Bringing clarity to your practice data

The Theon Care Optimizer® platform, imagined by Geneia®, is your resource for successful population health management. This innovative analytics platform brings you the information you need to analyze your practice data to uncover meaningful and actionable information.

Request access

Understanding dashlets and action reports

Dashlets and Action Reports provide quick access to detailed information that can be used in both strategic and detail-level analysis and decision-making. Depending on your security role/access level, you may have access to most or all of these reports.

Dashlets

Acute care utilization

Utilization within a short hospital stay showing admissions per 1,000 (i.e. ED, urgent care, IP admits, and observation) for the health system and peer.

Commercial risk adjustment

Information on the top 5% of the attributed commercial population as determined using the health and human services (HHS) risk model and assigned a commercial risk adjustment (CRA) score. The top portion of the dashlet reflects information for the entire commercial population. The missing and suspected HCC's reflect information for the small group and individual commercial populations only.

Inpatient utilization

Utilization by inpatient facility type (i.e. SNF, rehabilitation, acute care, readmission, and mental health/substance abuse) showing admission per 1,000 for the health system and peer.

Medical cost

PMPM for medical costs with and without outliers for the health system and peer.

Medicare Advantage risk adjustment

Information on the top 5% of the attributed Medicare population as determined using the CMS risk model and assigned risk adjustment factor (RAF) score. The dashlet contains information related to the Medicare Advantage population include average risk adjustment factor (RAF) score, the number of Medicare Advantage members attributed to the practice, an identifier of no primary care physician visits, chronic HCC's missing, and HCC's suspected.

Operational performance

Measures relating to diabetes management, coronary artery disease (CAD), and chronic heart failure (CHF).

Pharmacy cost

PMPM for pharmacy costs with and without outliers for the health system and peer.

Program management

Information on case management and disease management identification for the commercial and Medicare Advantage populations.

Quality opportunities

Quality and disease management initiatives by identifying measures on a patient level that have not yet received recommended screenings or treatments including: open Star opportunities, open care opportunities, open coding opportunities, and deviations.

Quality performance

High level statistical information on attributed patients currently within disease management programs: diabetes management, coronary artery disease (CAD), and chronic heart failure (CHF).

Risk adjusted cost overview (with or without outliers)

PMPM by designated service area (i.e. ER, lab, primary care, hospital, radiology, pharmacy, and specialty care) for the health system and the peer with and without high dollar claimants.

Savings opportunities

Potential areas for dollar savings by specialty area. The objective is for each index to not only be under the established index goal to achieve a dollar saving, but also to achieve an index that is lower in relation to the peer.

Utilization overview

Encounter count by per 1,000 visits by service area for the health system and peer.

Dashboard

Personal profile

Displays your name, last log-on date, and user role within the system.

Dashboard

Provides an overview of financial and clinical data with the ability to filter a health system's performance based on rolling 12-months of attributed patient data.

Focus dashboard

Allows you to customize and view 6 additional dashlets of cost drivers and key performance indicators (KPIs) available under the 'customized view' filter.

Refine role

Allows users who have multiple roles to conveniently switch view types. For any practice or provider-level roles, the refine population filters will automatically set to the associated health system.* Caution: any changes made presents you with a dialog box alerting you to the closure of your open 'Action Reports,' and asks if you would like to continue.

Refine population

Presents filters that reflect the available options derived from a top-down hierarchy. The values for the hierarchy are determined during installation of Theon and are maintained by your system administrator. It provides users the ability to refine the patient population and peer group used for comparison. Caution: whenever new filters are chosen or the 'reset prompts' button is selected, you will be presented with a dialog box that alerts you to the closure of your open 'action reports,' and asks if you would like to continue.

Peer group

Contains four (4) options to select as your peer group: health system, LOB (line of business), health system and LOB, and program.

Dashlets

Provide visual representation of performance information.

