Q1 Recap Video
March 20, 2024
Q3 2023 is now available!
Marketscape Insights has been updated with Q3 2023 Medicare Part A and B Fee-for-Service claims data, along with updated Medicaid, Medicare Advantage, and commercial data. Users may see shifts in certain metrics because of these updates. This is a great time to perform competitive analysis and evaluate market share.
Code Sets can now be set at the User level
- Your Trella Customer Success Manager can now limit the code sets seen by users in your company
- Removes clutter of seeing all code sets, and lets users focus on code sets of interest
- Note: your Trella Customer Success Manager can also rename your code sets to more accurately represent your product/service line
Claim Counts and Patient Counts are now available in Physician and Organization Analyze Pages
- Expanding on decile rankings to provide visibility into the size of Physician and Organization relationships
- Physician Analyze > Utilization and Order Share
- Physician Claim Counts represent the sum of estimated claims filed with the listed physician NPI for all claims billed during the most recent 18 months for the listed code set. The purpose is to quantify the claim volume for the listed code set where the listed physician was either the referring physician or likely influenced the referral based on Trella's algorithms
- Physician Patient Counts represent the count of distinct patients who had a claim filed with the listed physician NPI for claims billed through the listed payer mix during the most recent 18 months for the listed code set. The purpose is to quantify the distinct patient count for the listed code set where the listed physician was either the referring physician or likely influenced the referral based on Trella's algorithm
- Organization Analyze > Order Share
- Organization Claim Counts represent the sum of estimated claims filed with the listed organization NPI for all claims billed during the most recent 18 months for the listed code set. The purpose is to quantify the claim volume for the listed code set where the listed organization was either the billing organization or likely influenced the supply based on Trella's algorithm
- Organization Patient Counts represent the estimated count of distinct patients who had a claim filed with the listed organization NPI for claims billed through the listed payer mix during the most recent 18 months for the listed code set. The purpose is to quantify the distinct patient count for the listed code set where the listed organization was either the billing organization or likely influenced the supply based on Trella's algorithm
Physician Analyze > Utilization
Physician Analyze > Order Share
Organization Analyze > Order Share
Expanded Physician's/Organization's Patient Population Trends
- Physician Analyze > Patient Population > Patient Volume
- Organization Analyze > Patient Population > Patient Volume
- Additional visibility into a Physician's/Organization's patient population to identify the right partnerships for referral
- You can now see Annual Patient Count and quarterly trends for MA, Medicaid, Commercial and Other patients
February 9, 2024
Claim counts and Payer Mix Patient Counts by Code Set are now available in Physician and Organization Explore
Physician Explore
- Overview: All patient and claim counts associated with a physician on the Explore page are related to the referrals that a physician made for a given HME or Infusion code set.
- Physician Claim Counts: The estimated number of claims associated with the patients a physician referred to an organization for the selected code set. This count represents the most recent 18 months of claims data. The counts are broken out by “Physician Total Claim Count” which represents all payer types and “Physician Medicare FFS Claim Count” which is 100% of Medicare FFS data.
- Physician Patient Counts: The estimated number of patients a physician referred to an organization for a selected code set. This count represents the most recent 18 months of claims data. There are five different columns with patients counts: Medicare FFS, MA, Medicaid, Commercial, and Other. Other typically means the patient's insurance is VA (Veterans Affairs), Tricare, Workers Comp, or we cannot map the payer to a payer type.
- Note: The Payer Mix %s in Physician Analyze and Explore are based on all claims that physician billed – the above patient counts are based only on the patients represented in that code set.
Organization Explore
- Overview: Organizations are typically the HME or Infusion provider that is billing the claims associated with the code sets. These organizations can also be a Clinic, Physician Practice, or other organization types. All patient and claims counts are based on the organization that is billing the claim as opposed to the physician that is referring.
- Organization Claim Counts: The number of claims this organization billed for the selected code set. This count represents the most recent 18 months of claims data. The counts are broken out by “Organization Total Claim Count” which represents all payer types and “Organization Medicare FFS Claim Count” which is 100% of Medicare FFS data.
- Organization Patient Counts: The number of distinct patients this organization billed for the selected code set. This count represents the most recent 18 months of claims data. There are five different columns with patients counts: Medicare FFS, MA, Medicaid, Commercial, and Other. Other typically means the patient's insurance is VA (Veterans Affairs), Tricare, Workers Comp, or we cannot map the payer to a payer type.
- These additional metrics will provide further insights into volumes and relative size of referral and growth opportunities to target vs the current deciles of Order Rank / Organization Rank alone.
Claim counts and patients counts will be added to Analyze pages where code sets appear over upcoming releases. - Note: The data Trella Health receives from the various payers and clearinghouses is not 100% complete due to data use agreements and HIPAA requirements. Because of this, Trella Health has created an evidence-based imputation logic when fields such as referring NPI or billing NPI are missing from the raw medical claims. As this imputation logic is proprietary, and routinely refined, there are cases where claim counts will not always be 100% accurate, but are accurate relatively and directionally.
How to view a table with just the columns of interest and in the order you like
- Sort on any claim count column by clicking on the column header that will toggle between high to low, low to high, default sort
- Move columns in to any order using column drag and drop
- Add/remove columns you wish to show/hide using the three vertical bars next to the Search
- Note: the existing Payer Mix % metrics that are based on all of a Physician's claims have been removed from the default Physician Explore view, as the Patient Counts by Payer Mix present a more accurate representation by code mix. However, these metrics can be added back at any time as needed using the Add/remove column functionality. These metrics are still available in Physician Analyze.
- You can save a view with just the columns of interest
New Data
Trella Health has integrated additional vendor data into the HME and Infusion product. Users can expect to see an improvement in the payer mix data and possible shifts in the order and diagnosis ranks.
Release
January 10, 2024
- Top Home Health Destinations and Top Skilled Nursing Destinations moved from Physician Analyze > Practice Details tab to Physician Analyze > Order Share tab
- Bug Physician/Organization Explore > Range filter - Order Rank and Diagnosis Ranks now correctly filter above 0 and no longer include blanks in the retrieved data set
Admin - Bug
- Last Activity Date in the Users report has been corrected and matches the date shown in the Usage report
