Utilization Profile I

This reporting dashboard presents aggregate-level Inpatient and Emergency Department encounter information for all eligible MaineCare members who have had an encounter within the last 365 days. The information provided in the reporting can be filtered by a number of criteria based on user selection.

Before Getting Started

Before diving in, use of this reporting dashboard requires clear understanding of a few foundational components that we leverage in our analytics and reporting. If you haven’t already, be sure to read through some precursory definitions and methodologies. Those areas that we think may be helpful to review specific to the understanding of this reporting dashboard include:

Data Sources & Refresh Frequency

HealthInfoNet’s reporting dashboards combine a number of data files sourced from HealthInfoNet’s Health Information Exchange (HIE) data warehouse and MaineCare’s eligibility and claims information. For each dashboard available, users should understand the primary data source(s) and refresh frequency to instill confidence in and inform use of the reporting within their workflows. Learn more…

Member Eligibility Inclusion Criteria

HealthInfoNet’s data use agreement with the Maine Department of Health and Human Services permits the Office of MaineCare Services to view information from the statewide HIE according to specific member eligibility inclusion criteria. To meet this criteria, HealthInfoNet receives a daily eligibility file from MaineCare that is used to refresh each reporting dashboard on a daily basis. Learn more…

Member & Organizational Attribution

Attribution is the process of assigning members to individual organizations as well as identifying the hierarchical arrangements among the distinct types of organizations available within reporting. What results is the ability for users to view their members' healthcare utilization, predicted risks, and quality outcomes aggregated in different ways to meet various use cases and programmatic needs. Learn more…

Tips & Tricks

The more you know how to work the nuts and bolts of each reporting dashboard’s built-in functionality, the better you’ll be able to effectively and efficiently use the dashboards to your advantage. That’s why we’ve created a list of best practices, lessons learned, and other tips and tricks to optimize your experience while working in the platform. Learn more…

Dashboard Definitions

Not sure what you’re looking at? No problem! We’ve done the homework for you by detailing the definitions, use cases, and any other relevant notes about all charts and tables available in this dashboard.

📈 Total Inpatient Encounters

Contains key information about the Inpatient encounters had by eligible members.

Metric	Definition	Notes
Count	The total number of Inpatient encounters had by eligible members based on defined organizational attribution, admission date period, and other relevant filter selections.
Rate	The rate of Inpatient encounters per 1,000 encounters had by eligible members based on defined organizational attribution, admission date period, and other relevant filter selections.	Calculation: (Numerator/Denominator)*1000 Numerator - All Inpatient encounters had by eligible members. Denominator - All Inpatient and Emergency Department encounters had by eligible members.
Comparison	The percent difference in the total number of Inpatient encounters had by eligible members between two comparable admission date periods.	The comparison of two comparable admission date periods is defined by the Admission Date Comparison filter.
Trending	The trend of Inpatient encounters had by eligible members over the last 12 months based on defined organizational attribution, admission date period, and other relevant filter selections. Note: By default, the x-axis of the chart is broken into week segments, beginning with the first of the week of the selected Admission Date period.	Benchmarking - The dotted line in the chart represents the average number of Inpatient encounters experienced by rendering facilities over time. Color Coding - The differences in colors represent encounters with emergent (green) versus non-emergent (red) primary dx codes.

📈 Total Emergency Department Encounters

Contains key information about the Emergency Department encounters had by eligible members.

Metric	Definition	Notes
Count	The total number of Emergency Department encounters had by eligible members based on defined organizational attribution, admission date period, and other relevant filter selections.
Rate	The rate of Emergency Department encounters per 1,000 encounters had by eligible members based on defined organizational attribution, admission date period, and other relevant filter selections.	Calculation: (Numerator/Denominator)*1000 Numerator - All Emergency Department encounters had by eligible members. Denominator - All Inpatient and Emergency Department encounters had by eligible members.
Comparison	The percent difference in the total number of Emergency Department encounters had by eligible members between two comparable admission date periods.	The comparison of two comparable admission date periods is defined by the Admission Date Comparison filter.
Trending	The trend of Emergency Department encounters had by eligible members over the last 12 months based on defined organizational attribution, admission date period, and other relevant filter selections. Note: By default, the x-axis of the chart is broken into week segments, beginning with the first of the week of the selected Admission Date period.	Benchmarking - The dotted line in the chart represents the average number of Emergency Department encounters experienced by rendering facilities over time. Color Coding - The differences in colors represent encounters with emergent (green) versus non-emergent (red) primary dx codes.

🔢 Encounters by Rendering Facility

Contains key information about the encounters had by eligible members per rendering facility.

Metric	Definition	Notes
IP Encounters	The total number of Inpatient encounters had by eligible members per rendering facility based on defined organizational attribution, admission date period, and other relevant filter selections.
IP Rate/1000	The rate of Inpatient encounters per 1,000 encounters had by eligible members per rendering facility based on defined organizational attribution, admission date period, and other relevant filter selections.	Calculation: (Numerator/Denominator)*1000 Numerator - All Inpatient encounters had by eligible members. Denominator - All Inpatient and Emergency Department encounters had by eligible members.
ED Encounters	The total number of Emergency Department encounters had by eligible members per rendering facility based on defined organizational attribution, admission date period, and other relevant filter selections.
ED Rate/1000	The rate of Emergency Department encounters per 1,000 encounters had by eligible members per rendering facility based on defined organizational attribution, admission date period, and other relevant filter selections.	Calculation: (Numerator/Denominator)*1000 Numerator - All Emergency Department encounters had by eligible members. Denominator - All Inpatient and Emergency Department encounters had by eligible members.

