In many locations throughout the Trella Health Marketscape for Home Health, there are "total" counts that don't equal what seems to be the counts of all parts. The most simple example would be when the counts for four quarters don't equal the count of the entire year. The answer is below, but this article will break down a couple examples to help make sense of what we see.
Quarterly Patient Counts vs. Annual Patient Counts
Question - In this case, we expect the counts in the four quarters to add up to the One Year Total column. But, when we add the numbers for the four quarters, the total is 19,869 Medicare Patients, not the 16,151 in the Total column. Why?
Explanation - The reason is that all of the counts in these columns represent counts of distinct patients. If a patient was admitted into post-acute care in more than one quarter, each admission would be counted in the relative quarter, but only once in the "Total" column.
Observation - The size of the difference between the totaled columns and the One Year Total is interesting. All columns reflect one patient population. The difference between the two totals is indicative of a provider who is seeing a larger percentage of patients multiple times. If this percentage of visits outstrips other providers in the same specialty, that could suggest potential discovery through digging deeper.
For counts compiled over a time period, it is better to not think of the first column as a total, which implies that you are combining or adding the four columns. It is better to think of the metrics provided as an annual metric and quarterly metrics.
Claims don't add up
These claim type metrics can be found on the Explore page for physicians.
Question - The patient counts that are tied to each claim count look like divisions of the total. Why don't the three claim types add up to the Physician HHA Patients? In this example, the three claim types add up to 929, not 490.
Although this example is taken from Marketscape for Home Health, the same principle applies to the similar claims in Marketscape for Hospice and Marketscape for SNF.
Explanation - Although the counts in each of the claim type columns does represent distinct patients; for a given physician/patient pair, some claims could represent more than one claim type. For example, a claim that was the last one prior to admission that was within 90 days of admission would be counted in both columns; Patient 3 Months Prior and Last Claimed Patients. A single claim could therefore be counted in more than one column, but that patient would only be counted once under Physician HHA Patients.