Total Cost of Care Per Member Per Month (TCOC PMPM)
The total cost per member per month for all care delivered to commercial plan patients attributed to the ACO. This reflects medical services from all providers and is risk adjusted based on patient health status.
Total Cost Index (TCI)
Total Cost Index (TCI) Is an indicator of efficiency or cost effectiveness in treating patients. A negative value means an ACO has below average costs.
Resource Use Index (RUI)
Resource Use Index (RUI) measures the impact of differences in the number of medical services used to treat patients on TCOC. Positive values indicate above average use of services.
Price Index (PI)
Price Index (PI) captures the impact of differences in prices paid for services used to treat patients on TCOC. A negative value means that prices for services are below average.
The DHIN Analytics team leveraged the Johns Hopkins University ACG® System, 3M MS-DRG episode grouper (a component of the 3MTM Core Grouping Software), Delaware consensus patient attribution parameters, and the HealthPartners’ Total Cost of Care and Resource Use Framework (TCOC) to develop inputs to generate the CostAware measures.