MEDICAL LOSS RATIO (MLR) REPORT?

Answer #9 FINANCIAL REPORTS

Question #10 WHY IS THE MLR REPORT A USEFUL TOOL FOR THE IPA AND YOUR CLINIC TO UNDERSTAND?

Answer #10 AT THE IPA LEVEL IT ALLOWS YOU TO SEE IF YOU ARE GENERATING A SURPLUS OR DEFICIT. A DEFICIT MEANS YOU EXCEEDED YOUR SPENDING LIMIT AND THERE WOULD BE NO BONUS DOLLARS AVAILABLE FOR DISTRIBUTION. AT THE CLINIC LEVEL YOU ARE ABLE TO IDENTIFY WHERE PATIENTS ARE SPENDING THEIR DOLLARS AND WHERE IMPROVEMENTS CAN BE MADE WITHIN THE CLINIC TO CONTROL SPENDING.

Question #11 HOW WOULD YOU USE THE ER PATIENT CONTACT REPORT LIST?

Answer #11 YOU WOULD USE THAT LIST TO CONTACT THOSE PATIENTS THAT ARE ATTRIBUTED TO YOU, BUT YOU HAVE NOT SEEN IN YOUR OFFICE, TO COME IN TO SEE YOU.

Tie Breaker #1 WHAT DO THEY DIFFERENT COLORS (RED, YELLOW & GREEN) MEAN ON THE DASHBOARD REPORT?

Tie Breaker #1 RED = YOUR CLINIC’S RATE IS BELOW THE IPA TOTAL RATE AND BELOW THE THE 75 TH PERCENTILE. YELLOW = YOUR CLINIC’S RATE IS ABOVE THE IPA TOTAL RATE AND BELOW THE 75 TH PERCENTILE. GREEN : YOUR CLINIC’S RATE IS ABOVE THE IPA TOTAL RATE AND ABOVE THE 75 TH PERCENTILE. *MORE GREEN-SHADED RATES YIELD THE BEST PAYOFFS FROM THE MCOS.