Risk Assessment based on Medicare Utilization

Data released to the public by the Centers for Medicare and Medicaid Services detail the procedures performed by each physician as well as the amounts they were paid.

Because critical information, such as payer mix, diagnoses codes, patient acuity, etc., were not provided by CMS, using the raw values, such as total services or payments, are basically useless. Our tool has been designed to provide physicians with a real-world perspective on their Medicare billing activity. In order to both understand and benchmark your data, it first needs to be reduced to ratios, which is what we have done here. So, rather than try to compare total payments with that of your peers, it is much more valuable to look at total payments as a ratio of unique beneficiaries — a metric that is agnostic to payer mix and other important data points.

Have more than 50 providers? Send a list of your NPIs to support@complianceriskanalyzer.com