Sample Reports: Understanding Your Cost Drivers
The MHMC offers a suite of standard reports that aim to help you identify cost drivers and improve the quality of care for your population. Samples of our standard reports for plan sponsors and for provider organizations are provided below. Can’t find what you’re looking for? Enhanced Data Members can work with MHMC’s data team to design custom reports to meet specific business needs.
For Plan Sponsors:
Access to benchmark data based on other Maine-based employers is key to understanding your plan’s performance. That’s why our reports incorporate benchmarks calculated from the claims experience of Coalition data members working in a variety of industries across the entire state. Comparing your population to the Coalition’s benchmark allows you to understand where your organization differs from other employers in Maine and helps you to formulate a targeted strategy to lower cost while improving care for your employees and their dependents.
MHMC’s standard reporting package for plan sponsors is available on a quarterly basis and includes the following:
- Plan Performance Report – The Plan Performance Report provides a high-level overview that compares your population to other Coalition plan sponsors on demographics, plan design, cost, utilization, chronic illness burden, and preventive care visits.
- Benchmark Report – The Benchmark Report provides a snapshot of your population compared to the Coalition benchmark on nearly 40 cost and utilization metrics across inpatient, outpatient, professional, and pharmacy services. The Benchmark Report employs a rigorous methodology to control for high-cost claimants, pediatric members, and individuals residing outside of Maine in order to ensure a fair comparison to your own population. In addition, reported benchmarks are adjusted to reflect the age and gender distribution of your specific population.
- Arrow Health Care Report – The Arrow Health Care Report provides a comprehensive view of your plan’s expense and utilization over the prior 24 months. With 9 chapters covering topics including admissions and readmissions, high-cost radiology procedures, frequent ER utilizers, preventive care services, high-cost claimants, and specialty drug spend, the Arrow Health Care Report serves as a go-to reference for managing your plan.
Whether you’re interested in managing a risk-based contract or in understanding how providers within your system perform relative to their peers, MHMC has reporting products to meet your needs:
- Global Payment Dashboard Report – The Global Payment Dashboard Report provides risk-adjusted PMPM’s and utilization rates by detailed service type for a defined population in a risk-bearing arrangement. The high-level summary allows provider systems to track performance against a PMPM target and to isolate specific areas of over- and under-use compared to historical norms. With sections dedicated to inpatient, outpatient, professional, and pharmacy claims, the Global Payment Dashboard Report is essential for helping provider organizations manage their risk-bearing contracts with MHMC data members.
- Out-of-Network Utilization Report – The Out-of-Network Utilization Report displays aggregate amounts paid to providers outside the system for a defined population in a risk-bearing arrangement. Designed to help provider systems better manage costs for an at-risk population, the Out-of-Network Utilization Report identifies out-of-network providers delivering high-volume and/or high-cost services across inpatient, outpatient, and professional settings.
- Primary Care Practice Report – The Primary Care Practice Report provides a detailed accounting of a practice’s performance on cost, utilization, and evidenced-based quality measures compared to benchmark. The report, generated from MHMC’s all-Commercial payor claims database that is sourced from the MHDO, is intended for practices with 100 or more attributed patients. Leveraging HealthPartners’ Total Cost of Care and Relative Resource Use methodology, the Primary Care Practice Report helps provider organizations understand how they compare to practices with comparable patient panels.
- High-Cost Patient Report – The High Cost Patient Report identifies high-cost, high-utilizing, or high-risk patients attributed or enrolled to a provider practice. The report also allows treating providers to coordinate care, ensure efficient resource use, and improve clinical outcomes for complex patients.