Monthly Staff Metrics February 2017
Clinical & Medical Management Kim Kirk
Outpatient Surgeries 119Outpatient (347 in 12-2016) 746Office Visit 3IP Acute (82 in 12-2016) (10 OON) 190Observation 72IP Maternity 25Physical Therapy (67 in 12-2016) (5 OON) 331Dialysis 5Speech Therapy (1 in 12-2016) 22Occupational Therapy (5 in 12-2016) 40IP Rehab 3Residential - CD 2IP Psych and Substance Abuse (6 in 12-2016) 13IP SNF 4IP Newborn 5IP Chem Dep 1Home Health 29Durable Medical Equipment 68Home Health - PT 2Pharmacy 9Orthotics 4Inpatient Hospice 1Hospice 1
PAs from 1-1-2016 through 2-3-2016.Due to the increase in the AHP population there has been a correlating increase in PA requests.P&T meeting update: Meeting 2-1-2017 with the P&T Committee, representatives from Navitus andrepresentative from IPC Rx. Reviewed financial summary for 2016. Findings that a significant driver forutilization is the Analgesic/Anti-inflammatory category. Top drugs in this category are Humira andEnbrel. Other high cost drivers were hemophilia and pulmonary hypertension medications utilized by asmall population.Navitus recommended restricting the pharmacy network by removing CVS and Wal Mart. Approximately600K in savings based on the 2016 member data.Navitus recommended moving some expensive generic acute medications to higher co-pay tiers bymoving to the Select Formulary. Estimated 118K in savings.CQIC meeting: held 1/18/2017. Approved 2 new policies: Cardiac Devices and Procedures for Occlusionof the Left Atrial Appendage; Transplant Facility Policy Pediatric.Trends: increase in PT requests. More than doubled the 12-2016 amount.DM stats for January 2017:Asthma Level 1: 1260Asthma L2: 15Asthma L3: 3Diabetes Level 1: 2717Diabetes L2: 156Diabetes L3: 10Total Level 1: 3977Total L2: 171Total L3: 13
Contracting Celeste Richards
Contract Type Fee Schedule Offered7 group > 7 @ FS 1087 individual > 2 @ FS 119 > 5 @ FS 124 Total: 14 contra
Provider Type > 1 ASC > 4 Behavioral Health > 2 Physical therapy > 1 Pediatrics > 3 Primary Care > 1 Spec - Podiatry > 1 Spec - Cardiology > 1 Urgent Care Centersacts
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Fee Schedule Provider TypeContract Type OfferedGroup FS119 Urgent Care CentersGroup FS108 Primary CareIndividual FS124 Behavioral HealthGroup FS108 Behavioral HealthIndividual FS108 Primary CareIndividual FS108 PediatricsIndividual FS119 Primary CareGroup FS108 Specialist - PodiatryIndividual FS124 Behavioral HealthIndividual FS124 Behavioral HealthGroup FS108 ASCIndividual FS124 OT/PTGroup FS124 PTGroup FS108 Specialist - Cardiology
