Conquer Value-Based Payments with Customized Reports in Your Agency

If you put some of the best minds in behavioral health together and asked them what the most important reporting needs are to succeed in value-based payments, many of them would probably agree.  You might even get close to a consensus on some of them.

But if you asked each of them to individually draw up what those reports should look like, you wouldn’t get a single duplicate.  That’s because reports are preparation for action steps, and each leader or stakeholder in behavioral health is executing a unique and completely original plan.

Enter – the need for customized reports.

Customized reporting requires the right tools, and the right understanding of who creates reports and who consumes them.  Understanding those two parties and how they relate to one another forms the Creator & Consumer model of custom reporting and analytics. 

What’s the Creator and Consumer relationship?

Every agency has both creators and consumers. When these individuals work together, they’re able to create customized reports for each part of their agency.

Report Creators

Creators are analytically minded workers who are comfortable reading data. This role requires patience and a willingness to consistently revise drafts. A creator must also be proficient in whichever data analytics tool you wish to use.

Report Consumers

Consumers will be found in all areas of your agency because each area has a unique need for data. A consumer must be able to describe their needs to the creator and be willing to collaborate with them to achieve a usable final report.

The 3 Types of Consumers

In order to frame how critical, it is to recognize the separation of reporting needs, consider the three most common groups of report consumers in behavioral health. Each description of report consumers contains example graphs that have been sanitized and all real names have been replaced.

  1. Management Consumers

This group of report consumers are typically interested in data that is reflective of the entire agency – no-show rates, outcomes measures, HEDIS follow-up appointment metrics, and many others. This group is looking to make strategic decisions on behalf of the agency; whether it’s the board of directors looking for success numbers to help lobby for new grant funds, a quality and compliance director seeking accreditation, or a CEO positioning to negotiate value-based payment contracts or expand services into new markets. 

These management consumers need to start their analysis at the top of ladder with data that represents either the whole, or very large sections, of the agency operations, depending on how homogenous your programs or service offerings are. 

Managers are responsible for resource allocations.  Think about that for a second before considering the content with which managers read data.  They need to decide which programs deserve more staff, which programs should be eliminated.  They can also make the case for the quality work being provided for programs or areas that struggle financially, justifying providing supplemental funding, or running a deficit program for the betterment of the community that needs the services.

Consider the dashboard below.  It shows the PHQ-9 depression scale scores of the agency’s clients as they change each time the assessment is administered.  It shows averages of the latest scores against the target score, and the average change from first to last assessment. 

Management Report

The key components here that make this a management type report are the visuals that demonstrate, for these outcome scores, what are the breakdowns of ages and diagnoses that make up these outcomes scores.  This dashboard gives management the ability to uncover value propositions by a simple click that can automatically isolate the desired information. There’s no need to create new dashboards to look at different pieces of data.  Below is a visual that depicts how the outcomes change for just those clients under 18 years of age at discharge.

Management Report

Now we will explore how the same data set needs to be represented differently for other consumer personas.

  1. Clinical Consumers

Clinical report readers typically need reports that are less about the past, and more about the present.  They are looking to keep a quality status check on the people currently in clinical care.  Clinical report readers tend to be managers and clinicians who want to identify those who are at-risk and those who are habitually missing appointments to track the progress of outcomes measurement scoring.

The reporting needs of clinical consumers varies greatly from that management.  While managers may be forming strategic ideas based on outcomes of past clients that can be segmented for a value proposition, the clinical staff is focused on everyone currently entrusted to their care.  The critical differentiator for the clinical report reader is that drill-down to the client level is often necessary to draw meaningful conclusions.

In our example, the Clinical Consumer needs to be able to drill the information down to the client level for managing interventions.  You can see that our new dashboard below no longer has the primary diagnoses and age ranges, but instead has the individual outcome progress of each client, with the ability to filter down easily into programs and individual caseloads.

Clinical Report

 Clinical staff then get the ability to filter the whole dashboard for a single individual.  When doing treatment plan updates or discharge planning, these are the outcomes reports that at the individual level support the activities that drive success at the whole agency level that our managers are monitoring on the previous dashboard.

Clinical Report

  1. External Stakeholders

External Stakeholders typically need a more refined version of information that is less about performing analytics and much more about supporting your claim.  The same outcome data needs to be used differently for different purposes.  The clinical staff monitors existing client data to drive positive interventions and improve scores, while the managers analyze the information in demographic contexts for strategic decision making. The manager then makes a value-based case to an external stakeholder with a simple visual with defined parameters.

In this case the below dashboard defines the outcomes for the following segment:

  • Discharges occurred in the past 12 Months
  • Clients aged 18 or younger
  • Length of Stay is longer than 6 months
  • Client has Blue Cross Blue Shield as Primary Insurance

External Stakeholder Report

This is an example of a case that can be made to an insurance company to say, this is the quality of outcomes when the client population is as stated, so rates should be negotiated higher for service to that client segment.

Creators and Consumers

This simplistic example is meant to highlight the different lenses that report consumers look through.  Understanding the Creator and Consumer approach to report building and analytics helps put not only the right data in front of the right people, but also the right visualizations of that data for maximum impact and appropriate usability.

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Topics: Industry Insights, Business Process