Patrius Health offers the interactive Patient Health Snapshot (PHS) to help provide you with a complete picture of your Blue Advantage^® patients’ health. The PHS gives you easy access to important patient health information, including:

• Gaps in care
• Chronic conditions
• Diagnoses
• Recently received healthcare
• Drug information

Log in to myBlue Provider and click Blue Advantage Resources on the left-hand menu to sign on to the Patrius Health provider website. Once logged in, you will find the Patient Health Snapshot link under Provider Tools in the menu at the top of the Patrius Health provider website. Refer to the PHS each time your Blue Advantage patient comes into the office as gaps in care and diagnosis information often changes. In preparation for patient office visits, you can also print the PHS by clicking the blue “View/Print PHS” button in the upper-right corner of the application. 

PHS Quick Reference Guide

With the exception of the Conditions/Diagnoses sections, the PHS displays information for a 12-month rolling period, not a calendar year. The Conditions/Diagnoses section displays information for the full prior year and the current year-to-date data.

Filter Options

You can view patient data for an individual patient or all patients in a medical group. To view data for all patients, choose the “All Medical Group Patients” tab. You will then have an option to sort the list of patients by choosing the downward triangle to the right of each column. This enables you to filter the list by the number of gaps in care or potential conditions. You can also sort to view patients with a low, medium, high or very high risk of non-adherence with medications. 

You can easily select patients from the list and then view and print that list by clicking the blue View/Print PHS button on the right-hand side.

Care Gaps – Non-Compliant or Compliant/Controlled (Data Lag: Up to 7 Days)

• See recommended screenings for the patient according to nationally endorsed quality metrics and how often they should be performed.
• If the patient is non-compliant on any of these screenings, consider performing or ordering the service to ensure the patient has no gaps in care.
• See our Blue Advantage Quality Measures Coding Guide and Tips for Addressing Gaps in Patient Care for help in closing gaps in care.

Recent Care (Data Lag: Up to One Month)

This section will indicate whether the Blue Advantage patient has received an Annual Wellness Visit in the current year. Recent care includes: 

• Annual Wellness Visit for Blue Advantage Patients
• Coming Soon! ER Visits/Admissions/Readmissions

Conditions/Diagnoses (Data Lag: Up to One Month)

This section includes diagnoses that map to a CMS Hierarchical Condition Category (HCC) received for the patient in the current or prior calendar year.

In addition to showing the diagnosis codes and descriptions, the Conditions/Diagnoses section of the Blue Advantage PHS will display the corresponding HCC code and description for each diagnosis. A flag will indicate if we received the condition from multiple sources and a column will indicate the source of the condition (i.e., Claim, Supplemental Data, HR360 HRA, or AWV). 

Sources of Data for Patient Conditions/Diagnoses: Information in this section includes data obtained from multiple sources – claims, internal or vendor medical record reviews, and health risk assessments. In cases where a diagnosis was coded as a result of an internal or vendor chart review, the “Provider” column on the PHS will be populated with the provider name (when available) or labeled as “Supplemental Data.” In the case of an in-home health risk assessment, the provider name will be populated with “HRA.”

Coming Later in 2024: Disputing Chronic Conditions

Providers will be able to dispute a condition identified on the PHS for a Blue Advantage patient if they believe the diagnosis is not applicable to the patient. Details will be released when this option becomes available.

Drug Information (Data Lag: Up to 7 Days)

This section outlines medications the patient has been prescribed and whether they are compliant with those medications. Drug information includes:

• Non-Adherence Forecast – Pharmacy and claims data provides a non-adherence forecast value for these measures of either very high, high, medium or low to reflect a patient’s likelihood to be noncompliant at the end of the measurement year. For example, a value of very high would indicate that a patient is at very high risk for being non-compliant at the end of the year, while a value of low would indicate that the patient is at low risk.
• Refill Status* – The refill status for each medication is indicated as "Missed" (refill overdue), "Fill Soon" (refill due in next 30 days), or "Fill > 30 Days" (refill due more than 30 days from the current date). 
• Medication Therapy Management Program Eligibility - This indicates if a Blue Advantage patient is eligible for the Patrius Health Medication Therapy Management Program. For more information on this program, see the Medication Therapy Management Program webpage.

*Note: Information for patients who take statins will vary from data for other medications. The refill status will be blank if the patient has already filled one required prescription for the measurement year, or "Missed" if the patient has not yet filled a statin prescription in the measurement year.

Coming Soon: Health and Clinical Engagement Programs (Data Lag: Up to 7 Days)

The Health and Clinical Engagement Programs section will display information when your patients qualify for our health and clinical engagement programs: Chronic Condition Management and Serious Illness Care Program.

You will be able to see the programs available for your patients along with their qualifying diagnosis. The "Enrolled” status lets you know your patient is participating in the program. If your patient is enrolled in a program but not participating, a “Non-Compliant" status will be displayed.

You will be able to click the “Eligible” link for additional information that explains the available program and how to enroll.