VMC is committed to providing our Network with the most comprehensive statistical information available.  Our Analytics & Reporting Team gathers medical and pharmacy claims data from each of our contracted payers, combines that with member and provider information, and uses a variety of programming and analytical methods to produce high quality and meaningful reports from a myriad of perspectives.

• PCP Detail Reporting
• Requesting Data Reports
• Questions or Comments
• Schedule of Report Mailing Dates

PROVIDER DETAIL REPORTING
VMC is proud to present to our Network Primary Care Physicians (PCP) and High-Volume Specialty groups comprehensive cost and utilization reporting. These reports are developed internally without the need for external consultant so we can give our network providers high quality product as well as any drill-down supporting information of interest to our providers.  Utilizing Symmetry ETG®, ERG® and EBM Connect®, which are industry-standard claims analysis software products, VMC has the ability to calculate patient risk, calculate Evidence-Based Guideline compliance for over 50 clinical conditions, and make meaningful severity and case-mix adjusted comparisons of cost and utilization measures of provider to their peers.

We are very pleased to provide our providers with a unique reports that pools data from the three VMC contracts; MVP, TVHP and the Fletcher Allen Preferred Medical Plans, enlarging the denominator and making the information more statistically significant.

These reports captures data for a rolling 12-month period  with a three month run-out. They are delivered to Network PCP and selected Specialty providers with at least 30 unique episodes of care who have been part of the VMC Network for at least four consecutive months.  VMC provides reports to our PCPs every six months and to specialty groups every 12 months. Schedule of Report Mailing Dates

Samples of  all our reports along with definitions can be found via the links below.

PCP Detail Reports

        Family Medicine Detail Report
          Family Medicine Report Definitions

        Internal Medicine Detail Report 
          Internal Medicine Report Definitions
          
        Pediatric Medicine Detail Report
          Pediatric Medicine Report Definitions

Group Speciality Detail Reports

      Cardiology Detail Report
        Cardiology Report Definitions

      OBGYN Detail Report
        OBGYN Report Definitions

      Orthopaedic Detail Report
        Orthopaedic Report Definitions

      PT Detail Report
        PT Report Definitions

 REQUESTING DATA REPORTS
VMC strives to share the most up to date and relevant information possible with all network participants.  As a step towards fulfilling that vision, the VMC Board of Directors, with recommendations from VMC Senior Leadership, has recently approved the VMC Data Release Policy.

What this means to you is you can request ad-hoc data reports from VMC as they relate to the contracts you hold through VMC.  VMC will review your request and if it is within the parameters of the Data Release Policy, your report request will be approved.  You will be notified of receipt of your request, whether your request was approved, and the time needed to generate your report.

As additional report requests are approved, we will add them to the list of "Available Reports" below.  If you are interested in requesting one of these reports or would like to request a new report, go to the "ASK VMC" link found in the "red swirl" in the top left corner of this and every page of the VMC Web Site.

We are very excited to be able to provide you with this resource to help you with the management decisions you face in your practices and hospitals.

Approved Reports:

• Withhold Claims Detail:  Withhold report at claim level.
  Added 10/26/07
  
  
• Provider Performance Report Detail:  Drill-down of metrics reported on provider reports. 
  
  
• Home Health & Hospice Services:  Services, cost & utilization FAP and VMC-TVHP members received, by VNA location, for a 12 month period.
  
  
• Facility Cost and Utilization Breakdown:  Cost and utilization breakdown report by type of service as compared to other VMC facilities in total.
  
  
• PCP Practice Pattern Comparison Data: comparison data based on cost measures by provider age (over 40 vs. under 40), provider county (outside Chittenden County vs. inside Chittenden County), and solo vs. group practices.
  
  
• Facility Physical Therapy Utilization Reporting:  A) monthly reports detailing number of PT visits and total costs, sorted by referring provider, as compared in total to visits to other in-network facilities or providers, sorted by referring provider, zip code of referring provider, and patient's diagnosis grouping.  B) report calculating the percent of PT services performed by facility as compared to other in-network facilities or providers in total by member county of residence.
  
  
• Referral Pattern Summary: report summarizing referral patterns into and out of network practice.
  
  
• PHO Hospital, PCP and Specialty Claims Summary: Network PHO's Gross Revenue broken down by Hospital, Primary Care, and Specialty claims for MVP, TVHP and FAP lines of business.

QUESTIONS OR COMMENTS
Your questions and comments are important to us because we want to provide you with information that is useful and applicable in your day-to-day practice management.  Feel free to contact your Provider Relations Team at 802-847-8161 or 800-639-3881, or via the "Ask VMC" link above.