Provider Name Location 3700 Cahaba Beach Rd.,American Family Care Birmingham, AL 35242Lifetime Family 7869 Villa Rica HwyMedicine Dallas, GA 30157 569 Granite CourtMia Garret, MSW Lawrenceville, GA 30044Sreedevi Vayalapalli 950 Scales Rd., Ste 302MD PC Suwanee, GA 30024-4340 41 Wellington Mill Rd.Leslie Cottrell, MD Whitesburg, GA 30185 6470 Georgia Hwy 400, 1st Fl.Ashley O'Shields, MD Cumming, GA 30028 124 Historic Homer Hwy.Hill, John Clark, III, MD Homer, GA 30547Easy Walk Foot Clinic, 3364 Medina DriveLLC Jonesboro, GA 30236 107 Colony Park Dr., Ste 700Walter Jones, III, MS Cumming, GA 30040 585 Research Dr., Ste BStacy Sampson, LPC Athens, GA 30605Foot Ankle & Leg 101-A John Maddox Dr.Center of Rome Rome, GA 30165 2920 Ronald Reagan Blvd., SteAmy Wallace CHT 110, Cumming, GA 30041Lanier Therapy in 5005 Lanier Islands Pkwy,SteMotion 300, Buford, GA 30518Total Cardiology of 2801 North Decatur Rd.Atlanta Decatur, GA 30033
Contract Name ContrApolloMD Proposed UpdatedGordon Hospital/Murray Medical current year MedicCenter GH requested increHarbin ClinicHCA: Redmond, Parkridge and Proposed UpdatedCartersville Medical Center current year MedicPHS - Physician Health ServicesQuest Diagnostics Updating current c structure Updating current ra based on current y Moving from Lette contract
ract Offered Provider Type ER and Hospitalists at Floyd,d Fee schedule based on Polk, Murray, Gordon andcare Wellstar Hospitals in Murray andease in rates Gordon Counties Multi specialty provider groupd Fee schedule based on and ancillaries in Floyd andcare Bartow Counties Hospitals in Floyd and Bartowcontract template and rate County in addition to Hamilton County TN.ate template and rates Physicians in Whitfield andyear Medicare Murray countieser of Agreement to full Lab Vendor - national
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Credentialing &Network Management Misty Maddox
UNIQUE HOA PROV12,000 5,10,000 2,812 680 1,296 538 2,089 3,89 8,000 1,43 6,000 1,911 680 1,296 538 1,406 4,000 901 0 0 0 683 2,000 0 EXC Provider Category‐Direct
VIDERS BY CATEGORY,334 148 421 0 0 71 197 0 0 137 131 151 38 0 17 270 33CLUDES PHCS Provider Category‐Delegated
HOA PROVIDERS (IN80,000 37,47970,000 3,51060,00050,000 33,969 5,59540,000 3,94030,000 1,282 4,581 1,309 1,655 120,000 1,282 4,5081 510,000 1,309 0 0 0 E Category by Location‐Dire
NCLUDING ALL LOCATIONS) 20,502 692 943 0 0 81 1 630 0 0 115,008 62 233 40 0 5,494 710 41EXCLUDES PHCSect Category by Location‐Delegated
UNIQUE HOA PROVIDERS BY Ryan White Aids Clinic 0% Hospital 1% Health Department 0% Urgent Care 1% Ancillary 8%Speciality Care Physician 43%
Y CATEGORY (EXCLUDES PHS)FQHC 0% Allied Health Allied Health 27% ER Physician Hospitalist Hospital Based Provider 0% Hospitalist Primary Care Physician ER Physician Speciality Care Physician 0% Urgent Care Ancillary Hospital Based Provider FQHC 0% Health Department Hospital Ryan White Aids ClinicPrimary Care Physician 20%
HOA PROVIDERS (INCLUDING A Ancillary 2% Urgent Care 0% Primary Care Physician 4% Hospitalist 0%Hospital Based Provider 0% Speciality Care Physician 13%
ALL LOCATIONS) (EXCLUDES PHCS) Ryan White Aids Clinic Allied Health 0% ER Physician Hospital Based Provider Hospital Hospitalist 0% Primary Care Physician Speciality Care Physician Health Department Urgent Care 0% Ancillary FQHC FQHC Health Department 0% Hospital Ryan White Aids Clinic Allied Health 81% ER Physician 0%
