Financial Outcomes

1min

Welcome to Financial Outcomes!
This is where you can view financial return on investment for your clinical program interventions. 
There are two financial outcomes sections!
Pre/Post Intervention Financial Outcomes: View the change before and after your clinical intervention using the pre/post financial outcomes tab
General Financial Trends: View general financial trends on a selected population
Pre/Post Intervention Financial Outcomes
General Financial Trends
Use this section if you want to see how a given intervention has changed the financial outcomes of your selected population.
To get started on this page:
Select a population:
Rule: Selecting a rule will include all patients that had an intervention generated from that rule and provide their financial outcomes before and after the date that the intervention generated
Plan: Selecting a plan will include all patients that have been included in that plan. The plan start date will be the one that was selected for the population or the one that was selected for each patient. (See "My Population" for further information on creating a plan)
Select the time period:
Months for PMPM: Select the number of months of data you would like to include for the PMPM calculation
Once all selections have been made, click on apply filters.
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Description of Tables and Graphs
Table/Graph
Description
Tips for use
Pharmacy Pre/Post plan
Pulls all pharmacy spend from the specified number of months before and after the intervention/plan start date and shows the cumulative pharmacy spend of the patients in this cohort
This cumulative spend changes depending on the number of months entered in "Months for PMPM"
Medical Pre/Post plan
Pulls all medical spend from the specified number of months before and after the intervention/plan start date and shows the cumulative medical spend of the patients in this cohort
This cumulative spend changes depending on the number of months entered in "Months for PMPM"
PMPM (Total Patients in Plan)
Calculates and shows the pharmacy and medical pre/post PMPM based on the total number of patients in the plan and the selected number of months. 
Shows the change in spend  before and after the plan/intervention for patients included in this analysis
PMPM (Total Covered Lives)
Calculates and shows the pharmacy and medical pre/post PMPM based on the total covered lives in the health plan and the selected number of months
Shows a true PMPM calculation and the impact of spend on all covered lives
Pharmacy and Medical Cost by Month
Shows spend/month trend for the number of months selected pre and post intervention 
Medical or Pharmacy expenditure can be toggled on and off within this graph to view only one at a time. Hover over a data point to see an exact value
Plan Spend
Shows calculated average monthly pharmacy, medical, and total spend pre and post plan/intervention date.
Average is based on the number of months entered in "Months for PMPM"
Average Pharmacy spend by Demographic
Shows calculated average pharmacy spend for each demographic cohort before and after the intervention/plan start
The average spend is calculated using spend data from the specified number of months entered in "Months for PMPM"
Average Medical Spend by Demographic
Shows calculated average medical spend for each demographic cohort before and after the intervention/plan start
The average spend is calculated using spend data from the specified number of months entered in "Months for PMPM"
PMPM Trends by Month
Shows monthly PMPM for pharmacy, medical, and total spend pre and post intervention/plan start
Any line can be hidden to refine the view in the graph.  Number of pre/post months visible is based on value entered for "Months for PMPM". Hover over a data point to see an exact value
Expenditure by member
Shows all patients included in the analysis and additional patient spend details. 
Member ID's can be clicked and will direct you to that specific patient's individual profile page
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Use this section to select a tag/patient cohort and view financial trends on patients within the tag.
Select a population:
Tag: Select a tag that you would like to view financial trends on. 
Select the time period:
Date Range: Select a start and end date that you would like spend data pulled on the selected population
Once all selections have been made, click on apply filter.
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Description of Tables, Graphs, and Visuals
Table/Graph/Visual
Description
Tips for Use
Current Patients on Tag
Shows the number of patients included in the selected tag for analysis
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Pharmacy Total Spend
Shows total pharmacy spend and average spend per patient in the tag within the date range selected
Adjusting the date range will change your results
Medical Total Spend
Shows total medical spend  and average spend per patient in the tag within the date range selected
Adjusting the date range will change your results
Total Spend
Show total spend and average spend per patient in the tag within the date range selected
Adjusting the date range will change your results
Pharmacy Spend Heat Map
Shows a heat map of pharmacy spend by zipcode
Zoom in and out for a closer look. Utilize the legend to understand heat map colors
Medical Spend Heat Map
Shows a heat map of medical spend by zipcode
Zoom in and out for a closer look. Utilize the legend to understand heat map colors
PMPM Trends per month
Shows pharmacy and medical PMPM each month based on selected date ranges
Adjusting the date range will change the x-axis of your graph
Total Spend per Month
Shows total spend per each month
Adjusting the date range will change the x-axis of your graph
Average Spend by Demographic
Shows average spend in pharmacy, medical, and total, based on each demographic group
Remember, this is showing an average, not a sum.
Expenditure by Member
Shows each patient in the selected tag alongside additional spend details.
Member ID's can be clicked and will direct you to that specific patient's individual profile page
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Table/Graph	Description	Tips for use
Pharmacy Pre/Post plan	Pulls all pharmacy spend from the specified number of months before and after the intervention/plan start date and shows the cumulative pharmacy spend of the patients in this cohort	This cumulative spend changes depending on the number of months entered in "Months for PMPM"
Medical Pre/Post plan	Pulls all medical spend from the specified number of months before and after the intervention/plan start date and shows the cumulative medical spend of the patients in this cohort	This cumulative spend changes depending on the number of months entered in "Months for PMPM"
PMPM (Total Patients in Plan)	Calculates and shows the pharmacy and medical pre/post PMPM based on the total number of patients in the plan and the selected number of months.	Shows the change in spend before and after the plan/intervention for patients included in this analysis
PMPM (Total Covered Lives)	Calculates and shows the pharmacy and medical pre/post PMPM based on the total covered lives in the health plan and the selected number of months	Shows a true PMPM calculation and the impact of spend on all covered lives
Pharmacy and Medical Cost by Month	Shows spend/month trend for the number of months selected pre and post intervention	Medical or Pharmacy expenditure can be toggled on and off within this graph to view only one at a time. Hover over a data point to see an exact value
Plan Spend	Shows calculated average monthly pharmacy, medical, and total spend pre and post plan/intervention date.	Average is based on the number of months entered in "Months for PMPM"
Average Pharmacy spend by Demographic	Shows calculated average pharmacy spend for each demographic cohort before and after the intervention/plan start	The average spend is calculated using spend data from the specified number of months entered in "Months for PMPM"
Average Medical Spend by Demographic	Shows calculated average medical spend for each demographic cohort before and after the intervention/plan start	The average spend is calculated using spend data from the specified number of months entered in "Months for PMPM"
PMPM Trends by Month	Shows monthly PMPM for pharmacy, medical, and total spend pre and post intervention/plan start	Any line can be hidden to refine the view in the graph. Number of pre/post months visible is based on value entered for "Months for PMPM". Hover over a data point to see an exact value
Expenditure by member	Shows all patients included in the analysis and additional patient spend details.	Member ID's can be clicked and will direct you to that specific patient's individual profile page

