Overview
The Sales Spotlight tab and the Sales Spotlight email have two sections of metrics:
- Top Metrics that help you to evaluate the selected hospital.
- Relationship metrics that help you to create a story about your chosen "My Agency."
Click on the Metric name below to immediately navigate to the details for that metric.
- Top Physician Metrics
- Readmission Rate: 30-Day - the percentage of patients readmitted into any hospital within 30 days of their discharge from the selected inpatient facility during the two-year reporting period.
- SNF Utilization - Percentage of stays that were discharged during the one-year reporting period (ending in the specified quarter) and received skilled nursing services within 30 days of discharge from the facility
- Top SNF Destinations - SNFs with the highest percentage of patients who were admitted to the SNF within 30 days of discharge from the selected hospital during the one-year reporting period
- Highest Readmission Rate MS-DRGs - List of MS-DRGs associated with the highest 30-day readmission rates for the selected hospital
- Annual Patient Count - Count of distinct Medicare FFS patients discharged from the facility during the one-year reporting period, by claim type
- Patient Risk Score - Average Hierarchical Condition Category (HCC) Patient Risk Score for this hospital/agency (based on claim type)
- "My Agency" Relationship
- 6-month Risk Adjusted Total Patient Cost Following SNF - The average total risk-adjusted Medicare spend per patient during the 6 month follow-up period after admission to the chosen SNF.
- SNF Readmission Rate: 30-days - Rate at which the listed SNF's patients came from an inpatient setting, were admitted to the selected SNF, and were subsequently readmitted to any hospital within 30 days of the first inpatient discharge (based on 2-years of discharges, shifted back 30 days)
- Average Medicare Days per Stay - The average number of Medicare days per stay the selected SNF's patients spent receiving skilled nursing services, for patients that completed their stay during the one-year reporting period
In this article we take a deep dive into each metric; definition, calculation, and where to find each metric in Marketscape.
Some of these metrics include trend information and county or state benchmarks.
Understanding the Metrics - Section 1 - Top Hospital Metrics
What is in here?
The Hospital Top Metrics in the Sales Spotlight tab on a Hospital Analyze page and the content of the Sales Spotlight email are different. The table below shows the metrics and identifies which metric can be found in each location. In addition, when you click on Conversation Starters, metric names are changed.
Metric | Sales Spotlight on Analyze Page | Sales Spotlight Email |
Click on an image to expand it
Each Header below is a link to the content in the article below. |
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Patient Volume | Appears when you click on the Conversation Starters toggle. | |
Annual Patient Count (FFS) | Not included in email - The content is partially included in Patient Volume | |
Readmission Rate: 30-days | ||
SNF Utilization | ||
Top SNF Destinations | - Called Top SNF Destinations Last 12 Months | |
Highest Readmission Rate MS-DRGs | ||
Patient Risk Score | Not included in email |
Usage Note
When you click on the toggle to turn on Conversation Starters there are a few outcomes:
- Any Top Hospital Metrics not included in the Sales Spotlight email are removed from view.
- Some metrics that are additional in the email will be displayed. (For example, Patient Volume.)
- All other metrics will be displayed in the format of the Sales Spotlight email.
Patient Volume
Definition
Patient Volume includes two metrics:
- Skilled Nursing Patients is the count of distinct Medicare FFS Patients treated at the selected facility during the one-year reporting period who received skilled nursing services within 30 days of discharge. Note: The discharge reporting period is shifted back 30 days to allow for post-acute events. - In the examples above, this count is 829 patients.
- Medicare FFS Patients is the count of distinct Medicare FFS patients discharged from the selected facility during the most recent one-year reporting period.
Calculation
Both of these metrics are unique counts from Medicare claims submitted during the one-year reporting period.
Where can I find this metric?
In addition to the Hospital Sales Spotlight email, you can find these metrics:
- On the Hospitals and Agencies Explore page. The metrics are Skilled Nursing Patients, and Annual Patient Count (FFS).
- On the Analyze Page for the selected facility, under the Patient Population tab, there is a table called Patient Volume which includes these counts as well as facility mortalities and quarterly counts of the same metrics.
Annual Patient Count (FFS)
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Not included in SS Email | Not included with Conversation Starters on Analyze page. |
Definition
These metrics are the counts of distinct patients discharged from the selected hospital during the one year reporting period. To get a better picture of the overall patient population of the hospital we include a count for inpatient care and outpatient care.
You can't add Inpatient and Outpatient counts together to get a total number of patients. A large number of patients treated by any hospital will receive both inpatient and outpatient care and will be included in each separate count. If you add the two counts together, those patients would be counted twice.
