Overview

The Explore page for Marketscape Insights for HME/Infusion has seven different tabs - six tabs for different referrer types and one tab for billing Organizations. This article covers the Hospitals tab.

Select the tab you want to open by clicking on the text in the tab.

Each tab will display different metrics, and some of the available features on the page will change.

  For an overview of the features and tools on the Explore page, see The Explore page.

 In this article

• Filters
• Understanding the Metrics

Filters

The following filters are available under the Hospitals tab.

In short, the filters allow you to find hospitals with metrics that align with specific parameters of interest to you.

In most cases, you will start by setting the Code Set filter and then you will set the Location filter. For some users you will only have access to a single code set, which will save you a step.

Code Set - If your company specializes in providing specific services or products, by using the Code Set filter, you can limit the table to hospitals that align with the correct code set(s) of interest. Click on the "Code Set" filter to open the options (shown at right) Click on the desired code set Click on the "Code Set" button to close the options Click on the "Apply Filters" button You can select multiple code sets at the same time.
Location - In almost every instance of using the Explore page, set the location filters to limit the table to hospitals in a specific territory. You can choose any number of locations, including, for example, two counties or cities in adjacent different states. Click on the "Location" filter to open the options (shown at right) Click on the desired state or states, counties, cities, etc. Click on the "Location" button to close the options Click on the "Apply Filters" button
Claim Type - the Claim Type filter allows you to limit metrics shown in the table to either inpatient or outpatient.

For more information on how to use filters effectively, see Filters - Overview and Strategy.

Understanding the Metrics

The table below includes a brief definition of the columns in the Explore page table for the selected tab.

The following image shows all possible metrics in the Hospital Explore table.

Metric name	Description
Hospital Name	The hospital's name - taken from the NPPES database. The name is a link to open the Analyze page for the selected hospital.
NPI	The hospital's NPI - taken from the NPPES database.
Street Address/City/County/ State/ZIP Code/Telephone	Information in these columns is taken from the NPPES database from the Primary Practice Address section. For the NPPES database - see NPPES NPI Registry
Claim Type	The type of claim identified on the CMS-1450 form
Star Rating - Patient Satisfaction	This column displays the Star Rating for the hospital in the row. The CMS five-star quality rating system measures the experiences Medicare beneficiaries have with their health plan and health care system on a scale of 1 to 5 stars, with 5 being the highest quality
Code Set	The listed HME/Infusion code set is based on a list of HCPCS codes.
Metric Name		Description
Code Set Received: 0-30 Days Post Discharge - Patient Count More below		The number in this column is the estimated count of distinct patients who were discharged from the hospital and had a claim filed with the listed organization NPI within 30 days after discharge during the most recent 12 months for the listed code set
Annual Total Patient Count (All Payers)		The count of distinct patients discharged from the listed hospital during the most recent 12 months of data
Annual Medicare Patient Count Since the patient counts in these two columns come from different one year periods use the counts for a general comparison.	FFS	Count of distinct Medicare FFS patients who were discharged from the listed hospital during the one-year reporting period
	MA-20XX	Count of distinct Medicare Advantage patients who were admitted to the listed hospital during the most recent year available from CMS. Complete Medicare Advantage metrics are not available for about 2 years after the claim year.
Highest Affiliated Owner	Name	This column lists the highest affiliated direct owner of the hospital displayed in the same row. JV indicates Joint Venture. NP indicates Not for Profit. Additional owner details can be found on the Analyze page.
	Percentage	Percentage ownership of the highest affiliated direct owner of the hospital in the same row. Additional owner details can be found on the Analyze page.
Top Patient Location	State	Top state of residence for Medicare FFS patients who were treated during the one-year reporting period; based on the beneficiary’s state filed on the claim. Additional patient location details can be found on the Analyze page.
	County	Top county of residence for Medicare FFS patients who were treated during the one-year reporting period; based on the beneficiary’s county filed on the claim. Additional patient location details can be found on the Analyze page.
	County Percentage	Percentage of Medicare FFS patients treated during the one-year reporting period associated with the top patient county. Additional patient location details can be found on the Analyze page.
Assigned Users		This column displays any users from your company who have the listed hospital assigned to them.

Code Set Received: 0-30 Days Post Discharge - Patient Count

The purpose of this metric is to show inferred referral relationships for patients that were discharged from the hospital.

Details

• This is a unique patient count - for the reporting period, some patients might have had multiple life events that apply, but they will only be counted once,
• This count applies to patients who received a code from the selected code set after leaving the hospital.
  • The patient is counted when the code is applied within the timeframe of zero to thirty days after discharge
  • The patient is only counted if the patient did not receive the code while still in the hospital
• The count is applied to the patient when two claim events occur that are connected, 1) the hospital claim, and 2) the HCPCS claim
  • We do this to make the connection between the hospital and the application of the HCPCS code to that patient. When we see the HCPCS code on a claim, we look back within 30 days for an applicable hospital claim
  • This is why the count is an "inferred" connection. There is no referring facility field on a HCPCS code claim.
• Final note: Since not all claims are available, we can't always draw the connection, so the counts shown will be lower than actuals