We are excited to announce that Payer Mix data has been enhanced and reintroduced to the PlayMaker Spark application. We're also proud to say that we are the first market data provider in the industry to offer Medicare Advantage data to our clients.
Our Payer Mix data is now based on procedure claims, unlike the previous version of Payer Mix which was based on retail prescriptions. Using procedure claims as the basis, the data is more indicative of a physician’s true patient population as it utilizes claims from the patient’s visit with the physician.
The following columns provide decile and count rankings in various categories for physicians.
What is Payer Mix?
Payer Mix is the percentage of claims data for a physician broken down by payer (insurance) type, provides further clarity and insight into what type of payers a provider interacts with.
What does this look like within TargetWatch?
Payer Mix columns have been added to all applicable target tabs, and are located between the "All Codes" and the "Total Patient Volume" within the tab.
Is [insurance plan] included in Payer Mix?
- Medicare includes traditional Medicare Part A and B plans
- Medicaid includes Medicaid plans
- Commercial includes all other commercial plans, including Medicare Advantage, other commercial Medicare, Workers Compensation and VA plans.
What is "All Codes Practitioner National Rank?" Is this new?
All Codes Practitioner National Rank was reintroduced to our enhanced data set along with Payer Mix.
This is a combined, national decile ranking of all diagnosis code groups for the specified practitioner. On the HHA and HOS Practitioner tabs, the Total Patient Volume ranking usually defaults to County, only changing to State or National if County data is unavailable.
Utilizing this national decile in conjunction with the diagnosis code group deciles provides richer context into practitioner trends.
Note: The Market Intelligence Data used in this program is derived largely from Medicare and is dependent on Medicare’s reporting. To determine the reporting period for the year selected, please refer to the TargetWatch Data: Reporting Periods article. Please contact your Client Success Manager with any questions or to demo any of the above data.