Demand/Capacity Tool Dashboard

The Demand/Capacity Tool Dashboard provides information on TriWest's network adequacy, based on operational performance and other network metrics.

Filtering

• Visualizations can be filtered by using the selections along the top of the dashboard. The VAMC filter will be automatically set to the VAMC associated with your VA Portal account and cannot be changed.
• The "Authorizations Created Within" filter allows for a selection of dates from today's date back the specified amount of time. Clicking on the filter will display a window where you can select the number of months.
• Surge Capacity
  • New Initial Appointments – This parameter allows you to enter the number of surge appointments you expect your VAMC to send to TriWest. Based on that number, TriWest draws from the Demand/Capacity model to estimate current provider capacity and to project the number of weeks required for the network to complete the surge of appointments.
  • Surplus capacity and weeks to complete the surge work are based on the number of providers in the network, but do not take into account individual provider availability and time needed for outreach and appointing. Therefore, this is not a guarantee that TriWest will be able to schedule and complete all appointments within the given time period.
  • This dashboard is for your reference and any information you enter here will not be sent to TriWest. If you determine that there will be a surge in appointment volume, please fill out a Surge Notification Form.

Definitions

• Last Whole Month – Displays the "Last Whole Month" available in the dataset. Partial months cannot be shown as the data for that month would be incomplete.
• Data Refreshed – When the data was last refreshed in Tableau
• VAMC – This represents the catchment area around the physical location of a VA Medical Center for which VA has indicated the VAMC is responsible for.
• Specialty Rollup – This is a unique rollup that only includes provider specialties that were included in the Demand/Capacity model. This does not include every specialty. Instead, it is a set of high volume specialties that make up an estimated 90% of historical authorization volume. These specialties are not the same as the Category of Care assigned to authorizations. Categories of Care have been matched or rolled up to provider specialties for purposes of reporting operational metrics in this dashboard, but metrics in this dashboard should not be directly compared to metrics in other dashboards which have been summarized at the Category of Care level, as they are not the same. Metrics in this dashboard are not meant to be used for contractual purposes.
• Utilized – A provider has at least one authorization associated with them within the selected time frame.
• Unutilized – A provider does not have any authorizations associated with them within the selected time frame. Unutilized providers should be evaluated for potential future utilization prior to reporting network shortfalls.

Metrics

• Appointing Standard
  • Routine appointments must be scheduled within 30 days.
  • At least 90% success meets the contract standard.
• Commute Standard
  • The drive time between a Veteran's residence and their appointed provider must not exceed specific limits (based on type of care and Veteran's rurality) subject to Veteran preference.
  • At least 90% success meets the standard.
• Network Returns
  • The percent of authorizations received that were returned for network-related reasons within TriWest's control. This does not include all returns, only those related to network adequacy. For example, an authorization returned due to no network provider available would be considered network-related.

Measures

• Authorizations – The total number of authorizations received for the selected time period and filters. Any appointments received that did not become authorizations are not counted here, as there would have been no opportunity to evaluate network performance for those appointments.
• Network Returns – Authorizations that were returned with a network-related return reason within TriWest's control. This does not include all returns, only those related to network adequacy. For example, an authorization returned due to no network provider available would be considered network-related.
• Network Return % – The number of "Network Returns" divided by "Authorizations".

General Information

• Network Adequacy – Metrics
  • Network Adequacy- Metrics display the total number of Authorizations, Network Returns, and Network Return % by Specialty. This also provides a breakdown of the Commute and Appointing standards by specialty, and a trend line for how each metric has changed over the time period specified.
• Network Adequacy – Utilization
  • Network Adequacy- Utilization displays a comparison of Utilized to Unutilized providers, and displays the percentage that is utilized.
  • The maps provide details on where the Utilized and Unutilized providers are located within the VAMC catchment area, and also how each VAMC is performing compared to the Commute Standard for Veterans in each county.
• Demand/Capacity
  • Demand/Capacity provides the output of the Demand/Capacity model at the county level based on weekly demand and capacity data.
• Surge Capacity
  • Surge Capacity displays the weekly surplus of available appointments for the selected specialty based on the size of the network. You can select one, several, or all counties within the VAMC catchment, depending on where the surge is originating from. The dashboard will display an estimated time to appoint the surge based on the number entered by the user.
  • Surplus capacity and weeks to complete are based on the number of providers in the network, but do not take into account individual provider availability and time needed for outreach and appointing. Therefore, this is not a guarantee that TriWest will be able to schedule and complete all appointments within the given time period.
  • The map displays the surplus appointment availability for each county (darker green indicates greater surplus), and also where each provider is located within the VAMC catchment.
• Provider List
  • This provides a list of network providers based on the filters selected by the user. Providers are displayed once per specialty, group, and location they practice in, so this is not a distinct list of providers.