Dashboard Filters

Want to tailor the dashboards to look at only a certain member population or with certain conditions applied to encounter criteria? Easy. We’ve got plenty of embedded and stock filters for you to use to meet various cross-cutting use cases and needs.

🔍 Stock Filters

Stock filters are the drop-downs, sliders, and free-text fields located at the top of each reporting dashboard that allow users to slice and dice the data contents in diverse ways.

Filter	Definition	Notes
Attribution Type	View our section onAttribution Selection from more information.	For more information on HealthInfoNet’s attribution methodologies, see the section on Member & Organizational Attribution.
Attribution Level	View our section onAttribution Selection from more information.
Attribution Entity	View our section onAttribution Selection from more information.
Admission Date Period	The defined range of admission dates corresponding to a member’s encounters.	Options for this filter allow users to configure the report based on either a rolling-period basis (e.g., last 90 days) or on a calendar-period basis (e.g., last full quarter).
Admission Date Comparison	The comparison of two comparable admission date periods.	This filter is used to populate the Comparison metric located in the dashboard’s charts.
Encounter Status	The indication of whether a member’s encounter is considered currently hospitalized or whether it has been discharged and, if so, to which setting.	For more information on HealthInfoNet’s encounter status methodology, see the section on Encounter Status.
Diagnosis Type	The indication of whether the primary diagnosis code reported on a member’s encounter is classified as Emergent or Non-Emergent.	This filter uses an ICD-10 value set identified by MaineCare under “Section 45 Non-Emergent Use of Emergency Department: ICD-10 Codes,” effective October 1, 2015, as "Non-Emergent" diagnosis codes.
Chronic Condition	The identification of encounters only for members with a present chronic condition.	Chronic conditions are identified by whether a member has a score of ‘100’ for any of the available condition predicted risk models. For more information on HealthInfoNet’s condition-based predicted risk models, see the section on Predictive Risk Modeling.

🔍 Default Stock Filters

For each stock filter available, there must be a default value assigned in order to populate the reporting dashboards for users to work from. Those default values are defined below per stock filter.

Filter	Default Value	Interpretation
Attribution Type	View our section onAttribution Selection from more information.	Retrieves encounter data per members' attribution to organization(s) based on their encounter histories.
Attribution Level	View our section onAttribution Selection from more information.	Retrieves encounter data on all levels of organizations that are affiliated with members' attributed organization(s) based on their encounter histories.
Attribution Entity	View our section onAttribution Selection from more information.	Retrieves encounter data on all organizations that are affiliated with members' attributed organization(s) based on their encounter histories.
Admission Date Period	Last 30 Days	Retrieves encounter data based on admission dates from the last 30 days (from today).
Admission Date Comparison	Last 30 Days vs. Prior 30 Days	Compares the volume of encounter data based on admission date between the last 30 days and the prior 30 days.
Encounter Status	All	Retrieves encounter data for all encounter statuses (i.e., currently hospitalized and discharged).
Diagnosis Type	All	Retrieves encounter data for all types of primary diagnosis codes (i.e., emergent and non-emergent).
Chronic Condition	All	Retrieves encounter data for all members regardless of whether they have a chronic condition.

📊 Embedded Filters

By selecting a particular data point in either the dashboard’s charts or table, a tooltip will appear with a variety of information, including the ability to allow users to filter the contents of the current reporting dashboard based on the selected attribute.

Use Case: As a user, I want to view the Total Inpatient Encounters and Total Emergency Department Encounters charts for only encounters rendered at Bridgton Hospital by eligible members. To do so, I would select the Bridgton Hospital record in the table and the “Filter dashboard by selected attribute” hyperlink from the tooltip. Doing so will automatically adjust the remaining contents of the dashboard to reflect only activity at Bridgton Hospital.

Dashboard Linkage

Did you find an interesting trend or result that you want to explore more? Our reporting dashboards have been carefully linked together to allow for deeper dives and tangential investigation into available data. Continue reading to learn which of our other dashboards this report links to for continued study.

📈 Chart Linkage

By selecting a particular point (i.e., admission date month) in either encounter trend chart, a tooltip will appear with a variety of information, including the ability to allow users to drill-down into the underlying member-detail utilization (see Member Utilization) for the selected attribute.

Use Case: As a user, I want to view all Inpatient encounters had by eligible members during May 2021. To do so, I would select the May 2021 segment in the Total Inpatient Encounters chart and then the “View corresponding member-level utilization” hyperlink from the tooltip. Doing so will automatically redirect my reporting to the Member Utilization dashboard, filtered to just those specific encounter records.

🔢 Table Linkage

By selecting a particular organization or cell within the table, a tooltip will appear with a variety of information, including the ability to allow users to drill-down into the underlying member-detail utilization (see Member Utilization) for the selected attribute.

Use Case: As a user, I want to view all encounters rendered at Bridgton Hospital by eligible members. To do so, I would select the Bridgton Hospital record in the table and the “View corresponding member-level utilization” hyperlink from the tooltip. Doing so will automatically redirect my reporting to the Member Utilization dashboard, filtered to just those specific encounter records.

Want to keep learning about our reporting dashboards? Great! There’s more utilization-related information for you to explore. Try checking out one of these dashboards to continue your study:

Utilization Profile II - Additional aggregate-level information on Inpatient and ED encounters.
Member Utilization - Underlying member-level encounter information.