Executive Overview
Executive Overview
TCM to PCM bridge pilot performance, revenue capture, outcomes, containment, and data completeness.
Patient Journey Funnel
Eligible → Reached → TCM → PCM → Billed
Weekly Pilot Trend
Eligible episodes, TCM completed, PCM enrolled
Revenue Realization
Expected vs paid by month
Network Containment
USC capture vs external leakage
110 · 60%
72 · 40%
Outcomes
ED · readmits · complications
ED rate
5.3%
Satisfaction
4.35/5
Top Operational Risks
Open exceptions by severity & age
| Severity | Stage | Owner | Due |
|---|---|---|---|
| High TCM Overdue | Outreach | Felix Stone | 47d overdue |
| High Referral Documents Missing | Referral Closed | Felix Stone | 47d overdue |
| High Referral Leakage Risk | PCM Active | Liam Chen | 25d overdue |
| High Referral Documents Missing | Referral Closed | Jamal Carter | 19d overdue |
| High Referral Leakage Risk | PCM Active | Elena Rivera | 8d overdue |
| High Billing Defect | PCM Active | Carmen Ortiz | 3d overdue |
| High TCM Not Scheduled | Outreach | Sofia Diaz | 7d |
Recent Patient Journey Activity
Latest discharged episodes with stage, NBA, and billing
| Patient | Episode | Stage | Next Action | Risk | Billing |
|---|---|---|---|---|---|
| Vincent RomeroUSC-900042 | EPI-2026-0042 DC Mar 26, 2026 | PCM Enrolled | Log additional PCM time this month | Low | Paid |
| Jonas KetteringUSC-900109 | EPI-2026-0108 DC Mar 26, 2026 | Referral Closed | Schedule TCM encounter | Medium | Paid |
| Patricia EvansUSC-900005 | EPI-2026-0005 DC Mar 25, 2026 | Outreach | Resolve exception: TCM Not Scheduled | Medium | Draft |
| Xavier ThompsonUSC-900044 | EPI-2026-0044 DC Mar 25, 2026 | Outreach | — | High | Draft |
| Octavia PembertonUSC-900114 | EPI-2026-0089 DC Mar 24, 2026 | Pre-Visit Ready | Schedule TCM encounter | High | Draft |
| Peggy LopezUSC-900037 | EPI-2026-0037 DC Mar 23, 2026 | Outreach | Resolve eligibility for PCM | Medium | Draft |
| Greta HollowayUSC-900106 | EPI-2026-0081 DC Mar 22, 2026 | Referral Outreach | Resolve exception: Referral Documents Missing | Medium | Draft |
| Valentin WassermanUSC-900121 | EPI-2026-0096 DC Mar 21, 2026 | Pre-Visit Ready | Schedule TCM encounter | Medium | Paid |
EPIC Workflow Operations
EPIC Workflow Operations
Workflow mix, intake triggers, program assignment, order sets, AI activation, pathways, and task health — synthetic.
EPIC Workflow Mix
Episodes by EPIC workflow
64 · 56%
20 · 18%
20 · 18%
10 · 9%
Intake Trigger Volume
Top trigger types
Program Assignment Mix
Recommended programs
Order Set Activations
By activation status
EKG / RPM
28 · 31
DME / IPC
23 · 17
AI Activation Score
Distribution across cohort
Care Pathway Distribution
Order set activations by pathway
Referral Center On-Ramp
Referral Center On-Ramp
Inbound specialty referrals, pre-visit readiness, PCM pre-visit conversion, downstream USC capture, and leakage — synthetic.
Active Episodes by On-Ramp
Generalist · Specialist · Office · Referral Center
Revenue / Expected Value by On-Ramp
Paid (billed) + projected USC value
Exceptions by On-Ramp
Open exceptions
Referral Readiness by Specialty
% visit-ready · avg readiness score
Downstream USC Capture by Specialty
Captured value vs leaked value
Leadership Watchlist · Referral Center
Highest-priority referrals: urgency, missing workups, readiness, PCM, and next best action
| Patient | Specialty | Urgency | Referral Status | Readiness | Missing Workups | PCM | Next Best Action |
|---|---|---|---|---|---|---|---|
| Pascal QuinteroEPI-2026-0090 | Urology | Emergent | Outreach Started | In Progress | 1 of 4 | N/A | Confirm reach + offer PCM |
| Desmond EberhardtEPI-2026-0078 | Oncology | Emergent | Completed | At Risk | Complete | Eligible | Close loop with referring provider |
| Greta HollowayEPI-2026-0105 | Nephrology | Emergent | Closed | In Progress | Complete | Eligible | Close loop with referring provider |
| Camille DoolittleEPI-2026-0101 | Pulmonology | Emergent | Scheduled | Ready | Complete | Enrolled | Confirm appointment + send reminders |
| Jonas KetteringEPI-2026-0060 | Urology | Urgent | Blocked | Blocked | 2 of 4 | Eligible | Resolve documents/intake blocker before outreach |
| Xiomara YanceyEPI-2026-0074 | Urology | Urgent | Blocked | Blocked | 2 of 3 | Eligible | Resolve documents/intake blocker before outreach |
| Reinaldo StavrosEPI-2026-0092 | Oncology | Urgent | Outreach Started | At Risk | 2 of 2 | N/A | Confirm reach + offer PCM |
| Lorenzo MendizabalEPI-2026-0110 | Urology | Urgent | Outreach Started | In Progress | 2 of 4 | N/A | Confirm reach + offer PCM |
| Hideki ImamuraEPI-2026-0058 | Urology | Urgent | Blocked | Blocked | 1 of 4 | Enrolled | Resolve documents/intake blocker before outreach |
| Adrian BeasleyEPI-2026-0075 | Cardiology | Urgent | Intake Started | At Risk | 1 of 3 | Eligible | Close loop with referring provider |
| Desmond EberhardtEPI-2026-0054 | Nephrology | Urgent | Closed | In Progress | 1 of 3 | Eligible | Close loop with referring provider |
| Estela FramptonEPI-2026-0055 | Pulmonology | Urgent | Intake Started | In Progress | 1 of 4 | Eligible | Close loop with referring provider |