P1Model performance

Circle of Care Model Performance

Are we engaging the right members and keeping them connected to care?

Reporting period

Last 30 days

Part 1 · Now

Current COC Population

Who is in the model right now, and where do they stand?

COC panel

11,017

+182 this month

Critical risk

1,204

11% of panel

High risk

3,480

32% of panel

Care pathway

7,940

72% eligible

TOC pathway

258

2% eligible

Care Journey Waterfall — All Regions

Current period · Blue line = target
100%
11,017
COC Panel
67%
7,420
Engagement Due
79%
5,860
Reached
79%
4,610
Visit Scheduled
85%
3,940
Visit Completed

Care Pathway Calculation

All Regions
Journey stage% of prior% of firstMembersTarget
COC Panel100%11,017
Engagement Due67%67%7,420
Reached79%53%5,86082%
Visit Scheduled79%42%4,61080%
Visit Completed85%36%3,94085%
On Cadence79%28%3,12082%

Region by Region Comparison

Conversion rates by stage · % first, members in parentheses
RegionPanelEngagement DueReachedVisit ScheduledVisit CompletedOn Cadence
Northeast3,62069%(2,480)83%(2,050)81%(1,660)87%(1,450)82%(1,190)
Southeast2,98067%(2,010)74%(1,490)75%(1,120)83%(930)75%(700)
Midwest2,41068%(1,630)80%(1,310)79%(1,040)87%(900)82%(740)
West2,00765%(1,300)78%(1,010)78%(790)84%(660)74%(490)

Cohort Health & Tenure

Current panel composition

182

New

41

Re-entered

Exited

96

74%

71 members

Attrition

26%

25 members

Deceased

1,440
13%
< 30 days
3,210
29%
1–3 months
2,880
26%
4–6 months
3,487
32%
7+ months

TOC Reconnection

Transition of care pathway
Eligible258
Reached71%(183)
Follow-up62%(160)

Engagement Status Summary

2,318 members flagged · counts only — details on P2

Overdue

11%

1,180 members

past cadence window

Not reached

21%

1,560 members

of engagement due

No-show / cancel

15%

670 members

of scheduled visits

On cadence

79%

3,120 members

of completed visits

Part 2 · Historical

Historical Model Performance

Are we moving members through the model better, and what changes after joining COC?

Historical Journey Waterfall

Trailing 12 months
100%
41,800
Total Due
79%
32,900
Reached
78%
25,700
Visit Scheduled
83%
21,400
Visit Completed
79%
16,900
On Cadence

Where the Model Breaks

vs prior 12 months
Break pointMembersRateTrend
Not reached8,90021% of due−3 pts
No visit scheduled7,20022% of reached−5 pts
No-show / cancel4,30017% of scheduledflat
Dropped off cadence4,50021% of completed+1 pt
Journey stage% of prior% of firstMembersTarget
Engagement Due100%41,800
Reached79%79%32,90082%
Visit Scheduled78%61%25,70080%
Visit Completed83%51%21,40085%
On Cadence79%40%16,90082%

Before & After Impanelment

Tenure-aligned · 3,540 members · through M+6

Every member is aligned to their own COC start month (M0), so a continuously refreshing panel can still be compared on one curve. Select the join months you want to include.

Joined COC

Engagement by tenure

% of cohort in month
Reached Scheduled Visited

Utilization by tenure

per 1,000 members
Admissions / 1K-25% ED / 1K-29%

Lines stop where a cohort has no elapsed tenure yet — newer join months contribute only to the months they have actually lived through.