Transcript BASIC UHC PowerPoint Template

UnitedHealthCare CSI: Rhode Island
Episode Risk Group Report
Randie Caetano-Cadigan
and
Karen Stolle
Portal Access
• Reporting and payment statements can be found on UHCONLINE.com
– Reporting access must be granted by main administrator in order to view reporting
information
• Log In>Clinician Resources>Performance Management Reporting>Physician
Performance Based Compensation>Reporting
– Please note expansion sites will not be set up in physician performance based
compensation until Q4 2013
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Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Episode Risk Group (ERG) Report
• Using medical and pharmacy claims information and demographic data, the Episode
Risk Group (ERG) Report provides individual health risk scores for each every
member attributed to the participating practice. The report provides both the past and
projected risk scores and the Episode Risk Groupings (ERGs) that are driving those
scores.
• The purpose of the report is to provide practices with actionable clinical information
that will:
– Assist in the empanelment process (grouping members by health risk) for
appropriate care management intervention
– Identify members with specific care management opportunities
– Help the practice prioritize their care management interventions to focus on those
members with the greatest opportunity for health improvement and utilization/cost
savings
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Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
ERG Example
• View Report Example
---------------------------------------------------------------------------------• UHC National PCMH Key Contacts:
– Karen Stolle, Clinical Program Consultant, [email protected]
– Randie Caetano-Cadigan, Deployment Program Manager,
[email protected]
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Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.