Your dashboard

Your dashboard houses the following tools:
  • Dashboard - provides you with quick access to the 'dashboard' and the 'focus dashboard'.
  • Action reports - This is a drop down menu reflecting all of the available reports in the Care Optimizer module.
  • System administration - The system administration section allows the account and system administrator to update user information, set data parameters, and create new user accounts. Please note: this is only available for the system administrator user role.
  • Message center - The message center lists current date parameters and provides other important information or alerts from the system administrator.

Action reports

Claim detail

All claim lines under the parent claim.

Claim summary

A one line per Claim ID summarization with multiple descriptive fields.

Cost and utilization summary by cost bucket

PMPM dollar amounts spread across the 7 cost and use buckets (lab, radiology, ER, hospital, pharmacy, specialty care, and primary care). Each bucket has PMPM's divided into 'with' and 'without' outlier categories.

Inpatient admission

Past and current inpatient admissions based on a supporting claim or census data. Information is presented one line per confinement with multiple descriptive fields.

Medical and pharmacy cost summary

PMPM data calculated in various fashions and at different groupings.

Medical and pharmacy financial summary

The summary displays PMPMs after applying stop loss, previous PMPMs after applying stop loss adjusted for change in risk, and risk index.

Patient opportunity detail

A member level detailing of a patient's opportunity through the use of a drill path. This report contains the following information: Practice/Facility/Site name, Provider name, Patient name, Patient age, Opportunity type, Opportunities, Opportunity due date, Opportunity status, Star measure, etc.

Patient opportunity summary

After filtering on the standard combo boxes, a patient-by-patient listing of various opportunities are provided (total open opportunities, total number of open HCCs, open HCCs suspected, open HCCs missing, open care, actionable opportunities, open Star, and number of deviations) along with counts for each category. Patient birth date, gender, and age are provided along with their practice/facility/site name and provider name.

Patient panel

A patient listing with the following attributes: Attributed PCP name, age of patient, line of business code, total member cost (with and without outliers), etc.

Patient profile

A patient listing with the following attributes: Attributed PCP name, age of patient, line of business code, total member cost (with and without outliers), etc.

Pharmacy detail

A one line per claim ID summarization with information on medications and prescriptions.

Prescribing pattern

Various pharmacy data metrics. From an overall perspective, total units and costs for data versus the peer. Also, an NDC summarized list with multiple metrics including specialty drug indicator, generic name, drug type, total cost, total scripts, and generic available indicator.

Quality opportunity summary

A listing of quality measures with the following metrics: contract flag, number of Medicare Advantage Star opportunities, number of quality opportunities unmet per measure, number of quality opportunities met per measure (numerator), number of quality opportunities per measure (denominator), and capture rate.

Top 10 performing providers by cost bucket

Risk adjusted PMPM dollar amounts spread across the seven cost and use buckets (ED, hospital services, lab, pharmacy, primary care, radiology, and specialty care) with a top 10 provider listing by actual risk adjusted PMPM. Other metrics include: total cost, total visits, and percentage of total cost bucket. An eleventh category titled "other" encompasses the remaining providers.

Top 10 performing providers by specialty

Risk adjusted PMPM dollar amounts for the top 10 providers under specialty groupings. Other metrics include peer risk adjusted PMPM, index, total cost, total visit, percent of total cost bucket, and percent of total specialty bucket. An eleventh category titled "other" encompasses the remaining providers.

Get support

Help is always just a phone call or click away. Our dedicated Theon support team is here to answer your questions or provide the technical assistance you need. Email or call the Theon support hotline at 800.793.4559.


Theon® is a product of Geneia®. On Behalf of Capital BlueCross, Geneia provides health data informatics and analytical support and services. Geneia is an independent company. Healthcare benefit programs issued or administered by Capital BlueCross and/or its subsidiaries, Capital Advantage Insurance Company, Capital Advantage Assurance Company® and Keystone Health Plan® Central. Independent licensees of the BlueCross BlueShield Association. Communications issued by Capital BlueCross in its capacity as administrator of programs and provider relations for all companies.