Calculation
Each of these counts is calculated from claims submitted during the one year reporting period.
Details
Along with the patient counts, the Annual Patient Count Sales Spotlight includes an annual difference indicator.
Where can I find this metric?
In addition to the Hospital Sales Spotlight on the Analyze page, you can find these metrics:
- On the Hospitals and Agencies Explore page. The metric is called Annual Patient Count (FFS). Each different claim type submitted by any organization will be presented in the Explore table in a separate row for the same NPI. For example, a single hospital will have a row for inpatient metrics and a row for outpatient metrics
- On the Analyze Page for the selected facility, under the Patient Population tab, there is a table called Patient Volume which includes an option to show either inpatient counts or outpatient counts, including mortality counts and quarterly counts.
Readmission Rate: 30 Days
For a lot more information, see Readmission Rates.
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Hospital Sales Spotlight on the Analyze page
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Definition
A readmission is a care event where a patient is admitted to any inpatient stay within 30 days of being discharged from a prior inpatient stay. The Trella Health Readmission Rate is a percentage measurement of readmissions against a select population. Specifically, it is the percentage of all patients discharged from the hospital who were readmitted to another inpatient hospital within 30 days of the initial discharge.
Since this readmission rate applies to a hospital, it is not necessary that any other medical care was provided between
Calculation
The calculation for a Readmission rate is:
Details
We include the state's average readmission rate for comparison. The metric is calculated from all hospitals in the state in which the selected hospital resides. With Conversation Starters on (and in the Sales Spotlight email) we state whether the selected hospital's readmission rate is higher or lower and include the difference.
Where can I find this metric?
In addition to the Sales Spotlight on the Analyze page and the Sales Spotlight email, you can find the Readmission Rate for your selected hospital in the following location:
- On the Explore page, in the row for your selected hospital in the column Readmit OR Hospitalization + 30 Rate. Because this table includes facilities other than hospitals, this column does double duty and will include the Readmit (Readmission) rate for hospitals, and the Hospitalization Rate + 30 for any other facilities.
- Under the Utilization and Quality tab, there is a table called Trended Readmission Rate that includes trended rates by quarter. The metric isn't the same, but this table provides a different view on the same insight.
SNF Utilization
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Definition
This metric is the percentage of patients discharged from the selected hospital who were admitted to SNF care within 30 days of discharge during the one year reporting period. We limit the period between discharge and admission in order to maintain a logical proximity between inpatient care and subsequent SNF care.
Calculation
The calculation for this metric is straightforward.
Details
Along with the performance percentage, the SNF Utilization Sales Spotlight includes an annual difference indicator. From the image above, we can see that the average for the most recent reporting period is 17.28%, which is 0.90% lower than the previous years performance, as indicated by the red arrow pointing down.
If the number is up from the previous year, you will see a green arrow beside the percentage change.
Each of the Sales Spotlight insights includes a comparison with county or state benchmarks, calculated from all hospitals in the same county/state as the selected hospital. From the image above, you can see that the state average is 17.64%.
With Conversation Starters on or within the Sales Spotlight email, the county/state comparison is presented as a sentence providing the hospital performance metric, the comparison benchmark, and the difference.
Where can I find this metric?
In addition to the Hospital Sales Spotlight insights, you will find SNF utilization metrics in the following location:
- On the Analyze page, under the Utilization and Quality tab, there is a table called Skilled Nursing Utilization. Although this tables does not include the exact metric, it has utilization metrics calculated for trended quarters.
Top SNF Destinations
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Definition
In all versions of this Sales Spotlight insight you will find the same content. The listed SNFs are the agencies that admitted the largest percentage of patients from the selected hospital within 30 days of discharged during the one year reporting period.
For each SNF, we provide a numbered rank, the count of patients admitted to the listed SNF, and the Affiliation, which is the percentage of the hospitals discharges admitted to the listed SNF. (See calculation below.)
If your selected "My Agency" is not in the top three SNFs, it will be included in the list along with the to three. (See the example at right.) - This example is for a different hospital and agency. |
Calculation
We count the number of patients from each hospital who are admitted to each SNF within 30 days of discharge. From those counts, we can easily calculate the percentage of SNF patients admitted at each facility. The top three are then added to the Top SNF Destinations Sales Spotlight insight.
The Affiliation metric is the percentage of patients discharged from the hospital who were admitted to any SNF within 30 days who were admitted to the listed SNF, or, in short, the percentage of all the hospital's SNF patients who were admitted to the listed SNF.
Where can I find this metric?
