Overview
The Physicians Explore table is a powerful tool that allows you to find individual physicians or groups of physicians in your available markets.
For an overview of the features and tools on the Explore page, see The Explore page.
Understanding the Metrics
The following table includes all of the metrics currently available in the Physician Explore Table.
| Metric | Description |
| Name | This is the physician's name, as listed in CMS Provider Data (NPI) file. |
| NPI | National Provider Identifier number for the physician in the row. This is maintained by CMS. |
| County, ZIP Code, State, and City |
This is the county, ZIP Code, city, and state that the physician has listed as their primary location of practice. (as pulled from the NPI Registry file)
|
| Specialty | This is the specialty that the physician reported in their NPI registry record. |
| Assigned User | If the provider in the row has been assigned to a user in your company, that user's name will show up in this column. |
| % of Total Claims (Billing NPI) | This field is only populated with data when a group billing NPI is selected in the filters. This metric is the percent of claims for the selected billing NPI that originated from the physician listed in the row. |
| Physician Medicare Patients | This is the count of distinct patients for which the selected physician filed a Part B claim during the most recent one year reporting period. |
|
Physician HHA Patients |
This is the number of the named physician’s distinct patients who received home health services during the reporting period. It is limited to patients who were counted under the three claim types, Patients Followed, Patients 3 Months Prior, and Last Claimed Patients. As such, it is a union of these three claim types, not a total, because a patient could be counted under more than one claim type. |
|
Followed Patients |
This is the count of distinct patients who were admitted to home health services during the reporting period where the named physician is identified as the certifying physician on the home health claim. |
|
Patients 3 Months Prior |
Patients Three Months Prior is the count of distinct patients where the named physician treated the patient in the 3 months prior to the patient's home health admission. |
|
Last claimed patients |
This metric is the count of distinct patients for whom the named physician submitted the last professional claim prior to the patient's home health admission. |
|
Days per episode |
The average home health episode duration, in days, for patients who were discharged from a home health stay during the most recent four quarters and who were also treated by the named physician within 3 months of their home health admission. |
| Episodes per patient | The average number of concurrent HH episodes per patient for patients discharged from a HH stay during the most recent four quarters who were also treated by the named physician within 3 months of their HH admission. |
|
Average Nurse Visits per Episode (Column name "Nurses") |
This metric is the average number of skilled nursing visits per home health episode for patients who were treated by the named physician within 3 months of their home health admission. |
|
Average Therapist Visits per Episode (Column name "Therapists") |
This count is the average number of therapy (PT, OT, SLP) visits per home health episode for patients who were treated by the named physician within 3 months of their home health admission. |
| HHA Utilization 3 Months Prior |
This is the percent of this physician's patients who received home health services during the most recent four quarters and were treated by this physician within 3 months of admission to home health. The calculation is Patients 3 months prior divided by Physician Medicare Patients.
|
|
HHA's Receiving > 10 Patients |
This is the count of home health agencies who admitted 10 or more patients treated by this physician where the physician had treated the patient within three months of home health admission. |
| Level of Affiliation |
This metric reflects the highest percentage share of home health patients received by any one home health agency, who were treated by this physician in the 3 months prior to the patient's home health admission.
|
| Highest Affiliation Agency | This column names the home health agency that admitted the highest share of home health patients treated by this physician in the 3 months prior to the patient's home health admission. |
| Patient Risk Score |
Average Hierarchical Condition Category (HCC) Patient Risk Score for the named physician.
|
| Risk Category | Categorization of your selected provider's Patient Risk Score in comparison to all providers of the same type. |
If this information is not accurate for the provider in the NPI Registry, it is possible that the physician's data could show up in the wrong state. We place physicians in the states in which they register.
This is a critical metric: a single home health agency with a high percentage indicates that an agency has market dominance for the named physician's patients. If this percentage is low, this indicates that this physician's patients are spread across a number of home health agencies, hence the physician is not committed to a specific home health agency and might be a good prospect as a partner.
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