Overview
The Patient Population section of the Facility Analyze Page contains patient demographics that make you the expert on your selected facility's patients. These metrics are found under the Patient Population tab.
In this article
- Patient Volume - Trended counts of patients over eight quarters
- Inpatient CMS Payer Mix - Distinct Patients - inpatient patient counts for Medicare FFS, Medicare Advantage, and Medicaid discharged from the selected facility
- Outpatient CMS Payer Mix - Distinct Patients - outpatient patient counts for Medicare FFS, Medicare Advantage, and Medicaid discharged from the selected facility
- Patient Locations - County - percentage of patient's county of residence.
- Diagnostic Breakout by Stay - counts of patient stays by Trella Health Diagnostic Group or MS-DRG for HHA patients discharged from the selected facility.
- Chronic Conditions - Breakdown of patients by chronic condition diagnoses
- Patient Age Groups - Breakdown of patients by age.
Understanding the Metrics
Patient Volume Table
The Patient Volume table provides metrics on the population of Medicare patients for the selected facility so you can gauge the facility's potential as a source of post-acute referrals.
 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. |
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The details shown in the following image can be found below.
Metric name |
Definition |
| Distinct Patients |
This row includes counts of distinct Medicare patients treated by the facility during the period listed in the column header.
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| HHA Patients | This row shows the counts of distinct patients discharged from the selected facility who were admitted to home health 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 home health within 30 days of discharge. |
| In-Facility Mortalities | The numbers in this row are the counts of patients who died while being treated at the selected facility. |
| Dual Eligible Patients | This row contains the counts of distinct Medicare FFS patients who were discharged from the selected facility and who were eligible for Medicaid coverage during the period specified in the header. |
| Admits | The count of distinct Medicare FFS hospital admissions to the selected facility during the period specified in the header. |
| Discharges | This row shows the count of distinct Medicare FFS hospital discharges from the selected facility during the period specified in the header. |
| Patient Days | This row displays the sum of days spent in the selected hospital for Medicare FFS patients who were treated by the facility during the period specified in the header. |
The column "Annual Patient Count" is not a total of the four quarters, it is a count of distinct patients from the most recent one-year reporting period.
Inpatient CMS Payer Mix - Distinct Patients
This table shows distinct patient counts of inpatient patients treated by the selected facility for the most recent year where comparative metrics can be displayed for Medicare FFS, Medicare Advantage, and Medicaid. The data for the listed year are broken out by quarter to show trends.
The metrics in this table are about 2 years old because complete Medicare Advantage data is only available after that period. Medicare FFS metrics and Medicaid metrics are shown for the same periods in order to make comparisons meaningful.
Inpatient CMS Payer Mix - Distinct Patients
This table shows distinct patient counts of outpatient patients treated by the selected facility for the most recent year where comparative metrics can be displayed for Medicare FFS, Medicare Advantage, and Medicaid. The data for the listed year are broken out by quarter to show trends.
The metrics in this table are about 2 years old because complete Medicare Advantage data is only available after that period. Medicare FFS metrics and Medicaid metrics are shown for the same periods in order to make comparisons meaningful.
Patient Locations - County
This table shows the percentage of patients treated by the selected facility within the one year reference period who resided in the listed county at the time their initial facility admission claim was filed. The one-year reference 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 patients with HHA related claims.
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.
State
For providers who serve multiple states, sometimes there might be two counties in different states with the same name. We have added the state in which the county resides to differentiate the counties in this situation.
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. Those "out of state" counties will only be included in this table if there is a sufficient count of patients.
Aggregated INS Counties and "Other"
- Any and all counties where the percentage was calculated from a count of less than 11 patients will not be identified in the table but will be aggregated into the row titled, "Aggregated INS County."
- For example, if the agency had 100 patients in the reporting period, any county with 10% of the total or less would represent less than eleven patients in that location and therefore, that location will not be identified, but would be combined with all other locations also not specified.
Diagnostic Breakout by Stay
This table provides a percentage breakout by two different diagnosis models. For each diagnosis in either model, we provide a percentage of patient stays where the primary diagnosis on the claim aligns with the listed diagnostic category.
Use the dropdown to choose which diagnosis model to display in the table.
- Trella Health Diagnostic Grouping - This is Trella Health's unique diagnostic grouping model based on the ICD-10 Chapters. There are 20 different groups for all diagnoses, making this model very general.
- Diagnostic Related Group (DRG) - CMS uses this diagnostic grouping model as the model for billing under IPPS. There are more than 450 DRGs, so using this model allows you to identify the mix of diagnoses for your selected hospital in a high level of detail.
Trella Health Diagnostic Groupings
Use this diagnostic grouping model to identify broad areas of specialization as a connection between the selected facility and your agency.
Any and all diagnostic categories where the percentage was calculated from a count of less than 11 patients will not be identified in the table but will be aggregated into the row titled, "Aggregated INS diagnostic categories."
For more information see, Trella Health Diagnostic Groupings.
Inpatient DRG
As you can see from the image, using the Inpatient DRG diagnostic model provides a much more detailed view of the diagnoses for patients discharged from the selected hospital.
Not all DRG's will be available in this table. We only include DRGs where the diagnosis represents >=11 distinct patients and more than 1% of the the total distinct patients.
These diagnoses percentages only apply to patients discharged from inpatient care at the selected hospital.
CC is Complication or Comorbidity, MCC is Major Complication or Comorbidity.
Chronic Conditions
This table shows distinct patient counts of patients treated by the selected hospital who were diagnosed with the listed chronic conditions.
Metric name |
Definition |
| Annual Patient Count | The metrics in this column are the count of distinct patients treated by the listed facility during the reporting period who met the criteria for the listed chronic condition based on the CCW Chronic Condition algorithm |
| Percentage of Patients | The metrics in this column are the percentage of distinct patients treated by the selected facility during the reporting period who met the criteria for the listed chronic condition based on the CCW Chronic Condition algorithm |
The percentages in the table will not add up to 100% since many patients will be identified with a diagnosis included in more than one row.
Patient Age
This table gives a simple breakout of the patients treated by the selected facility during the reporting period by age.
