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% of Panel
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DefinitionPercentage of Patients in Panel that meet the selected criteria such as Chronic Conditions or High Priority
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Acute Admissions per 1K
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DefinitionNumber of Acute Admissions per 1000 members in the current rolling 12 month period
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Age Range
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DefinitionIndicates the lower and upper bound of age used to refine and select the patient population
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Audit Determination
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DefinitionNumber of patients with custom Quality Initiative opportunities due to patient exclusions, chronic condition exclusions, or contraindication exclusions which have been accepted, rejected, or are awaiting audit
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CAD Indicator
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DefinitionIndicates if Patient has Coronary Artery Disease
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Care Management Programs - Asthma
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DefinitionNumber of patients enrolled in an Asthma Care Management program
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Care Management Programs - Asthma - Patients
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DefinitionNumber of patients enrolled in an Asthma Care Management program
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Care Management Programs - Case Management
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DefinitionNumber of patients enrolled in an any Care Management program
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Care Management Programs - Case Management - Patients
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DefinitionCategory header for all care management programs
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Care Management Programs - Chronic Obstructive Pulmonary Disease
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DefinitionNumber of patients enrolled in a COPD any Care Management program
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Care Management Programs - Chronic Obstructive Pulmonary Disease - Patients
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DefinitionNumber of patients enrolled in a COPD Care Management program
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Care Management Programs - Coronary Artery Disease
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DefinitionNumber of patients enrolled in an a CAD Care Management program
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Care Management Programs - Coronary Artery Disease - Patients
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DefinitionNumber of patients enrolled in a CAD Care Management program
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Care Management Programs - Depression
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DefinitionNumber of patients enrolled in a Depression Care Management program
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Care Management Programs - Depression - Patients
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DefinitionNumber of patients enrolled in a depression Care Management program
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Care Management Programs - Diabetes
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DefinitionNumber of patients enrolled in a Diabetes Care Management program
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Care Management Programs - Diabetes - Patients
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DefinitionNumber of patients enrolled in a diabetes Care Management program
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Care Management Programs - Discharge Outreach Call
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DefinitionNumber of patients who have received a outreach call after discharge
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Care Management Programs - Discharge Outreach Call - Patients
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DefinitionNumber of patients who have received an outreach call after discharge
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Care Management Programs - Heart Failure
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DefinitionNumber of patients enrolled in an a CHF Care Management program
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Care Management Programs - Heart Failure - Patients
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DefinitionNumber of patients enrolled in a CHF Care Management program
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Care Management Programs - Low Back Pain
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DefinitionNumber of patients enrolled in an a Low Back Pain Care Management program
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Care Management Programs - Low Back Pain - Patients
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DefinitionNumber of patients enrolled in a Low Back Pain Care Management program
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Care Management Programs - Maternity Case Management
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DefinitionNumber of patients enrolled in an a maternity Care Management program
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Care Management Programs - Maternity Case Management - Patients
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DefinitionNumber of patients enrolled in a Maternity Care Management program
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Care Management Programs - Oncology Case Management
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DefinitionNumber of patients enrolled in an Oncology Care Management program
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Care Management Programs - Oncology Case Management - Patients
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DefinitionNumber of patients enrolled in an oncology Care Management program
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Care Management Programs - Smart Surgery
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DefinitionNumber of patients enrolled in a Smart Surgery Care Management program
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Care Management Programs - Smart Surgery Patients
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DefinitionNumber of patients enrolled in a Smart Surgery Care Management program
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Care Management Programs - Transplant Case Management
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DefinitionNumber of patients enrolled in an a Transplant Care Management program
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Care Management Programs - Transplant Case Management - Patients
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DefinitionNumber of patients enrolled in a Transplant Care Management program
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Care Opportunities
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DefinitionThe count of any open care opportunities available for a patient. This count will include quality, coding, and Custom QI opportunities
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Care Opportunities - Generic Drug Opportunities
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DefinitionPatient has at least one generic drug opportunity
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Care Opportunities - Open Coding Opportunities
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DefinitionPatient has at least one open coding opportunity
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Care Opportunities - Open Quality Opportunities
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DefinitionPatient currently has at least one open quality opportunities
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Care Opportunities - Pending/Closed Coding Opportunities
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Definitionpatient has at least one pending or closed coding opportunity
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Care Opportunities - Pending/Closed Quality Opportunities
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DefinitionPatient has at least one pending or closed quality opportunity
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Care Opportunities - Star Indicator - Closed Opportunities
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DefinitionPatient has at least on closed Stars indicator as defined by HEDIS
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Care Opportunities - Star Indicator - Open Opportunities
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Definitionpatient has a last one open Stars indicator as defined by HEDIS
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DefinitionCHF Indicator
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DefinitionIndicates if Patient has Congestive Heart Failure
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Chronic Conditions - Congestive Heart Failure (CHF)
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DefinitionIndicates if Patient has Congestive Heart Failure
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Chronic Conditions - Coronary Artery Disease (CAD)
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DefinitionIndicates if Patient has Coronary Artery Disease
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Chronic Conditions - Diabetes
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DefinitionIndicates if Patient has Diabetes
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Chronic Disease - CAD - Patients
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DefinitionCount of patients identified as having CAD
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Chronic Disease - CHF - Patients
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DefinitionCount of patients identified as having CHF
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Chronic Disease - Diabetes - Patients
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DefinitionCount of patients identified as having Diabetes
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Coding Opportunities - Closed - Patients
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DefinitionThe count of HCC-driven coding opportunities which have been closed
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Coding Opportunities - Open - Patients
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DefinitionThe count of HCC-driven coding opportunities which are currently open
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Coding Opportunities - Pending - Patients
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DefinitionThe count of HCC-driven coding opportunities which have been submitted by a ACA and are awaiting audit determination
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Coding Opportunities - Snoozed - Patients
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DefinitionThe count of HCC-driven coding opportunities which have been postponed by the ACA for review at a future date
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Condition Risk Score
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DefinitionA member-level risk score calculated based upon the patient's clinical condition as represented in the claims history
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Contract Flag
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DefinitionIndicates if a Patient has been included a Contract by the Health System or Practice
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Contracted Patient
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DefinitionNumber of patients associated to a provider contract
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