This insight isn't a "metric" it is a list of agencies who admitted patients discharged from the selected hospital. The complete list of SNFs that admitted patients, with a lot more related metrics, can be found on the Analyze page under the Destinations tab in the table, SNF Destinations.
Highest Readmission Rate MS-DRGs
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Definition
This insight contains the three MS-DRGs associated with the highest 30-day readmission rates for the selected hospital.
This insight includes the following:
- MS-DRG - The three digit code for the DRG
- MS-DRG Description - The name/description of the MS-DRG
- Distinct Patient Count - The count of patients discharged from the selected hospital where the listed MS-DRG was the primary diagnosis on the claim.
- Percentage of patients - The percentage of discharged patients for whom the listed DRG was their primary diagnosis (See calculation)
- Readmission Rate - The percentage of discharged patients for the listed DRG who were readmitted to inpatient care within 30 days of discharge from the selected hospital. (See calculation)
Calculation
Distinct Patient count
This is a count of distinct patients who were diagnosed with the listed DRG, taken from discharge claims.
Percentage of Patients
The percentage of all discharged patients who were diagnosed with the listed DRG.
Readmission Rate
This metric is calculated for the patients with the listed DRG, not all discharges from the selected hospital.
Where can I find this metric?
In addition to the Sales Spotlight email and Sales Spotlight on the Analyze page, you can find the table of all MS-DRGs with related metrics under the Utilization & Quality tab in the table, Inpatient MS-DRG Breakout.
Patient Risk Score
Definition
Risk Scores provide insight into the amount of care that can be expected for a patient population, and it helps calibrate a provider’s performance relative to its peers.
For more information, see Risk Scores and HCC.
Where can I find this metric?
In addition to the Hospital Sales Spotlight on the Analyze page, you can find these metrics:
- This metric can be found on the Explore page in the row for the selected hospital.
Understanding the Metrics - Section 2 - My Agency
Beneath the top metrics, which are designed to help you to evaluate the selected hospital, there is a section of metrics specific to your selected "My Agency."
You select your My Agency at the top of the Sales Spotlight section.
The My Agency selector will include all of your company's agencies. This allows you to choose which agency you want to evaluate against the selected hospital.
The metrics in this sections are created from the selected hospital and the chosen "My Agency." More specifically, comparisons are drawn between your chosen agency and the top patient destinations for the selected hospital. You need to match your agency and hospital carefully.
If you select a local hospital from which your agency admits patients, the comparisons in this section will be made to other agencies (the top three) from the same locale. In this case, your performance will be evaluated against your direct competitors.
If you select a hospital from a thousand miles away, you will still see comparative metrics between your agency and the top three agencies for the selected hospital. You might do this if you are considering moving into the area and want a "what-if" comparison.
The following image shows the selected hospital and the chosen "My Agency."
Details
Two important observations from the image above:
- The first row of insights are calculated for all diagnoses, or, the metrics are calculated for all patients. IF there are metrics that we can calculate for one of the top three highest MS-DRG Readmission metrics, we will include insights in additional rows. Since the second row only includes Average Medicare Days per Stay, that means that we did not have enough raw data to calculate other insights for the specific diagnosis. Since the other two top MS-DRG Readmission rate metrics do not appear, we did not have enough from the raw data to create any insights for the additional diagnoses.
- The Inn at Sarasota Bay did not have any favorable metrics against competitors among the other top three SNFs. As a results, no competitive metrics are shown for other SNFs. The Inn at Sarasota Bay is compared against state and county averages.
To demonstrate comparative metrics against competitors, examples for the remainder of the article will use a different SNF as our chosen "My Agency."
Understanding the Metrics
There are three metrics included in this section that are calculated against all patients discharged from the selected hospital.
Under the Sales Spotlight tab with Conversations Starters off, the Insights contain the relevant metrics. With Conversation Starters on, or in the Sales Spotlight email, the same metrics are compared to a listed top three agency and stated as a comparison. Your agency is presented to show your competitive advantage, first against a competitor, then against a county or state average. See images in the table below to compare the difference between Conversations Starters on and off.
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6-Month Risk Adjusted Total Patient Cost Following SNF
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Definition
This dollar amount is the average total, risk-adjusted, Medicare spend per patient during the 6-month follow-up period after admission to your agency. From another angle, consider a single patient experience. The patient is admitted to SNF care on January 1. From that day, and for the next six months, we add up the costs from every Medicare FFS claim for that patient. This will include SNF costs, of course, but it could include Physician visits, other post-acute stays, inpatient stays, DME, everything.
