URSA-PHF | Surgical Encounter Metrics

Overview

This report contains financial, outcome, and population rate measures related to surgical encounters including pre-op and post-op periods. The pre-built boards in this report will introduce users to key concepts while also providing users with several ready to use analyses such as measuring the opportunity for shifting surgeries to a lower acuity setting where appropriate.

Use this report to

• Develop an understanding of a surgical encounter and categorizations of types of encounters by procedure performed and setting.
• Monitor population rates of surgery encounters.
• Measure spending across types of surgeries, settings, and providers to determine averages and outliers.
• Classify spending in the pre-op and post-op periods to identify gaps in services versus potentially avoidable costs.
• Compare outcomes across providers and types of surgeries such as post-op admissions and SNF utilization.

Potential takeaways

• What percent of my surgeries are occurring in an ambulatory surgical center versus hospital inpatient or hospital outpatient?
• What are the most common surgeries across my population or within subpopulations?
• What percent of surgeries are elective?
• What are the top drivers of cost in the post-operative period?
• What percent of hospital inpatient or hospital outpatient surgeries result in a same day discharge and could that procedure have been performed in an ambulatory surgical center?
• For patients with a surgical procedure that can typically be performed in an ASC, such as a hip or knee replacement, what is the potential savings of shifting X% of those procedures to an ASC?
• How much is being spent on preventive care, such as physical therapy, in the pre-op period?

Measures included in this report

• URSA-PHF-R01: Patients with Active Membership
• URSA-PHF-R07: Registry of URSA-CORE Surgical Encounters
• URSA-PHF-006: Surgery Encounter PMPM Plan Spending
• URSA-PHF-006b: ASC Encounter PMPM Plan Spending
• URSA-PHF-025: Surgery Encounters per 1000 Patient-Years
• URSA-PHF-040: Post-Op 90 Day Episode Plan Spending
• URSA-PHF-041: Post-Op 180 Day Episode Plan Spending
• URSA-PHF-042: Pre-Op 180 Day Episode Plan Spending
• URSA-PHF-043: 90-Day Post-Op All-Cause Hospital IP Admission
• URSA-PHF-044: 30-Day Post-Op All-Cause Hospital IP Admission
• URSA-PHF-046: Percent of Surgery Encounters Discharged Home
• URSA-PHF-047: Surgery Discharges with SNF Stay within 7 Days