Oracle® Healthcare Foundation

Total medicare, medicaid, and commercial members. This report shows the organization's exposure to different insurers based on the number of patients they cover.

Total Members by Primary Care Physician. This report shows each primary care physician's exposure to different insurers based on the number of patients they cover.

Total Members by Attributed Provider. This report shows each attributed provider's exposure to different insurers based on the number of patients they cover.

PMPM overall, medical and drug cost in dollars, overall dollars spent, and average cost per procedure. This report allows you to see the average monthly costs per member and their distribution between medical and drug PMPM costs. It also allows you to evaluate your total costs and the cost of a typical procedure.

High Cost Members by Attributed Physician. This report helps you understand the PMPM costs that attributed physicians generate through the average monthly cost per member and the total number of members assigned. The distribution between emergency and inpatient members also helps to understand the associated costs.

High Cost Members by Primary Care Physician. This report helps you understand the costs that primary care physicians generate through the average monthly cost per member and the total number of members assigned. The distribution between emergency and inpatient members also helps to understand the associated costs.

Claim payments by member - A tabular report that lists all members and their claim payments. This report allows you to drill down to the payments claimed for each member.

Claim payments by procedure - A graphical representation of the weight each procedure has in the overall payments claimed. This report helps you visualize the procedures that generate the largest claims.

Claim payments by care setting - Graphical representation of the claim payment amounts for each case setting. This report helps you visualize the care settings that generate the largest claims.

Claim payments by PCP - Graphical representation of the claimed payment amounts and billed amounts by primary care physician. This report allows you to compare the overall payments claimed by primary care physicians and to check how they are covered by the billed amounts.

Cost by Payer Network - Lists the total billed amount for each payer network. This report allows you to evaluate the exposure to each payer network, based on the amounts billed.

Total number of patients with risk score, average scoring events per patient and average days since last scoring event. This report helps you understand the scoring activity volume based on the number of patients it is performed on, the number of scoring events per patient and their frequency.

Risk analysis by gender, ethnicity, and age band. Correlate this report with the total numbers of patients in each category to understand which genders, ethnic groups and age bands are more exposed to risks.

Prescription count and cost analysis - This report helps you understand how often different medicines are prescribed and the costs that these prescriptions generate.

Out of pocket costs report shows the average out of pocket cost that patients pay for a given set of medicines along with the breakdown of the total cost by total copay, deductible, and patient responsibility amounts.

ACO Quality Measures - Graphical representation of the percentile rating for the selected organization providers for specific measure types. This report allows you to compare how organization providers compare to each other on different measures. The detailed tabular report below the chart also includes the percentile variance from the previous year to the current year, providing insight into the progress of an organization over different ACO quality measures.

Patient Satisfaction Survey - Shows patients' surveys during their encounters with the caregiver. It displays the performance score for each area. For example, "During the hospital stay, how often doctors explained in a way that the patient could understand?" has a score of 80%, which means 80% of patients agreed that the doctors explained clearly.

Survey Category - Shows the survey response results rolled up to the categories, such as cleanliness of hospital environment, communication about medicines, and communication with doctors, nurses.

Overview - An overview of counts in a Hospital enterprise including number of the patients, discharges, emergency department patients, inpatients, and outpatients. This helps you to compare the inflow and outflow of patients, and to allocate resources based on the distribution of patient care efforts between emergency, ambulatory and inpatient services.

Number of patients or encounters by admission type. This report allows you to see the inflow of patients that go through different admission types (referral, transfer, emergency, etc.) and to adjust your admission operations accordingly.

Number of discharges by diagnosis - Modify this report to show the number of discharges for a specific diagnosis of interest. You can correlate this report with the Top 10 Diagnoses report and see if they are proportional. If the number of discharges for a specific diagnosis is trailing, it may indicate a long-term tendency for cases with that specific diagnosis to accumulate in the organization. You may want to investigate such situations and address them.

Number of encounters by organization. This report allows you to see the workload distribution between your organizations and plan your staffing, budgeting, and resource allocations accordingly.

% of encounters by diagnosis - Modify this report to show the % of encounters for a specific diagnosis of interest. You can use this report to estimate the mix of specialists that you need, based on the workloads that the various types of treatments require.

Number of encounters by inpatient and outpatient. The balance between the inpatient and outpatient services you provide may help your organization adjust its focus either on clinics or hospitals.