The following image shows a sample of total patient costs from our Report page Total Patient Costs, which includes the same metric(s) displayed comparatively for the sample SNF.
To get the average for all patients, we add up the total patient costs for all patients admitted during the one-year reporting period and divide by the number of patients.
The image above is not the same SNF used in the rest of the article.
Calculation
This one is simple, we look at every claim submitted during the reference period for each patient, sum them together and divide by the number of patients.
Details
Comparison
Notice that with Conversation Starters on or off we have the same information presented. The Total Patient Cost for Rest Haven patients is $33,631. This is 12.33% lower than their competitor, Pleasant Acres. The dollar amount for Pleasant acres is provided and the green arrow indicates that our chosen "My Agency" is performing better.
We try to show the best possible scenario for the chosen "My Agency." If the chosen "My Agency" performs worse than a competitor, that will be shown in the metric and listed in the Conversation Starter. The percent difference will be red, and the arrow will be red, pointing up. Also, since the "My Agency" doesn't outperform a competitor, the comparison will be made to the state average The following example of this is from the Hospital Sales Spotlight for a home health agency and shows what a poorly performing agency looks like:
Where can I find this metric?
On the Reports page is a tab called Total Patient Cost which provides more information and additional options for looking at patient cost metrics. The following image shows the details available on that page.
SNF Readmission Rate: 30-Days
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Definition
A readmission is a multi-claim event where a patient is discharged from inpatient care, is admitted to post-acute care, in this case, to a SNF, and is then re-admitted to inpatient care within 30 days of the initial discharge. The rate is the percentage of all applicable patient who were readmitted.
Since this is a readmission rate specific to the "My Agency" SNF, the readmission rate is the percentage of all patients who were admitted to "My Agency" during the 30 day period between inpatient discharge and inpatient readmission who were readmitted. This is a rate based on all patients admitted to "My Agency" not just patients from the selected Hospital.
Calculation
The SNF Readmission rate for "My Agency" is calculated on the population of patients who were admitted to the SNF for care.
Details
Competitive Comparison - To the left of the readmission rate for "My Agency" is a comparison with one of the "Top Three" SNF destinations for the selected hospital. The competitor is listed beneath the readmission rate for "My Agency" with the competitor's readmission rate. The comparison shows that "My Agency" had a readmission rate 1.20% less than my competitor. The green arrow indicates the favorable comparison and points down to indicate that my readmission rate is lower.
If a favorable comparison doesn't exist for my agency against a competitor, then the comparison will be made with a county or state average, again, to show a favorable story. If "My Agency" does not have a favorable metric in comparison to competitors or the state or county benchmarks, a comparison will be shown for a benchmark metric and a red arrow will indicate that our readmission rate is higher than all comparisons, and we need to get to work to improve our performance.
Conversation Starters On - The Conversation Starters put the above comparison in a statement form.
Where can I find this metric?
In addition to the Sales Spotlight, "My Agency's" readmission rates can be found:
- On the Skilled Nursing Explore page, in the row for your agency, there are trended readmission rates. Although these are not the exact same rate, they provide additional insights into readmission rates for your agency.
- On the Analyze page, under the Insights tab.
- On the Analyze page, Under the Quality tab, there is a table of trended readmission rates. Although these are not the exact same rate, they provide additional insights into readmission rates for your agency.
Average Medicare Days per Stay
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Definition
This metric is the average number of Medicare days per stay the selected SNF's patients spent receiving skilled nursing services at the chosen "My Agency", for patients that completed their stay during the one-year reporting period.
Calculation
As an average, we count all patient days and divide by the number of patients.
Details
Competitive Comparison - To the left of the average count for "My Agency" is a comparison with one of the "Top Three" SNFs for the selected hospital. The metric included is a percentage difference between your chosen "My Agency" and the competitor listed below. The green arrow indicates that the metric is favorable for you. From the example below, my agency's average stay is 25.30% shorter than the listed competitor.
If a favorable comparison doesn't exist for my agency against a competitor, then the comparison will be made with a county or state average, again, to show a favorable story. If "My Agency" does not have a favorable metric in comparison to competitors or the state or county benchmarks, a comparison will be shown for a benchmark metric and a red arrow will indicate that our average number of days is higher than all comparisons. We need to get to work to improve our performance.
Conversation Starters On - The Conversation Starters put the above comparison in a statement form.
Where can I find this metric?
In addition to the Sales Spotlight, "My Agency's" readmission rates can be found:
- On the Skilled Nursing Explore page, in the row for your agency.
- On the Analyze page, under the Operational tab, there is a summary of metrics for the selected SNF. The metric is in that table.
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