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Customer Service Patricia Hawkins
Interaction Statistics - Enhanced CustomerQueue Date Calls Offered Calls Answered Calls Answered Abandoned (NCO)Alliant Health (NCH) within SL NCH out of SL Calls (ABA)ACDAlliant Health 01/02/2017 535 480 311 169 19ACDAlliant Health 01/03/2017 1,364 858 249 609 162ACDAlliant Health 01/04/2017 1,143 795 185 610 114ACDAlliant Health 01/05/2017 952 693 151 542 91ACDAlliant Health 01/06/2017 377 346 266 80 7ACDAlliant Health 01/07/2017 25 0 0 0 7ACDAlliant Health 01/09/2017 1,035 658 153 505 143ACDAlliant Health 01/10/2017 882 729 280 449 51ACDAlliant Health 01/11/2017 817 748 506 242 26ACDAlliant Health 01/12/2017 821 744 393 351 17ACDAlliant Health 01/13/2017 685 597 214 383 22ACDAlliant Health 01/16/2017 622 586 421 165 9ACDAlliant Health 01/17/2017 760 681 362 319 24ACDAlliant Health 01/18/2017 788 667 173 494 49ACDAlliant Health 01/19/2017 767 701 441 260 29ACDAlliant Health 01/20/2017 699 570 265 305 61ACDAlliant Health 01/23/2017 1,131 727 231 496 197ACDAlliant Health 01/24/2017 972 693 308 385 147ACDAlliant Health 01/25/2017 851 617 259 358 129ACDAlliant Health 01/26/2017 817 683 396 287 67ACDAlliant Health 01/27/2017 735 529 214 315 88ACDAlliant Health 01/30/2017 1,282 708 120 588 260ACD 01/31/2017 1,388 696 72 624 351Total 19,448 14,506 5,970 8,536 2,070
Interaction Statistics - EnhancedQueue Date Avg Speed Avg IB Talk Avg OB Talk Answer (ASA) SLA % Time TimeAlliant Health ABA %ACD 155 58.13% 326 0Alliant Health 01/02/2017 3.55% 320 18.26% 321 0ACD 303 16.19% 324 0Alliant Health 01/03/2017 11.88% 305 15.86% 339 0ACD 123 70.56% 375 0Alliant Health 01/04/2017 9.97% 0ACD 0 0.00% 0 0Alliant Health 01/05/2017 9.56% 286 14.78% 353 0ACD 218 31.75% 341 0Alliant Health 01/06/2017 1.86% 146 61.93% 320 0ACD 145 47.87% 313 0Alliant Health 01/07/2017 28.00% 188 31.24% 339 0ACD 137 67.68% 338 0Alliant Health 01/09/2017 13.82% 156 47.63% 313 0ACD 204 21.95% 323 0Alliant Health 01/10/2017 5.78% 139 57.50% 290 0ACD 172 37.91% 302 0Alliant Health 01/11/2017 3.18% 184 20.42% 301 0ACD 165 31.69% 300 0Alliant Health 01/12/2017 2.07% 154 30.43% 295 0ACD 147 48.47% 299 0Alliant Health 01/13/2017 3.21% 149 29.12% 297 0ACD 234 9.36% 302 0Alliant Health 01/16/2017 1.45% 243 5.19% 304ACD 0Alliant Health 01/17/2017 3.16% 200 30.70% 318ACDAlliant Health 01/18/2017 6.22%ACDAlliant Health 01/19/2017 3.78%ACDAlliant Health 01/20/2017 8.73%ACDAlliant Health 01/23/2017 17.42%ACDAlliant Health 01/24/2017 15.12%ACDAlliant Health 01/25/2017 15.16%ACDAlliant Health 01/26/2017 8.20%ACDAlliant Health 01/27/2017 11.97%ACDAlliant Health 01/30/2017 20.28%ACD 01/31/2017 25.29%Total 10.64%
