Contracts Page

View the list of contracts.

When you open Population Intelligence, the Contracts page is displayed. The Contracts page provides an overview of the configured contracts and current status.

Note:

For users who have access to both Quality and Contracts, the Quality page is displayed by default when you sign in. To access the Contracts page, select the Contracts tab at the bottom of the page.

Figure 4-1 Contract Page

The following information is available on the Contracts page:

• Filter: Filter by year to view contracts for a specific year.
• Contracts: A list of contracts that have been uploaded in the Console for performance monitoring. Contract-specific attributes and metrics are displayed per contract.
  • Line of Business: The line of business selected (if available) during the contract configuration.
  • Cost: Actual expenditure cost per member per month (PMPM).
  • Risk: HCC Redocumentation Risk. The HCC Redocumentation rate is the percentage of previously documented Hierarchical Condition Category (HCC) conditions that are accurately documented again in the current year.
  • Quality: Measure Quality displays the percentage of overall measures that are currently meeting their target.
  • Opportunities: Action items identified by both AI and by contract parameters that can be used to help meet contract goals. Opportunities are ranked in order of highest patient opportunity and are categorized as follows:
    • AI Patient Prioritization Insight: Artificial intelligence (AI)-based member monitoring aims to help identify which patients are at highest risk for acute utilization and suggest the next best action to reduce the likelihood of acute care utilization. The recommended action is to schedule a primary care provider (PCP) visit.
    • Condition Documentation: Alerts to ensure that previously documented conditions are accurately and consistently documented in a patient's record each year. Displays a list of persons with four or more undocumented conditions during the performance period and persons who have the top two highest suspected conditions that are undocumented.
    • Quality: Insights related to care gap measures associated with the contract. Displays the top three underperforming contract measures that are closest to the target.

If a contract name is selected, you are directed to a detailed view of the selected contract where additional KPIs, estimated financial performance, and opportunities for improvement are available.