Why isn’t [physician or facility] in the market data?
There are many reasons why a record isn’t in the market data.
- Often the answer lies in the way that the physician or facility submits their claims. The two most common are:
- HMS data is collected at the NPI level, and so claims come from the address or clearing house for billing, which is not always the same as the treatment office location(s).
- Not every physician has a hospital or SNF affiliation. The way the claims are processed, their name and the facility name must be on the same claim form otherwise TargetWatch can't make that association.
- Market data is based primarily on Medicare claims and that physician or facility accepts other payors such as Medicaid or private insurance.
- Check the latest claims update and confirm if the physician or facility was in business during that time.
Do clients only receive TargetWatch data for counties purchased?
Clients can only view counties that they purchased at the top-level tabs. However, with sub-reports, a client would see all associated data for the line that they’ve drilled into. Example: An agency only purchased data for Davidson County, TN. When viewing the Physician sub report () on a hospital in the county , physicians outside of Davidson County could be visible as long as they were affiliated to that hospital.
What is the “claim” – an actual claim on patients, an ADC, or is it billing?
Adjudicated claims (claims that were finalized).
Does TargetWatch display SNF discharge to hospice data?
Discharge to hospice data is not available for SNFs.
What’s the difference in Market Share and Hospice Share Percentages?
- Market Share = Where are patients going that the provider is signing orders for
- Hospice Share = Where are patients going that the provider is coming in contact with
What's the difference between the Hospital LTAC Readmit Rate and Agency LTAC Readmit Rate in the LTAC Hospital Crosswalk?
- Hospital LTAC Readmit Rate = the percentage of patients that were readmitted to the hospital after being discharged to LTAC
- Agency LTAC Readmit Rate = the percent of patients that are readmitted after being sent to Home Health from the LTAC
Now that count data is incorporated into the reporting, what are the nuances that we need to be aware of in terms of how data is being displayed?
Keep in mind that the analytics provided are based off adjudicated claims counts, though the numeric values provided in the “counts” columns are of Patient Count, not claim count.
What is the exact time frame for the data being pulled in TargetWatch? This article says that the current year is a rolling year, which sounds like it includes duplicate information for previous years.
Yes, there is some overlap in the current year data. We receive updates for any historical claims that are adjudicated since our last data refresh along with any new claims within the date range we receive from our data partner. Data sets that we’ve received full years on (2016, for example) do not “roll” – they just update as new adjudications are added. Until a current year is fully provisioned we backfill the year with the rolling calendar data to provide a 1:1 comparison with other annual data sets.
Example: A current rolling 12-month period is being compared to the last completed calendar year. Once a calendar year is completed, it simply shows the trend over the prior year.