SFHSS unveils measurement plan and APCD dashboard showing rising utilization and mental‑health visits
December 08, 2022 | San Francisco City, San Francisco County, California
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The San Francisco Health Service System presented a measurement plan to standardize patient‑level data from health plans and an "Express" APCD dashboard summarizing Q3 2022 utilization and quality trends.
Michael Visconti said SFHSS is working to align measures across vendors, set baselines and incorporate population‑health metrics into performance guarantees and the 2023–25 strategic plan. "We are standardizing and enhancing the collection of patient data across all of our plans," he told the board.
Ryn Coleridge, director of enterprise systems and analytics, presented the Q3 2022 Express APCD dashboard (claims incurred through June 2022, paid through Sept. 2022). The dashboard showed increases in utilization and preventive visits: admits per thousand rose, outpatient services per thousand increased, and adult preventive visits rose double digits from the prior period. Coleridge also flagged an increase in chronic‑condition prevalence (diabetes, asthma, low‑back pain) and a notable rise in mental‑health episodes and visit counts: the top mental‑health episodes showed higher patient counts and visit volumes compared with the prior period.
Coleridge emphasized that the APCD data complements health plan reports and serves both as a validation tool and a way to drill into disparities by race, age bands and other subgroups. He cautioned that the Express dashboard did not yet include Health Net Canopy Care data and that Medicare financial data are not present in the APCD feed, which can affect interpretation when plan responsibility changed during the period shown.
Board members asked about diagnostic coding, upcoding concerns and the dashboard’s use of primary diagnosis for episode counts. Coleridge said the Express report focuses on primary diagnosis for episodes but that SFHSS maintains ad hoc tools to analyze full diagnosis lists and detect anomalies.
Staff said they will use the APCD and plan data to set targets and tie them to performance guarantees and quality improvement activities during upcoming contract renewals.
Michael Visconti said SFHSS is working to align measures across vendors, set baselines and incorporate population‑health metrics into performance guarantees and the 2023–25 strategic plan. "We are standardizing and enhancing the collection of patient data across all of our plans," he told the board.
Ryn Coleridge, director of enterprise systems and analytics, presented the Q3 2022 Express APCD dashboard (claims incurred through June 2022, paid through Sept. 2022). The dashboard showed increases in utilization and preventive visits: admits per thousand rose, outpatient services per thousand increased, and adult preventive visits rose double digits from the prior period. Coleridge also flagged an increase in chronic‑condition prevalence (diabetes, asthma, low‑back pain) and a notable rise in mental‑health episodes and visit counts: the top mental‑health episodes showed higher patient counts and visit volumes compared with the prior period.
Coleridge emphasized that the APCD data complements health plan reports and serves both as a validation tool and a way to drill into disparities by race, age bands and other subgroups. He cautioned that the Express dashboard did not yet include Health Net Canopy Care data and that Medicare financial data are not present in the APCD feed, which can affect interpretation when plan responsibility changed during the period shown.
Board members asked about diagnostic coding, upcoding concerns and the dashboard’s use of primary diagnosis for episode counts. Coleridge said the Express report focuses on primary diagnosis for episodes but that SFHSS maintains ad hoc tools to analyze full diagnosis lists and detect anomalies.
Staff said they will use the APCD and plan data to set targets and tie them to performance guarantees and quality improvement activities during upcoming contract renewals.
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