Spot Trends Faster: The Best Financial Views in AccuReports
Risk-based relationships between payers and providers depend on cost controls to make the most of funding and maximize profits. How do health plan and health system executives get the required financial intelligence? How do they empower data analysts and providers to make the business of healthcare more effective and efficient?
In just a few clicks within AccuReports, healthcare stakeholders can spot financial trends as well as cost and care outliers in value-based care arrangements. Interactive links in AccuReports expose granular details that help users identify performance drivers. They also support clear action plans to improve operations and health outcomes.
The best reports for users to view financial trends in AccuReports are:
Funding and Expense by Month Report
To locate the report from the main menu in AccuReports, users navigate to the “Financials” section. This presents trends and profit-and-loss analysis, as well as loss ratio development by member.
The report specifically monitors the foundational profit and loss of a chosen member population (group, center, PCP) for a certain period. Understanding profit and loss helps payers assess the financial risk associated with a member population, monitor if financial goals are being met, and provide insights into areas where the member population may need improvement.
Within the report, users can view the service fund’s balance and status (surplus or deficit) before disbursement. This real-time visibility supports payer-provider collaboration to adjust processes and maximize savings.
Rs used in parallel with the report deliver the highest value when the date range or year, panel (group, center, and PCP), and carrier (payor, product, sub-product) are consistent. The Save Context feature enables AccuReports users to easily retain parameters to run reports across analytics categories. To save specific parameters, users should click the “Save Context” button after successfully running a report.
Users may run complementary reports with saved parameters to identify high and low performers and prioritize action.
For example, the Funding and Expense by PCP report shows member panels tied to trends over time in the Funding and Expense by Month report. Teams use this report to identify physician or PCP performance and guide conversations with provider partners at the group, center, or individual level. It helps highlight best practices from high performers and adjust strategies to close gaps in care and reduce avoidable high costs. Member-specific details in the report give payers visibility into the volume and acuity of members managed by a provider and the ability to align financial incentives with member outcomes.
Users can find the report on the main menu under the “Financials” section.
With the context saved, users can run the report for payor, product, group, center, PCP, and time frame, and isolate the providers with whom to schedule performance review calls.
Per Member Per Month Report View
Within the report, trends are easily observed in both Standard (total funding) and Per Member Per Month views. To switch to the PMPM view, users navigate to the “Report Views” section between the “Report Layouts” and “Year” and select “PMPM.” Once selected, the report page immediately reloads, and the section “Report Results” changes to “Report Results – PMPM.”
PMPM Report View offers a look into member-specific utilization associated with a panel. By examining granular member details, AccuReports users can identify, manage, and optimize care for high-cost individuals and transition away from ineffective and reactive, volume-based care that can cause unnecessary expenses.
Users identify drivers of overspending in the report by drilling into outlier values to see the underlying utilization. Drill down works only when users select one or more payors and groups.
Medical Claims List
In AccuReports, drilling down from a financial summary on inpatient claims produces a result similar to when a user orders specifically scoped data from the Medical Claims List report. The impact is visible in the context of the plan, product, provider, and time frame of the summary.
From the main menu, users navigate to the “Claims” section. This view presents all claim types, summarized into single lines for easy review.
Transparency in granular details and Total Cost of Care is essential for payers. It supports financial stability in risk-based contracts and helps evaluate performance beyond unit costs.
Funding Detail PMPM
Sometimes, unfavorable financial performance stems from insufficient funding. In these cases, users need to be able to inspect and understand funding at a member level and in total. The most detailed view of this data in AccuReports is the Funding Detail PMPM report. Users can access the report from the “Revenue” section of the main menu or by clicking on a value in the “Funding” column of any of the Funding and Expense reports.
The report presents paid revenue that does not include a risk-adjusted forecast. Relying solely on forecasted, risk-adjusted data can hide operational inefficiencies and lead to inaccurate final projections. When payers view “unadjusted” paid revenue, they can accurately measure performance and validate the risk-adjustment model.
Users can create a report for a specific PCP or other roll up. It shows risk adjustment paid details and the share of premium allocated to the member’s risk pool.
Drive Better Financial Decisions with AccuReports
AccuReports is a secure, customizable platform for analyzing trends, identifying cost drivers, and improving financial performance. It is designed to empower health plans, MSOs, IPAs, ACOs, and consultants to make confident, informed decisions. To learn more about AccuReports or RAMP, fill out the form on our website or call 888-466-1025 today.