Interaction Statistics - EnhancedQueue Date Avg Handle Avg Wrap-up Transferred Outbound Avg Time (ACW) Time Calls by Agent Agent Calls AbandonedAlliant Health TimeACD 01/02/2017 429 79 62 0Alliant Health 162ACD 01/03/2017 391 50 124 0 256Alliant Health 225ACD 01/04/2017 482 140 102 0 227Alliant Health 149ACD 01/05/2017 437 78 79 0 251Alliant Health 242ACD 01/06/2017 433 38 45 0 209Alliant Health 142ACD 01/07/2017 0 000 159Alliant Health 162ACD 01/09/2017 415 48 94 0 142Alliant Health 172ACD 01/10/2017 400 44 87 0 184Alliant Health 121ACD 01/11/2017 479 150 92 0 166Alliant Health 164ACD 01/12/2017 379 53 81 0 167Alliant Health 156ACD 01/13/2017 443 84 74 0 135Alliant Health 162ACD 01/16/2017 401 50 66 0 192Alliant Health 226ACD 01/17/2017 412 73 76 0Alliant Health 196ACD 01/18/2017 407 65 66 0Alliant HealthACD 01/19/2017 372 57 71 0Alliant HealthACD 01/20/2017 384 46 75 0Alliant HealthACD 01/23/2017 370 49 85 0Alliant HealthACD 01/24/2017 462 136 75 0Alliant HealthACD 01/25/2017 369 45 86 0Alliant HealthACD 01/26/2017 376 47 79 0Alliant HealthACD 01/27/2017 356 27 84 0Alliant HealthACD 01/30/2017 367 44 126 0Alliant HealthACD 01/31/2017 370 42 125 0Total 406 67 1,854 0
Interaction Statistics - EnhancedQueue Date Avg Diverted Transferred Calls Answered Avg Handle Calls Answered Time Calls - OutoundAlliant Health - Inbound Time INACD 58 0Alliant Health 01/02/2017 0 480 429 0ACD 0Alliant Health 01/03/2017 0 122 858 391 0ACD 0Alliant Health 01/04/2017 0 101 795 482 0ACD 0Alliant Health 01/05/2017 0 77 693 437 0ACD 0Alliant Health 01/06/2017 0 44 346 433 0ACD 0Alliant Health 01/07/2017 0 0 00 0ACD 0Alliant Health 01/09/2017 0 94 658 415 0ACD 0Alliant Health 01/10/2017 0 85 729 400 0ACD 0Alliant Health 01/11/2017 0 89 748 479 0ACD 0Alliant Health 01/12/2017 0 80 744 379 0ACD 0Alliant Health 01/13/2017 0 72 597 443 0ACD 0Alliant Health 01/16/2017 0 65 586 401ACD 0Alliant Health 01/17/2017 0 76 681 412ACDAlliant Health 01/18/2017 0 66 667 407ACDAlliant Health 01/19/2017 0 71 701 372ACDAlliant Health 01/20/2017 0 74 570 384ACDAlliant Health 01/23/2017 0 83 727 370ACDAlliant Health 01/24/2017 0 74 693 462ACDAlliant Health 01/25/2017 0 83 617 369ACDAlliant Health 01/26/2017 0 77 683 376ACDAlliant Health 01/27/2017 0 82 529 356ACDAlliant Health 01/30/2017 0 124 708 367ACD 01/31/2017 0 124 696 370Total 0 1,821 14,506 406
Interaction Statistics - EnhancedQueue Date Avg Handle Time OBAlliant Health Dequeued Calls Dequeued TimeACD 01/02/2017 0 10Alliant Health 70ACD 01/03/2017 0 80Alliant Health 60ACD 01/04/2017 0 50Alliant Health 00ACD 01/05/2017 0 30Alliant Health 70ACD 01/06/2017 0 30Alliant Health 12 0ACD 01/07/2017 0 11 0Alliant Health 20ACD 01/09/2017 0 7 64Alliant Health 40ACD 01/10/2017 0 80Alliant Health 60ACD 01/11/2017 0 30Alliant Health 70ACD 01/12/2017 0 40Alliant Health 70ACD 01/13/2017 0 50Alliant Health 90ACD 01/16/2017 0 70Alliant HealthACD 01/17/2017 0 132 64Alliant HealthACD 01/18/2017 0Alliant HealthACD 01/19/2017 0Alliant HealthACD 01/20/2017 0Alliant HealthACD 01/23/2017 0Alliant HealthACD 01/24/2017 0Alliant HealthACD 01/25/2017 0Alliant HealthACD 01/26/2017 0Alliant HealthACD 01/27/2017 0Alliant HealthACD 01/30/2017 0Alliant HealthACD 01/31/2017 0Total 0
