Risk Detail‎

Risk Model

The model assessing the prospective predictive risk (and/or present condition, as applicable) of a user’s attributed patients.

Risk Class

The text result (i.e., class) assigned to a user’s attributed patients that identifies their prospective predictive risk (and/or present condition, as applicable) for the selected Risk Model.

Valid values include Low, Moderate, High, Very High, and Present (for chronic condition risk models).

90D Risk Change

The indication of whether the risk class assigned to a user’s attributed patients for the selected Risk Model has changed between the time of reporting and 90 days prior.

Valid values include Increase, Decrease, and No Change.

Patient ID

The participant-supplied identifier(s) that identifies a user’s attributed patients based on where they received care.

An individual patient may have many participant-supplied identifiers if they have been treated at multiple care locations over time. Valid values are inclusive of Medical Record Number (MRN) values and other source system identifiers submitted via participants' Admission, Discharge, and Transfer (ADT) HL7 feeds, as well as Medicaid ID values (sometimes referred to as 'A' numbers) shared by the Office of MaineCare Services to uniquely identify its Medicaid members.

Note: Regardless of how many Patient IDs that an individual patient may have, they will only have a single HIN ID assigned.

Patient Name

The first and/or last names of a user’s attributed patients.

Attributed Patients

The count of unique patients who are attributed to the selected Attribution Entity and who meet the criteria of the selected personal characteristics.

For more information about the filters impacting this metric, visit the Insightsreporting dashboard’s filter section.

Patients with Risk

The count of a user’s unique attributed patients who have at least one available predictive risk result (i.e., Risk Class = Low, Moderate, High, or Very High; not Present) for the selected Risk Model(s).

For more information about the predictive risks measured in this metric, visit the Predictive Risk Modeling methodology section.

Patients with Chronic Condition(s)

The count of a user’s unique attributed patients who have at least one chronic condition (i.e., Risk Class = Present) for the selected Risk Model(s).

For more information about the chronic conditions measured in this metric, visit the Predictive Risk Modeling methodology section.

Record of Risk Class and 90-Day Risk Change per Risk Model by Attributed Patient

HIN ID

The HealthInfoNet-assigned identifier that identifies a unique patient within the HIE’s data warehouse.

Note: This field can be used to join patient records across all patient-level table exports.

Patient Name

The first and last names of the user’s attributed patient.

Date of Birth

The date of birth of the user’s attributed patient.

For more information, visit the Value-Add Field Logic methodology section.

Risk Model

Separate fields per selected Risk Model; for each Risk Model, the attributed patient’s assigned risk class and 90-day risk change indicator.

Legend:

• Orange- Patients with an increase in assigned risk class for the risk model between the time of reporting and 90 days prior.

• Blue- Patients with a decrease in assigned risk class for the risk model between the time of reporting and 90 days prior.

• Grey- Patients with no change in assigned risk class for the risk model between the time of reporting and 90 days prior.

Risk Model Description

The brief description of the model assessing the prospective predictive risk (and/or present condition, as applicable) of a user’s attributed patients.

Risk Score

The numeric result (i.e., score) assigned to a user’s attributed patients that identifies their prospective predictive risk (and/or present condition, as applicable) for the selected Risk Model. The Risk Class is a statistical translation of the Risk Score.

Valid values include 0-99 for identifying prospective risk and 100 for identifying present chronic conditions.

View patient’s MaineCare medications

MaineCare Medications

Shows only the selected patient’s MaineCare medications.

View patient’s NDPP measurement

NDPP Measurement

Shows only the selected patient’s available NDPP measure results.

View patient’s address history

Address History

Shows only the selected patient’s address history information.

View patient’s encounters

Encounter Detail

Shows only the selected patient’s encounter records.

View patient’s performance measurement

Performance Measurement

Shows only the selected patient’s available performance measure results.

View patient’s personal characteristics

Patient Detail

Shows only the selected patient’s demographics and personal characteristics.

View patient’s risk features

Risk Features

Selects the selected patient in the Patient table; however, users will still need to apply the linkage action from the record to refresh the Risk Feature table.