The Washington Health Alliance’s released their latest Total Cost of Care Highlight looking at the cost to provide medical services to patients with results reported by attributed primary care medical group and clinic location.
Using medical claims and enrollment data from its voluntary All-Payer Claims Database from multiple payers, the Alliance combined the cost of all health care services and patient payments, such as co-payments, co-insurance, and deductibles. The total is reported on a per patient per month basis (PPPM) and broken down into five major categories and dozens of services.
- Facility Inpatient—such as surgery, maternity, skilled nursing facility (SNF) and other care that includes an overnight hospital stay.
- Facility Outpatient—services provided on an outpatient basis such as day surgery, radiology, cardiovascular, emergency medicine, and pharmacy.
- Professional—a wide range of treatments including physical therapy, occupational therapy, radiology, emergency medicine, preventive care, specialty drug treatments, and urgent care.
- Prescription Drugs—medicines dispensed at retail pharmacies.
- Ancillary—includes ambulance, home health care, and specific supplies such as durable medical equipment, glasses and contacts, and prosthetics.
- Washington Health Alliance: Highlight: Total Cost of Care-Medical Groups and Clinics