Data Analytics Wesley Sanders
Summary IndividualStatistics GroupStatistics MembershipbSummary Memb TotalMembership RatingAr 2 Group 3 4 9,132 7 24% 9 10 Individual 13 Other 28,248 GrandTot 76% Month RatingAre 2 3 4 7 9 10 13 Other GrandTot
byCounty GroupMembershipby IFPbyCounty FFM byCounty % County S. .bershipbyRatingArea Group Individual GrandTotalrea % ofTotal Members % ofTotal Members % ofTotal Members 0% 25 1% 380 1% 405 5% 487 4% 1,206 5% 1,693 0% 15 4% 1,215 3% 1,230 8% 700 13% 3,682 12% 4,382 55% 4,985 16% 4,520 25% 9,505 8% 756 36% 10,056 29% 10,812 14% 1,277 25% 7,178 23% 8,455 10% 887 0% 11 2% 898otal 100% 9,132 100% 28,248 100% 37,380thlyPremium byRatingArea rea Group Individual GrandTotalotal $10,290.78 $219,913.74 $230,204.52 $231,175.05 $703,958.38 $935,133.43 $683,523.73 $691,168.52 $7,644.79 $1,958,657.23 $2,267,084.67 $308,427.44 $2,356,625.36 $4,631,978.24 $2,275,352.88 $6,172,523.80 $6,498,976.00 $326,452.20 $3,801,968.63 $4,393,834.52 $591,865.89 $411,968.33 $410,878.83 $1,089.50 $20,060,348.23 $4,162,087.86 $15,898,260.37
Summary IndividualStatistics GroupStatistics MembershipbIndividual/FamilyPlan(IFP)SummaryMembershipStatsbyRatingAreaRatingArea AllIFP FFM % APTC % CSROther Membership Membership 100.00% 100.00%23 11 5 79.12% 57.06%4 380 340 71.81% 46.65%7 1,206 1,089 94.67% 62.08%9 1,215 1,200 91.28% 64.70%10 3,682 3,405 93.36% 68.93%13 4,520 3,585 92.84% 67.86%GrandTotal 10,056 9,156 91.29% 67.87% 7,178 6,532 91.30% 66.26% 28,248 25,312IFPMonthlyPremium byRatingArea RatingArea $6,000,000.00 $5,000,000.00MonthlyPremium $4,000,000.00 $3,000,000.00 $2,000,000.00 $1,000,000.00 $0.00 2 3 4 7 9 10 1
byCounty GroupMembershipby IFPbyCounty FFM byCounty % County S. .TotalIFPmembershipbyRatingArea 13 2 47,178 380 1,215 7 3,682 9 4,520 1010,056 IFP:Individual/FamilyPlan FFM:Federally-FacilitatedMarketplace APTC:AdvancedPremium TaxCredit CSR:CostShareReduction13
Summary IndividualStatistics GroupStatistics MembershipbGroupSummaryCounty AllGroup Small Large Total RatingArea AllGroup Small Group Group Accounts 3 259 Group 7 231BARTOW 54 7 47 3 9 6,743 184 98 10 832 165CATOOSA 98 8 13 1,024 2,191 6 GrandTotal 9,089 245CHATTOOGA 6 19 1 230 23 3,015CHEROKEE 19 20 4 19COBB 23 3 2DADE 20 56 1DEKALB 19 80 3 Avg.MembershipPerGrp-All 17 29.80FANNIN 58 151 56 2 36 Avg.MembershipPerGrp-SmallFLOYD 86 73 30 13 11.87 128FORSYTH 28 24 28 1 Avg.MembershipPerGroup-Large 388FRANKLIN 43 43 1 127.5 6FULTON 80 2 7 47GILMER 17 12 2 1,801GORDON 915 3,015 764 20GWINNETT 36 2HABERSHAM 162 89 5HALL 203 75 7 NumberofGroups(Total):301 NumberofGroups(Small):257LUMPKIN 24 2 NumberofGroups(Large): 47MURRAY 651 263 28RABUN 6 1UNION 2 1WALKER 113 66 7WHITE 392 380 2WHITFIELD 6,034 4,233 177GrandTotal 9,089 6,074 301Note:Statisticsonthispagearebasedonthecountywheretheemployergroupislocated,notthemember'scountyofresidence.