Table/Graph/Visual	Description	Tips for Use
Current Patients on Tag	Shows the number of patients included in the selected tag for analysis
Pharmacy Total Spend	Shows total pharmacy spend and average spend per patient in the tag within the date range selected	Adjusting the date range will change your results
Medical Total Spend	Shows total medical spend and average spend per patient in the tag within the date range selected	Adjusting the date range will change your results
Total Spend	Show total spend and average spend per patient in the tag within the date range selected	Adjusting the date range will change your results
Pharmacy Spend Heat Map	Shows a heat map of pharmacy spend by zipcode	Zoom in and out for a closer look. Utilize the legend to understand heat map colors
Medical Spend Heat Map	Shows a heat map of medical spend by zipcode	Zoom in and out for a closer look. Utilize the legend to understand heat map colors
PMPM Trends per month	Shows pharmacy and medical PMPM each month based on selected date ranges	Adjusting the date range will change the x-axis of your graph
Total Spend per Month	Shows total spend per each month	Adjusting the date range will change the x-axis of your graph
Average Spend by Demographic	Shows average spend in pharmacy, medical, and total, based on each demographic group	Remember, this is showing an average, not a sum.
Expenditure by Member	Shows each patient in the selected tag alongside additional spend details.	Member ID's can be clicked and will direct you to that specific patient's individual profile page

Updated 26 Feb 2024

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