URSA-PHF | Clinician & Primary Care Visit Metrics

Overview

This report provides users with measures related to clinician office visits across specialists and primary care providers. The pre-built boards in this report will introduce users to key concepts related to these encounters, helpful ways of disaggregating results, and several ready to use analyses around cost/utilization, patient engagement, panel case mix, and surface variation across populations with varying degrees of risk in regards to social determinants of health.

Use this report to

• Develop an understanding of the definition of a clinician office visit and helpful categorical fields for disaggregating results related to the type of provider, reason for visit, setting, and services provided.
• Measure population rates and spending on office visits.
• Analyze which services are being provided during visits and by which providers.
• Classify patients level of engagement with primary and specialty care providers.
• Identify variation across primary care providers in their panel case mix.

Potential takeaways

• What is the variation in the utilization (population rate) and spending (PMPM) on clinician office visits? How can those visits be categorized by the type of provider, types of services, and setting?
• Across my entire population or comparing chronic condition or SDoH cohorts, where is there variation in the level of primary care engagement?
• Which patients are overdue for an annual wellness visit?
• Which patients are receiving preventive primary care services from a specialist instead of their primary care provider?
• Which patients are seeing a primary care provider that differs from the plan attributed primary care provider?
• How much is being spent on specialist visits and which services are they providing?
• Which specialists are my patients visiting?

Measures included in this report

• URSA-PHF-R01: Patients with Active Membership
• URSA-PHF-R11: Registry of Clinician Office Visits
• URSA-PHF-R12: Registry of Primary Care Office Visits
• URSA-PHF-004: Clinician Office Visit PMPM Plan Spending
• URSA-PHF-004b: Primary Care Office Visit PMPM Plan Spending
• URSA-PHF-013: Plan Paid Per Clinician Office Visit
• URSA-PHF-023: Clinician Office Visits per 1000 Patient-Years
• URSA-PHF-023b: Primary Care Office Visits per 1000 Patient-Years
• URSA-PHF-034: Patients with PCP Visit Last 12 Months
• URSA-PHF-035: Patients with AWV Last 12 Months