byCounty GroupMembershipby IFPbyCounty FFM byCounty % County S. .ll Large Total MembershipbyRatingAreap Group Accounts4 75 23 13 7 101,0245 66 16 231 8321 4,552 2075 587 190 794 365 6,074 301 9 6,743MonthlyPremium GroupMonthlyPremium byRatingArea RatingArea $2,000,000.00 $1,500,000.00 $1,000,000.00 $500,000.00 $0.00 3 7 9 10 13
Summary IndividualStatistics GroupStatistics Membershipb Marion Hamiltonm, Bradley Polk Cher 3 1 40 8 1 Dade Catoosa Fannin U 401 2,070 592 4 Jackson Walker Whitfield Murray Gilmer 1 1,911 6,711 2,190 908 DeKalb Chattooga Gordon Pickens Lump 1 603 2,226 898 69 Bartow Dawson 409 468Marshall Floyd 3 2,768 Cherokee Cherokee Forsyth 10 527 474 Polk Paulding Cobb Gwinn 1,043 16 63 52 Haralson DeKalb 222 Douglas Fulton 37 Carroll 5 930 64 {{x}} 1 Clayton 10
byCounty GroupMembershipby IFPbyCounty FFM byCounty % County S. . TotalMembershipbyCounty Membership 4,500 275erokee 1 Greenville Cheroke 15 3Union Towns Rabun Spartanburg 469 213 527 35 White Union 1,767 2 pkin Habersham Anderson698 1,197 Stephens 2 339 Hall Banks Franklin Hart 4,444 371 199 118h Madison Jackson 2 Elbert 249 10nett Barrow Clarke2 139 6 Walton Oconee 10 5}} Morgan Greene 4 2 Newton 3
Summary IndividualStatistics GroupStatistics MembershipbyCounty GroupMembe County Marion Hamiltonm, Bradley Polk Cher 3 1 40 8 Dade Catoosa Fannin U 23 433 52 Jackson Walker Whitfield Murray 1 244 3,699 1,223 DeKalb Chattooga Gordon Gilmer Lum 1 44 894 65 3 Bartow Pickens Dawson 157 17 6Marshall Floyd 3 224 Cherokee Cherokee Forsyth 10 41 15 Polk Paulding Cobb Gwinn 24 16 59 51 Douglas Fulton DeKalb 5 60 37 Carroll Clayton 12 10
bershipby IFPbyCounty FFM byCounty % Subsidizedby . County GroupMembershipbyCounty Membership 1,500 50erokee 1 Greenville Cherok 15 3Union Towns Rabun Spartanburg 3 5 14 35 White Union 330 2mpkin Habersham Anderson32 139 Stephens 2 9 Hall Banks Franklin Hart 166 11 33 6th Jackson Madison Elbert 15 2 3nnett Barrow Clarke51 4 4 Walton Oconee 10 1Newton Morgan Greene 3 4 2
In GroupStatistics MembershipbyCounty GroupMembershipby IFPbyCou Countydi.. IFPMembershipbyCountyDade Catoosa Fannin Union378 1,637 540 466 Walker Whitfield Murray Gilmer 1,667 3,012 967 843 Chattooga Gordon Pickens Lumpkin 559 1,332 881 666 Dawson 462 Floyd Bartow Cherokee Forsyth 2,544 252 486 459 Polk 1,019 Haralson 222 Carroll 918 Heard 75
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