Number of encounters by top 10 diagnosis - Modify this report to show the number of encounters for a specific diagnosis of interest. You can use this report to see which treatments that you provide are the most labor intensive.

Number of discharges by year and month on a time series. You can correlate this report with the number of encounters by year-end and see if there are any seasonal slow-downs in treatment delivery.

Number of encounters by year and month on a time series. You can use this report to see the long-term trends and seasonal spikes in workload.

Number of discharges by ethnicity - Shows a comparative analysis of number of discharges over two years by ethnicity. Modify this report to show the number of discharges for specific years of interest. You can correlate this report with the number of encounters by ethnicity to see if there is a systematic tendency to discharge members of certain ethnic groups after fewer investigations than the baseline.

Number of encounters by ethnicity - Shows a comparative analysis of the number of encounters over two years by ethnicity. Modify this report to show the number of encounters for specific years of interest. You can correlate this report with the number of discharges by ethnicity to see if there is a systematic tendency to discharge members of certain ethnic groups after fewer investigations than the baseline.

Patient encounter analysis by gender - Shows the workload distribution between male and female patients. You can use this report to plan gender-specific healthcare measures.

Number of encounters with Stroke diagnosis for the chosen time period - Shows the total number of encounters with stroke diagnosis in an organization against the total number of encounters as a whole in an organization. This lets you compare and contrast the volume of encounters in your organizations for a specific diagnosis.

Number of encounters with Stroke diagnosis and Endovascular procedure for the chosen time period - Shows the number of encounters with stroke diagnosis and the patients who received endovascular procedure treatment. This lets you evaluate the frequency of endovascular procedures performed on patients who suffered a stroke.

Number of encounters with Stroke and Endovascular procedure over a period of time. This report lets you see long-term trends and seasonal spikes for endovascular procedures performed on patients who suffered a stroke.

List of Patients Admitted with Stroke Diagnosis who received Endovascular Procedure for Treatment - Tabular report showing the list of patients with Stroke diagnosis who have received endovascular procedure for the chosen time period. This report allows you to drill down to the specifics of each encounter attended by individual patients.

Organizations - Encounters and Diagnosis - Tabular report showing monthly encounters for each diagnosis per organization.

Estimated ALOS versus Actual ALOS by time - Comparative analysis report that shows the average estimated LOS and average actual LOS over a period of time filtered by organization service provider. You can use this report to analyze and address issues with your LOS forecasting methodology for an organization service provider.

Estimated ALOS versus Actual ALOS by organization - Comparative analysis report that shows the estimated LOS and actual LOS by organization service provider. This report provides insight into the LOS forecasting gaps from each organization service provider.

Estimated ALOS versus Actual ALOS by Diagnosis - Comparative analysis report that shows the average estimated LOS and average actual LOS by diagnosis. You can use this report to analyze and address any issues with your LOS forecasting methodology for individual diagnoses.

Number of patient accounts by business unit. This report helps you understand the distribution of patient accounts across business units and it helps in resource planning to manage patient accounts effectively.

Total expected reimbursement amount by cost center, filtered by insurer. This report indicates the degree to which each insurer impacts the income of different cost centers.

Total reimbursement amount owed to business units, filtered by insurer. This report indicates the degree to which each insurer impacts the income of different business units.

A tabular report with patient, patient account, and reimbursement amount details. This report allows you to track the details of all the reimbursements that apply to each patient.

Total claim charge amount versus total non-covered claim charge amount. This report allows you to see the extent to which the charges claimed by each organization service provider are covered by insurers and to evaluate the risk of overdue or delinquent payments.

Total charges over time. This report helps you understand the trend in organization spending for patient services over a chosen period of time.

Total charges by department. This report helps you understand the charging distribution between departments.

Total billed amount versus total payment by organization and DRG - Graphical report and a tabular report showing the total billed amount and the total payment by organization filtered by DRG. This report helps you identify costs and payments for patient services specific to each organization based on diagnosis-related groups.

Total billed amount for stroke treatment by organization service provider - You can modify this report to use any diagnosis or procedure. This report helps you compare the costs that organization service providers spend on stroke treatments.

Total billed amount for stroke and endovascular procedure treatment by organization service provider. This report helps you compare the costs that organization service providers spend on stroke treatments and endovascular procedures.

Patient bill details - Tabular report showing the patient bill details for a selected patient account. This report allows you to drill-down to the detailed billing information of individual patients.