Overview

The Patient Population tab of the Facility Analyze page contains patient demographics that make you the expert on your selected facility's patients. 

 In this article

As we usually do, we want to help you to understand the tables and metrics, with particular focus on how to use the content. This tab contains 6 tables that are described below in the section Understanding the Metrics. Usage ideas are immediately below the following menu of links to table content.

The Patient Population tab includes the following tables:

• Patient Volume - Historical counts of patients by four different criteria
• CMS Payer Mix - compares patient counts for Medicare FFS, Medicare Advantage, and Medicaid
• Patient Locations - County - percentages of patient's county of residence
• Diagnostic Breakout by Stay - counts of patient stays either by Trella Health Diagnostic Group or by MS-DRG for HHA patients discharged from the selected facility
• Chronic Conditions - counts and percentages of patients by chronic condition
• Patient Age Groups - Breakdown of patients by age

Each of these sets of metrics can be viewed as a table or as a chart.

Using Patient Population

The primary use of the Patient Population tab is to evaluate the selected facility, which will be a hospital, most of the time.* Each table under this tab provides a different perspective on the patients treated at the selected hospital. This allows to quickly align a hospital's patient population with your agency's area of strength or specialization, or, you can identify patient needs that could suggest areas for new initiatives of care.

Specific usage suggestions will be included under each table's description below.

* Both SNFs and home health agencies can be considered source facilities that will appear on the Facility Analyze page for Marketscape for Hospice. When these facility types have sufficient counts of patients discharged to hospice care, you can do a similar evaluation, but generally the SNF to hospice or home health to hospice path in the continuum of care doesn't include enough patients to create useful metrics.

Understanding the Metrics

Patient Volume

The Patient Volume table provides metrics on the population of Medicare FFS patients for the selected facility so you can gauge the facility's potential as a source of post-acute referrals. For each type of patient category in the rows, 8 quarters of patient counts are presented. The column to the far right provides the patient counts for the most recent year.

The top grey box labeled "Inpatient" is a drop-down button that will allow you to change the content of the table to patient counts for outpatient discharges.

The Annual Patient Count is not a total of the four quarters. Each column is a count of all distinct patients, which means that a patient could be counted (once) in more than one quarterly column and will only be counted once in the annual count. For mathy people, the count in the annual column, is the union of the most recent four quarters.

Patient counts are a reflection of referral potential. A larger population of distinct patients flowing through the continuum of care provides more opportunity to intervene and procure a referral. Hospice patient counts identify the actual count of patients who were discharged from the selected hospital and who were admitted to hospice care. The In-Facility mortalities count provides a different angle on the number of patients who may have been hospice appropriate. 

Connections

Distinct Patients

This number is the count of distinct Medicare patients treated by the facility during the quarter listed in the column header.

Hospice Patients

This is the count of distinct patients discharged from the selected facility who were admitted to hospice during the quarter listed in the column header. In order to create a logical proximity between the discharge and subsequent post-acute care, we only count patients in this row who were admitted to hospice within 30 days of discharge from the selected facility.

In-Facility Mortalities

This number is the count of patients who died while being treated at the selected facility. 

For those of you who want the details the counts in this row are for patients discharged from the selected facility with the following codes:

• 20 - Expired (Patient did not recover)
• 40 - Expired at Home (hospice claims only)
• 41 - Expired in a medical facility such as hospital, SNF, ICF, or freestanding hospice. (hospice claims only)
• 42 - Expired at place unknown (hospice claims only)

Keep in mind that this patient count includes, for example, accident victims who may not be relevant for consideration as a referral to hospice care.

Dual Eligible Patients

The metrics in this row are counts of distinct Medicare FFS patients who were discharged from the selected facility and were eligible for Medicaid coverage during the quarter specified in the column header.

CMS Payer Mix

This table shows the distinct patient counts for the following CMS payers:

• Medicare FFS
• Medicare Advantage
• Medicaid

The date for this dataset can be found in the table header.

  As a sales rep this table will help you understand the general payer mix of potential referral sources to better determine how your agency can partner with the selected facility.

Counts displayed are based on the most recent data available for 100% of FFS, MA, and Medicaid provided by CMS. Distinct patient counts are based on the FFS, MA, and Medicaid claims submitted by the NPI and therefore the same patient may be included in multiple payer groups during the same time period.

Patient Locations - County

The Patient Location - County table shows the percentage and counts of patients treated by the selected facility within the one year reporting period who resided in the listed county at the time their initial facility admission claim was filed. The one-year reporting period aligns with the end of the last quarter for the data set included in Marketscape Insights.

The patient percentages in this table are calculated from all Medicare claims for the selected facility, not just Hospice related claims.

Usage

At the most basic level, this table shows you the number of patients treated by the hospital that live in counties served by your agency. 

County

For the selected facility, this table contains the names of the counties and the percentage of patients for each county from the facility's total patient count.

Since these metrics are based on the patients' place of residence, it is possible to have counties from states other than the state of the facility's location. This will be especially true for facilities located in smaller states or near state lines.

What is "Other?"

In the image above there is a row called "other." For any counties that have <11 patients treated by the selected hospital, we aggregate all of those patients into the row call "other."

Watch Out!

If you look at the image above, you will notice Berks county, sixth from the bottom. For the selected hospital, there were zero hospice patients, but there is a 1% in the Percentage of Patients column. At first it seems that this is an error, but each of these metrics is calculated from a different patient population. 

• Hospice patients is a count of well, patients admitted to hospice
• Percentage of patients is the percentage of all patients treated by the selected hospital who reside in the listed county.

Diagnostic Breakout by Stay

This table provides a percentage breakout by Trella Health Diagnostic Category or by MS-DRG for all hospice stays of patients discharged by the selected facility who were admitted to hospice where the primary diagnosis on the claim aligns with the listed diagnostic category or MS-DRG.

For more information see, Trella Health Diagnostic Categories.

If the number of patients for a specific category is <11, that category will not be displayed in the table.

Usage

This table allows to quickly align a hospital's patient population with your agency's area of strength or specialization, or, you can identify patient needs that could suggest areas for new initiatives of care.

Chronic Conditions

This table includes the counts and percentages of patients treated at the selected facility who met the criteria for the listed chronic condition based on the CCW Chronic Condition algorithm.

Details

• You will notice that the percentages listed add up to far more than 100%. (And the whole table isn't being shown.) The reason for this is that every patient is counted for every chronic condition that applies. That is, patients aren't limited to one row.
• The algorithms used to create this table can be found at the Chronic Conditions Data Warehouse website.

Usage

This table allows to quickly align a hospital's patient population with your agency's area of strength or specialization, or, you can identify patient needs that could suggest areas for new initiatives of care.

Patient Age Groups

This table gives a simple breakout of the patients for the selected facility by age.